국내 3차 병원에 내원한 다낭성 난소 증후군 환자의 약물치료요법 관리 및 추적 관찰분석

Abstract

PCOS is disease caused by excessive androgen secretion activity in the ovary due to hypothalamic-pituitary-ovarian hormone abnormalities. It occurs in 6~8% of women of childbearing age, and PCOS patients It is a gradually increasing trend. In this study, based on domestic and foreign PCOS treatment guidelines, we retrospectively investigate the treatment status of patients who visited a domestic tertiary hospital to analyze/evaluate the use patterns and safety of drugs. For patients diagnosed with PCOS between July 2014 and September 2022, patients younger than 13 years and patients not receiving medication were excluded. Patients aged 21 years or younger were divided into a youth group and patients aged 22 years or older were divided into an adult group and divided into two groups for statistical comparative analysis. The total number of patients was 212, including 105 adolescents (49.5%) and 107 adults (50.5%). Comorbidities were ovarian cyst 20 (9.4%), endometriosis 19 (9%), diabetes 14 (6.6%), thyroid dysfunction 12 (5.7%), hypertension/dyslipidemia 10 each (4.7%), followed by androgenic alopecia in 6 patients (2.8%). A total of 98 patients (46.2%) showed polycystic ovarian findings on ultrasonography, and the clinical symptoms were oligomenorrhea in 91 (42.9%), amenorrhea in 72 (34%), hirsutism in 36 (17%), and acne 24 (11.3%), followed by 10 (4.7%) infertility. During the study period, 114 patients (53.8%) were prescribed MPA, 66 patients (31.1%) were oral contraceptives, and 17 patients (8%) were concurrently prescribed MPA and oral contraceptives. Regarding PCOS, 45 patients (21.2%) changed prescriptions, 10 patients (22.2%) were changed due to side effects, and 8 patients (17.8%) were changed due to lack of effect. A total of 5 patients (2.4%) discontinued the drug only in adults. Fifty patients (23.6%) who visited the hospital during the study period and received a drug prescription and did not return to the hospital were not followed up. Adverse drug reactions occurred in 15 patients (7.1%), 5 adolescents (4.8%) and 10 adults (9.3%). Abnormal bleeding, depression, nausea, weight gain, and breast tenderness were reported. Nausea was the most common in 8 patients (3.8%), followed by breast tenderness in 6 patients (2.8%). In conclusion, this study was able to learn about the need for treatment of PCOS, which is considered a chronic disease, and the need for long-term drug management. The understanding of physiological changes related to reproduction in adolescents after menarche and the accurate diagnosis of PCOS and the appropriate drug use accordingly reduce complications of later infertility and ultimately reduce the prevalence of PCOS and accompanying metabolic diseases in adults is considered essential.