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Ovarian Cyst


What Is Ovarian Cyst?

The ovaries are a pair of glands on either side of the uterus. It produces hormones including the main female hormone oestrogen and small amounts of androgens such as testosterone. Ovaries produce ova (eggs) from a small swelling called follicle which is then released into the uterus once a month, during the menstrual cycle.

An ovarian cyst is any collection of fluid, surrounded by a very thin wall, within an ovary. Any ovarian follicle that is larger than about two centimeters is termed an ovarian cyst. An ovarian cyst can be as small as a pea, or larger than an orange. Most ovarian cysts are functional in nature, and harmless (benign). Some may cause problems such as rupturing, bleeding, or pain. Ovarian cysts affect women of all ages. However they occur most often during a woman's childbearing years.

In an ultrasound image, ovarian cysts resemble bubbles. The cyst contains only fluid and is surrounded by a very thin wall. This kind of cyst is also called a functional cyst, or simple cyst. If a follicle fails to rupture and release the egg, the fluid remains and can form a cyst in the ovary. This usually affects one of the ovaries. Small cysts (smaller than one-half inch) may be present in a normal ovary while follicles are being formed.

Classification

Functional ovarian cysts

  • Follicular cyst (the most common type)
  • Corpus luteum cyst
  • Theca Lutein cyst

A functional ovarian cyst is a sac that forms on the surface of a woman’s ovary during ovulation. It holds a maturing egg. Usually the sac goes away after the egg is released. If an egg is not released, or if the sac closes up after the egg is released, the sac can swell up with fluid.

Functional ovarian cysts are different than ovarian growths caused by other problems, such as cancer. Most of these cysts are harmless. They do not cause symptoms, and they go away without treatment. But if a cyst becomes large, it can twist, rupture, or bleed and can be very painful.

The development of a functional ovarian cyst depends on hormonal stimulation of the ovary. A woman is more likely to develop a cyst if she is still menstruating and her body is producing the hormone estrogen. Postmenopausal women have a lower risk for developing ovarian cysts since they are no longer having menstrual periods. For this reason, many doctors recommend removal or biopsy of ovarian cysts in postmenopausal women, particularly if the cysts are larger than 1-2 inches in diameter.

The size of the ovarian cyst relates directly to the rate at which they shrink. As a rule, functional cysts are 2 inches in diameter or smaller and usually have one fluid-filled area or bubble.

The cyst wall is usually thin, and the inner side of the wall is smooth. An endovaginal ultrasound can reveal these features. Most cysts smaller than 2 inches in diameter are functional cysts.

Non-functional ovarian cysts

There are several of the other conditions affecting the ovary, described as types of cysts, but are not usually grouped with the functional cysts. Some of these are more commonly or more properly known by other names. These includes

  • Serous Cystadenoma
  • Mucinous Cystadenoma
  • Dermoid cyst
  • Benign endometrioma or Chocolate cyst
  • Para ovarian cyst
  • Polycystic-appearing ovary

Risk factors

The following are possible risk factors for developing ovarian cysts:

  • History of previous ovarian cysts
  • Irregular menstrual cycles
  • Increased upper body fat distribution
  • Early menstruation (11 years or younger)
  • Infertility
  • Hypothyroidism or hormonal imbalance

Complications:

  • Twists (2-16%): Severe pain accompanied with vomiting
  • Rupture of endometrial cyst and chemical peritonitis caused by cyst content.
  • Haemorrhage
  • Secondary infection
  • Neoplasatic transformation (2.9%)
  • Pseudomyxoma peritonei
  • Malignancy
  • Adhesions
  • Impaction in the pouch of douglas or uterovisical pouch causing obstruction in labour
  • Autoimmune hemolytic anemia.
  • Infertility
  • Severe pain after or during sex
  • Small intestinal obstruction and sigmoid colon obstruction.

Clinical Features

In most cases the presence of cysts goes unnoticed. The reason being; the cysts generally don’t cause any kind of symptom. If the cysts don’t have any symptoms then their detection is generally accidental. They are found during routine pelvic check up or during an ultra sound examination. Once the diagnosis is confirmed, based on the size and condition of the cyst treatment is started.

In most cases cysts are benign in nature and rarely cause much trouble. However, the following symptoms may be present alone or in combination:

  • Dull aching, or severe, sudden, and sharp pain or discomfort in the lower abdomen (one or both sides), pelvis, vagina, lower back, or thighs; pain may be constant or intermittent—this is the most common symptom.
  • Secondary progressive cyclical severe dysmenorrhea. Pain starts 5-7 days before menses, becoming maximal at the height of bleeding and persists during menses and thereafter.
  • Feeling of fullness, heaviness, pressure, swelling, or bloating in the lower abdomen.
  • Breast tenderness.
  • For some women, the pain is felt in the lower back.
  • Pain during or shortly after beginning or end of menstrual period.
  • Long-term pelvic pain during menstrual period that may also be felt in the lower back
  • Pelvic pain after strenuous exercise or sexual intercourse
  • Pain or pressure with urination or bowel movements
  • Headaches
  • Strange pains in ribs, which feel muscular
  • Vaginal pain or spotty bleeding from the vagina
  • Infertility
  • Fever
  • Weakness, dizziness, or fainting
  • Pallor or anemia (possibly from loss of blood)
  • Abnormally heavy or irregular menstruation
  • Abdominal swelling or unusual increased abdominal girth
  • Increased facial hair similar to a male pattern
  • High or low blood pressure unrelated to medications
  • Excessive thirst or urination
  • Unexplained weight loss
  • A noticeable abdominal or pelvic mass
  • Strange nodules that feel like bruises under the layer of skin
  • The most common form of symptom caused by a cyst is pain. The pain occurs when a cyst ruptures or twists on its self. Such a situation can lead to severe pain and lots of discomfort.
  • If there is a sudden sharp pain in the lower abdomen, particularly during or after intercourse. There is a chance that the cyst has burst. When this happens, there is always the possibility of internal bleeding.

With most ovarian cysts, everyday activities can still be maintained and the woman's life will not be affected.

Ovarian Cysts Diagnosis

A health care practitioner may perform the following tests to determine if a woman has an ovarian cyst or to help characterize the type of cyst that is present:

  • Endovaginal ultrasound:

    This type of imaging test is a special form of ultrasound developed to examine the pelvic organs and is the best test for diagnosing an ovarian cyst. A cyst can be diagnosed based on its appearance on the ultrasound.
  • CT scanning aids in assessing the extent of the condition.
  • MRI scanning may also be used to clarify results of an ultrasound.
  • Laparoscopic surgery: In this procedure the surgeon makes small incisions through which a thin scope (laparoscope) can pass into the abdomen. The surgeon identifies the cyst through the scope and may remove the cyst or take a biopsy from it.
  • Serum CA-125 assay: This blood test checks for a substance called CA-125, which is associated with ovarian cancer (the CA stands for cancer antigen). This test is used in the assessment of epithelial ovarian cancer and may help determine if an ovarian mass is harmless or cancerous. However, sometimes benign conditions such as endometriosis or uterine fibroids may result in the elevated levels of CA-125 in the blood, so the test does not positively establish the diagnosis of ovarian cancer.
  • Hormone levels: A blood test to check LH, FSH, estradiol, and testosterone levels may indicate potential problems concerning these hormone levels.
  • Pregnancy testing: The treatment of ovarian cysts is different for a pregnant woman than it is for a non-pregnant woman. An ectopic pregnancy (pregnancy outside the uterus) must be ruled out because some of the symptoms of ectopic pregnancy may be similar to those of ovarian cysts.
  • Culdocentesis: This test involves taking a fluid sample from the pelvis with a needle inserted through the vaginal wall behind the uterine cervix.

Ovarian Cysts Treatment

About 95% of ovarian cysts are benign, meaning they are not cancerous. Functional ovarian cysts are the most common type of ovarian cyst. They usually disappear by themselves and seldom require treatment. Treatment for cysts depends on the size of the cyst and symptoms presented.

  • A warm bath, or heating pad, or hot water bottle applied to the lower abdomen near the ovaries can relax tense muscles and relieve cramping, lessen discomfort, and stimulate circulation and healing in the ovaries. Bags of ice covered with towels can be used alternately as cold treatments to increase local circulation.
  • Combined methods of hormonal contraception such as the combined oral contraceptive pills
  • Limiting strenuous activity may reduce the risk of cyst rupture or torsion.
  • Surgical removal of the cyst (cystectomy)

Home Treatment

Home treatment can help relieve the discomfort of functional ovarian cysts.

  • Empty the bladder as soon as there is urging to urinate.
  • Constipation should be avoided, though constipation does not cause ovarian cysts but may further increase the pelvic discomfort.

How can Homeopathy help?

There is no definite cause of formation of ovarian cyst, probably it is because of some hormonal imbalance of the ovary. That means ovarian cyst is true natural chronic disease with definite involvement of Miasm.

Homoeopathy got a generalized concept of disease irrespective of name and organ involved. It is the individual that is sick and to be restored to health, not the body, nor the tissue.

Ovarian cyst is not a disease itself rather it is a product and manifestation of some internal disease condition. Homeopathy can effectively treat ovarian cyst by correcting the hormonal imbalance, steadying the immunity and controlling the symptoms. In this process, a surgery is usually avoided and a long lasting cure results.