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. Such cysts range in size from as small as a pea to larger than
an orange.
The vast majority of ovarian
cysts are harmless (benign), most are functional cysts.
Ovarian cysts occur in women
of all ages including neonatal period and infancy. They are most prevalent
during infancy, adolescence and during the childbearing years. With ultrasonography ovarian
cysts can be demonstrated in nearly all premenopausal and approximately 18%
postmenopausal women.
Some ovarian cysts cause
problems, such as bleeding and pain or may raise concerns of malignancy.
Surgery may be required to remove cysts larger than 5 centimeters in diameter
SIGNS
AND SYMPTOMS
Some or all of the following
symptoms may be present, though it is possible not to experience any symptoms
1.
Abdominal pain. Dull aching pain
within the abdomen or pelvis, especially on intercourse.
2.
Uterine bleeding. Pain during or shortly
after beginning or end of menstrual period; irregular periods, or abnormal
uterine bleeding or spotting.
3.
Fullness, heaviness, pressure, swelling, or bloating in
the abdomen.
4.
When a cyst ruptures from the ovary,
there may be sudden and sharp pain in the lower abdomen on one side.
5.
Change in frequency or ease of urination (such
as inability to fully empty the bladder), or difficulty with bowel
movements due to pressure on adjacent pelvic anatomy.
6.
Constitutional symptoms such as fatigue, headaches
7.
Nausea or vomiting
8.
Weight gain
Other symptoms may depend on
the cause of the cysts
Symptoms that may occur if
the cause of the cysts is polycystic ovarian syndrome may include
increased facial hair or body hair, acne, obesity and infertility.
If the cause is endometriosis,
then periods may be heavy, and intercourse painful.
HOW
TO DIAGNOSE OVARIAN CYST
Ovarian cysts are usually
diagnosed by either ultrasound or CT scan, with additional
endocrinological tests
TREATMENT
Cysts associated with
hypothyroidism or other endocrine problems are treated by treating the
underlying condition.
About 95% of ovarian cysts
are benign, not cancerous.
1.
Functional cysts and hemorrhagic ovarian cysts
usually resolve spontaneously. However the bigger an ovarian cyst is, the less
likely it is to disappear on its own. Treatment may be required if cysts
persist over several months, grow or cause increasing pain.
2.
Treatment for cysts depends on the size of
the cyst and symptoms.
3.
Pain associated with ovarian cysts may be
treated in several ways
4.
Painrelievers,including acetaminophen/paracetamol (Tylenol or Panadol), nonsteroidal
anti-inflammatory drugs such as ibuprofen (Motrin, Advil),
or narcotic pain medicine (by prescription) may help reduce pelvic
pain. NSAIDs usually work best when taken at the first signs of the pain.
5.
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.
6.
Combined methods of hormonal
contraception such as the combined oral contraceptive pill – the
hormones in the pills may regulate the menstrual cycle, and prevent the
formation of follicles that can turn into cysts.(American College of
Obstetricians and Gynecologists, 1999c; Mayo Clinic, 2002e). However, a
Cochrane review in 2011 concluded oral contraceptives are of no benefit in
treating already present functional cysts.
7.
Also, limiting strenuous activity may reduce
the risk of cyst rupture or torsion.
Cysts that persist beyond
two or three menstrual cycles, or occur in post-menopausal women, may
indicate more serious disease and should be investigated through ultrasonography and laparoscopy,
especially in cases where family members have had ovarian cancer. Such
cysts may require surgical biopsy. Additionally, a blood test may
be taken before surgery to check for elevated CA-125, a tumour marker,
which is often found in increased levels in ovarian cancer, although it can
also be elevated by other conditions resulting in a large number of false
positives.
For more serious cases where
cysts are large and persisting, doctors may suggest surgery. This may involve
removing the cyst, or one or both ovaries.
Features that may indicate the need for surgery include
Persistent
complex ovarian cysts
Persistent cysts that are
causing symptoms
Complex ovarian cysts larger
than 5 cm
Simple ovarian cysts larger
10 centimeters or larger than 5 cm in postmenopausal patients
Women who are menopausal or premenopausal
Please see your doctor for more advise.
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