Ovarian cyst: Causes, symptoms and treatment
A female ovarian cyst is a fluid-filled protrusion that forms on the surface of one or both ovaries of a woman in most cases from the follicle. Anatomically, the cyst looks like a thin-walled cavity in the form of a sac. The size of this formation varies from several to 15-20 millimeters in diameter.
In 90% of cases, the cyst is functional, or follicular. The reason for its appearance is the “overriding” of the follicle – a special education in which the female sex cell develops. The fact is that each menstrual cycle, one of two ovaries normally produces one egg, which, when ripe, must leave the follicle into the fallopian tube, and the torn follicle becomes a yellow body that produces the hormone progesterone. This is the essence of ovulation.
The cyst is formed if the follicle is not broken, but is filled with fluid and remains in the ovary. Sometimes its dimensions begin to create inconvenience, blocking the exit to the fallopian tube and causing discomfort. But most often the follicular cyst resolves already during the next menstruation, without leaving any visible traces.
A functional cyst can also be triggered by the expansion of the corpus luteum. It has the same principles of education and is called the corpus luteum cyst.
Another type of functional cyst is a hemorrhagic cyst when blood vessels are broken inside the follicle or corpus luteum and hemorrhage occurs, accompanied by pain.
There is also a dysontogenetic cyst, resulting from impaired growth and development of the ovaries during puberty, as well as a cyst- tumor, which gives rise to ovarian cancer.
Signs and symptoms of ovarian cyst in women
Usually, an ovarian cyst does not make itself felt and decreases to complete disappearance in a few monthly cycles. You can detect it using ultrasound of the pelvic organs. Occasionally, the appearance of a cyst is marked by one or more of the following symptoms:
- lower abdominal pain, sometimes very strong and sharp
- heaviness, the pressure in the pelvic region
- prolonged pain during menstruation
- irregular monthly cycle
- nausea, gagging after intense exercise or intercourse
- the pressure during emptying of the bladder or rectum
- pain in the vagina, accompanied by bleeding.
At the same time, there are signs that, accompanied with the above symptoms, indicate that it is time to consult a doctor:
- temperature over 38 degrees
- weakness and dizziness
- copious discharge during menstruation
- an increase in the abdomen
- male facial hair growth
- great thirst with copious urination
- abnormal blood pressure
- uncontrolled weight loss
- probable seal in the abdominal cavity
Ovarian cyst examinations and analyzes
For the diagnosis of this pathology is used:
1. CT (computed tomography) and MRI (magnetic resonance imaging).
2. Transvaginal ultrasound examination.
3. Laparoscopy, with associated cyst removal, when detected.
4. Analysis of hormones: LH and FSH, estrogen and testosterone.
5. Puncture of Douglas pocket (posterior vaginal fornix) for suspected internal bleeding due to rupture of a cyst.
6. Analysis of the tumor marker CA-125 to exclude ovarian cancer.
7. Pregnancy tests are also mandatory, not only because the treatment of pregnant and non-pregnant women is different, but also to exclude an ectopic pregnancy, the symptoms of which are similar to those of an ovarian cyst.
Causes of ovarian cysts in women
Unfortunately, the physiological mechanisms of the appearance of ovarian cysts are not yet fully understood. Most physicians are inclined to believe that pathology occurs when hormonal disruptions, inflammatory processes, and apoptosis (programmed cell death).
According to statistics, the formation of ovarian cysts occurs in 7% of mature women, including after menopause. The appearance of this pathology is associated with the menstrual cycle and does not depend on the age and health of the woman, so it is logical that after menopause an ovarian cyst is a very rare phenomenon. However, the effect of a cyst on a woman’s body is different in nature and depends on many factors. For example, cysts that appear due to the use of drugs that stimulate the work of the ovaries, despite a large number, pass through several menstrual cycles without consequences.
In the case when the cyst is supported by risk factors: stress, sexually transmitted infections, artificial interruption of pregnancy, obesity, smoking, early menarche, late onset of menopause, such consequences as tumor processes, reduction of reproductive function up to infertility, miscarriage are possible.
Therefore, we can conclude that the risk of a cyst rises due to:
- irregular menstrual cycles
- the appearance of early menstruation (aged 11 years)
- hormonal disorders (for example, hypothyroidism)
- the appearance of cysts in the past
- treatment of breast cancer with tamoxifen
- operations on organs of the reproductive system
Can I get pregnant with an ovarian cyst?
In general, the childbearing function is not impaired due to the appearance of a functional ovarian cyst. Moreover, pregnancy contributes to the rapid disappearance of the pathology. Actually, during pregnancy, a cyst appears extremely rarely, since at this time follicles usually do not form.
If the cyst is in the ovary, and you want to get pregnant, you need to take into account many factors. In general, as mentioned above, the ovarian cyst is most often the result of stopping the process of ovulation. A follicle that has become a cyst does not “release” the egg into the fallopian tubes, obstructing the ovary and preventing other new follicles from developing normally. Therefore, if unsuccessful attempts at conception are detected, examination for the presence of cysts can determine their cause. Normally, such a cyst regresses in two to three menstrual cycles, and pregnancy becomes feasible.
However, you must be constantly monitored by a doctor. If a woman in reproductive age shows up:
- a cyst larger than 8 centimeters in diameter
- no signs of cyst regression
- increased content of tumor marker CA-125,
- – then laparoscopy is assigned, the cyst is removed and sent for histological analysis.
Before laparoscopy, gastroscopy, abdominal ultrasound, and colonoscopy to differentiate an ovarian cyst from other pathologies of the gastrointestinal tract and other organs of the abdominal cavity are performed.
But back to the normal situation, when pregnancy occurs against the background of an ovarian cyst (note that the corpus luteum cyst during pregnancy is the physiological norm, so all the above does not apply to this species). Monitoring patients in such a state (usually, this happens without planning a pregnancy and a preliminary examination) shows that approximately 4% required urgent surgery. The problem is twisting the leg of the cyst and the rupture of an ovarian cyst due to the pressure and growth of the fetus. To avoid such cases, it is imperative to undergo examination by a gynecologist before becoming pregnant.
Cyst of the left and right ovary in women
In addition to the reasons described in the section “causes of ovarian cysts,” a cyst of the left ovary is often a consequence of colitis (inflammatory processes in the sigmoid and descending parts of the small intestine). Since the ovaries and the intestines are located close to the abdominal cavity, there is a histological connection between them, and various pathologies spread to both sides. This must be taken into account in the differential diagnosis of ovarian cysts.
In the right ovary, cyst appears for the same reasons as in the left. In the case of the right ovary, in addition to the reasons already described, a cyst appears after appendectomy for the same reason for surgical intervention in the area of its location.
Ovarian cyst rupture
Symptoms of ovarian cyst rupture, as described above, adversely affect the well-being of women and provoke a loss of efficiency. These include:
- fever, which is not “lost” ordinary febrifugal
- acute abdominal pain
- nausea causing vomiting
- bleeding with mucous discharge from the uterus
- headaches, dizziness, loss of consciousness
- anemia (pale skin)
- pressure drop.
Such symptoms in themselves, even without knowledge of an ovarian cyst, cause anxiety and should cause a trip to the doctor, if not an ambulance call.
The consequences of ovarian cyst rupture after and during the onset of symptoms are not long in coming. The fluid that is inside the cyst and must be removed by the filtering system in the process of regression of the pathology enters the abdominal cavity. In addition to discomfort and pain, there is a real risk of inflammation (peritonitis), which can threaten the health and life of a woman. That is why it is necessary to consult a doctor at the first symptoms of an ovarian cyst rupture.
In order to prevent rupture of a cyst, be regularly examined by a gynecologist, and if you have a cyst, take medical advice. The specialist will tell you when the cyst is not dangerous and should wait until the regression begins, or else prescribe a laparoscopy to preserve the health of the woman. Modern methods of cyst removal are quite effective and simple, so as not to be afraid of this operation.
Those women who have refused regular examinations sometimes get on the surgical table at a critical moment when the cyst progresses to the extent that the ovary has to be removed. Health care depends entirely on the person himself, so a visit to a gynecologist is a personal matter, but such cases make women planning to conceive a child.
Laparoscopy (surgery to remove an ovarian cyst in women)
Laparoscopy is a modern method of surgery, the operation is performed through a hole of 0.5-1.5 cm. The operation is done using a laparoscope (telescopic tube with a video camera and cold light). During surgery, the operating cavity can be filled with carbon dioxide. The degree of use of laparoscopy is wide, from cholecystectomy to surgery on the colon and rectum.
The consequences of the removal of an ovarian cyst are limited to two weeks of rehabilitation to working condition and restoration of physical activity. Problems may arise with anesthesia, since everyone may have a non-specific reaction to the anesthetic drug, so it is advisable to have tests before the operation to determine the optimal anesthetic.
After laparoscopy, adhesions are the most harmful, but also rare. Without the necessary observation, adhesions that develop uncontrollably can lead to a number of diseases of the genital organs, and even to infertility. This is a fairly common problem after any operations, which once again prompts you to follow all instructions of the doctors and undergo a course of drug treatment during rehabilitation.
Sex and sport after laparoscopy of ovarian cysts are considered unacceptable loads. With regard to sexual intercourse and sports, the time for abstinence lasts one month. When restoring workouts, of course, you need to start with the lowest load in order to gradually master the lost skills and control the limit of permissible stress. In particular, doctors prohibit weight lifting of more than three kilograms in the first three months after the operation, and in the next three months – no more than five.
Half a year is the postoperative period, after which it is necessary to return to your doctor for examination for complications. And if the doctor resolves, it will be possible to return to normal loads – for most women, such requirements, in principle, do not change lifestyles, although athletes and workers from various industries or trade will have to limit themselves.
Pregnancy after laparoscopy of an ovarian cyst is not only a safe solution – the operation itself is often performed to treat infertility. As mentioned above, a follicular cyst can provoke infertility, since permanent cysts, despite regression and the absence of symptoms, prevent new follicles with eggs inside them from developing.
After laparoscopy, 85% of patients who treat infertility in this way become pregnant in the first year after surgery (20% in the first month, 20% in the period from three to five months, 30% in six months, and the remaining 15% expect nine months to a year).
By the fact that the terms are evenly distributed, it is clear that the period of the onset of pregnancy after the treatment of infertility is purely individual. If laparoscopy is done by dissecting adhesions, then the patient has a whole year to conceive, which is safe in terms of complications. If laparoscopy revealed other disorders other than cysts, and a course of treatment for gynecological problems was performed, then in the first few months, most likely, a long-awaited pregnancy will occur.
Monthly after laparoscopy, ovarian cysts should set in on schedule, since the integrity of healthy tissue during laparoscopy is not impaired. However, any operation on the ovary can shift the menstrual cycle – this is a phenomenon within the physiological norm.
After laparoscopy, there may also be discharge having a slimy character. Such discharges sometimes occur even immediately after the operation, and there is nothing bad to say. The reason for alarm will appear if these secretions acquire a yellow-green or brown-green shade – this means that an infection has appeared in the body. Usually, this symptom is accompanied by a characteristic weakness, drowsiness, fever, discomfort.
In addition, white discharge can also be detected, which appear as a result of laparoscopy while taking antibiotics. They can talk about thrush appeared, or about another infection, for the detection of which a smear is done. In any case, medical supervision and timely medical assistance help to quickly cure diseases in the early stages.
Diet after laparoscopy of ovarian cyst should maximally facilitate the rehabilitation process for the reproductive system. Due to the fact that the ovaries are in close proximity to the intestines, their condition also depends on the well-being of the gastrointestinal tract. Therefore, food consumed in the first three months should contain more fiber, which improves peristalsis and normalizes glucose levels. Accordingly, one should refrain from eating fatty, fried, very spicy and salty foods. Such food is too difficult to digest and, moreover, strongly irritates the mucous membranes of the gastrointestinal tract.
A special requirement for the diet after laparoscopy is a ban on the intake of alcoholic beverages of any kind for a month and a half.
The diet consists of eating foods that are easy for the digestive tract (vegetables, fruits, boiled, stewed dietary meat) in small portions 10-12 times a day. During the healing of internal wounds, the body is full of fresh vitamins, freshly squeezed juices, low-fat dairy products (kefir, milk), and cereal products (cereals). We remind you that, in connection with the probable prescription of a course of antibiotics, it is also necessary to forget about alcohol intake during the first month and a half.