Polycystic Ovary SyndromePCOS · 多囊卵巢综合征

Place · Level 3

全球育龄女性 8-13% · 胰岛素抵抗驱动 + 雄激素 + 月经紊乱 · 肌醇 + 地中海 + 减腰围 · 不是卵巢病

Rotterdam · 2 of 3

Stop 1/5

Rotterdam 标准 · 三选二

PCOS (polycystic ovary syndrome) is the most common endocrine-metabolic syndrome in reproductive-age women globally, prevalence 8–13% (Teede 2023 international guideline):

Rotterdam criteria (2003, international consensus): 2 out of 3 plus exclusion of other causes (Cushing / CAH / hyperprolactinemia / thyroid / ovarian tumor):

① Ovulatory dysfunction / oligomenorrhea
Cycle > 35 days or < 21 days< 8 menses per yearNon-ovulatory 'periods' are actually anovulatory withdrawal bleeding
② Hyperandrogenism
Clinical: acne / hirsutism (upper lip / jaw / chest / abdomen) / male-pattern hair lossBiochemical: total / free testosterone ↑ or DHEA-S ↑
③ Polycystic morphology (PCO ultrasound)
Single ovary with ≥ 12 follicles 2–9 mm or ovarian volume ≥ 10 mLNew guideline (Teede 2023): don't use PCO morphology in adolescents (physiological multi-follicular pattern persists until 7–8 years post-menarche)
PCOS isn't an 'ovary disease' — it's a systemic metabolic-endocrine syndrome:

The core driver is insulin resistance (IR) + hyperinsulinemia + androgens + LH/FSH imbalance.70–80% of PCOS patients have measurable insulin resistance, and lean PCOS often has it too.The ovaries are simply the most visible downstream presentation; the real 'root' is in metabolism.
That's why oral contraceptives alone can't 'solve' PCOS: they control symptoms (regular periods, improved hirsutism) but don't touch the metabolic root — symptoms typically return after stopping, and long-term cardiovascular, T2D, and endometrial cancer risk persist.

Typical features (not every PCOS has all):
Irregular or sparse mensesAcne + hirsutismDifficult weight loss / visceral fatTrouble conceivingAcanthosis nigricans (dark, thickened skin on the neck / axilla)Thinning hairMood / anxiety
PCOS is the most representative clinical scenario for integrating nutrition knowledge with lifestyle, involving inositol, Mediterranean diet, protein, strength training, vitamin D, omega-3, magnesium, and sleep. 'A single supplement solves PCOS' is one of the marketing claims this island most wants to dismantle.

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