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Endometriosis

What to know about endometriosis

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Endometriosis is a gynecological condition which is incurable, but manageable.

It happens when endometrial implants, consisting of tissue usually located within the uterus, occur in other areas of the body.

As the tissue begins to thicken, break down, react to hormones in the menstrual cycle and bleed throughout the menstrual cycle, endometriosis is developing deep within the body.

Scar tissue and adhesions are produced, and this can cause organ fusion and anatomical changes.

Endometriosis is thought to affect about 11 percent of women between 15 and 44 years of age in the United States.

Fast facts on endometriosis

Here are some key points about endometriosis. More information is in the main article.

  • Endometriosis affects between 6 and 10 percent of women of reproductive age worldwide.
  • The condition appears to be present in a developing fetus, but estrogen levels during puberty are thought to trigger the symptoms.
  • Symptoms are generally present during the reproductive years.
  • Most women go undiagnosed, and in the U.S. it can take around 10 years to receive a diagnosis.
  • Allergies, asthma, chemical sensitivities, autoimmune diseases, chronic fatigue syndrome, fibromyalgia, breast cancer, and ovarian cancer are linked to women and families with endometriosis.

What is endometriosis?

Endometriosis
Endometriosis sees the endometrial implant tissue, normally found in the uterus build up in other parts of the body.

Endometrial tissue is composed of the gland blood cells and connective tissue. It typically grows in the uterus, to prepare the womb’s lining for ovulation.

Endometrial implants are buildups of endometrial tissue, which develop outside of the uterus.

This is called endometriosis, as they develop outside the uterus.

They can grow in the body anywhere but they typically occur in the pelvic region.

They may affect:

  • the ovaries
  • the fallopian tubes
  • the peritoneum
  • the lymph nodes

This tissue is usually shed during menstruation but this can not be achieved by displaced tissue.

This leads to physical effects, for example, pain. They can affect bodily functions as the lesions grow larger. For example, it can block the Fallopian tubes.

The pain and other symptoms can affect various aspects of life, including the ability to function, the cost of medical treatment, and the difficulty of maintaining relations.

Symptoms

Other medical conditions such as pelvic inflammatory disease (PID), ovarian cysts and irritable bowel syndrome (IBS) can mimic endometriosis symptoms.

Symptoms of endometriosis include:

  • Severe menstrual cramps, unrelieved with NSAIDS
  • Long-term lower-back and pelvic pain
  • Periods lasting longer than 7 days
  • Heavy menstrual bleeding where the pad or tampon needs changing every 1 to 2 hours
  • Bowel and urinary problems including pain, diarrheaconstipation, and bloating
  • Bloody stool or urine
  • Nausea and vomiting
  • Fatigue
  • Pain during intercourse
  • Spotting or bleeding between periods

Pain is the most common symptom of endometriosis but it does not always correlate the severity of the pain with the extent of the disease.

After menopause, pain frequently improves, as the body stops producing estrogen. However, symptoms can continue if the hormone therapy is used during menopause.

Pregnancy may provide for temporary symptom relief.

Complications

Complications include:

  • infertility, which can affect 50 percent of those with the condition.
  • increased risk of developing ovarian cancer or endometriosis-associated adenocarcinoma
  • ovarian cysts
  • inflammation
  • scar tissue and adhesion development
  • intestinal and bladder complications

To avoid future complications it is necessary to see a health care provider about symptoms.

Treatment

endometriosis hysterectomy
A hysterectomy, or the removal of the uterus, will be considered when all other avenues of treatment have been exhausted.

Surgery is possible but it is typically only considered if other treatments are not successful.

Other solutions include:

Pain medications: either over-the-counter (OTC) non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB, others) or prescription medications to relieve painful menstruation.

Hormones: Treatment can be with hormonal therapies such as hormonal birth control, agonists and antagonists of Gonadotropin-releasing hormone (Gn-RH), Medroxyprogesterone (Depo-Provera) or Danazol. It may also be advisable to position an intrauterine device (IUD).

Surgery: Initial surgery may aim to remove the endometriosis areas but will involve a hysterectomy with removal of both ovaries.

Fertility treatment: In-vitro fertilization (IVF) can be recommended for pregnancy.

Managing symptoms at home

Alternative and complementary therapies may include acupuncture, chiropractic, and herbal medicine, but there is little evidence to prove that they are effective.

Caffeine avoidance can help to alleviate discomfort, as caffeine can exacerbate symptoms.

Exercise, such as exercise, can alleviate discomfort by reducing estrogen levels and slowing the development of the disease.

Due to the long-term complications of endometriosis it is important to control symptoms. You should report unbearable pain or unexplained bleeding to a doctor.

While endometriosis is currently not healed, most women are able to alleviate symptom pain and will still be able to have children.

Diagnosis

Diagnosis can be difficult, as there is no standardized diagnosis method.

The only way to truly confirm the condition is with an operative laparoscopy.

A surgical laparoscopy is a minimally invasive procedure in which a thin, lighted tube with an attached miniature camera, called a laparoscope, is inserted into the pelvic region through a small incision.

A  diagnosis can be graded as follows:

  • Stage 1: Lesions are minimal and isolated
  • Stage 2: Lesions are mild. There may be several and adhesions are possible.
  • Stage 3: Lesions are moderate, deep or superficial with clear adhesions
  • Stage 4: Lesions are multiple and severe, both superficial and deep, with prominent adhesions.

A diagnosis will take several years to get.

Many potential screening techniques include a pelvic exam, or magnetic resonance imaging (MRI) radiological imaging, or ultrasound, and the use of other drugs, including birth control or hormone releasing gonadotropin (GnRH) agonists.

Diet

Dietary steps to manage the pain and endometriosis symptoms have been suggested.

A research published in 2004 indicates that a brown seaweed called bladderwrack may have an effect that decreases estrogen in women. This can reduce the endometriosis growth rate.

One author has reported a case study using a diet low in short-chain fermentable carbohydrates to reduce endometriosis symptoms. The diet has been shown to function on IBS and because endometriosis is also present, the diet may be beneficial for those with endometriosis alone.

There is a need for further research but there is no risk in pursuing this method.

Dietary choices have also been related to endometriosis growth. A 2011 study indicated that fruit consumption decreased the risk of endometriosis, and decreased total fat consumption reduced the risk.

The risk of endometriosis was also shown to be decreased by dairy products although these findings were not statistically important.

Eating yogurt, sauerkraut, and pickles, or having a good source of probiotics, can help to reduce gastrointestinal symptoms and contribute to improved digestion.

Caffeine avoidance can help to reduce discomfort, as caffeine can worsen symptoms.

Causes

Endometriosis cramps
Endometriosis can lead to painful cramps in the pelvis, but doctors do not understand its exact cause.

The precise cause of endometriosis isn’t well known at the moment.

Possible causes include:

Menstrual flow problems: menstrual blood flows into the fallopian tubes and pelvis instead of normally exiting the body.

Embryonic cell growth: Often in those cavities, embryonic cells lining the abdomen and pelvis develop into endometrial tissue.

Fetal development: The data indicate that endometriosis may occur in a developing fetus, but the symptoms are thought to cause pubertal estrogen levels.

Surgical scar: Endometrial cells may move like a hysterectomy or a c-section during a procedure.

Transport of endometrial cells: The lymphatic system brings endometrial cells to various parts of the body.

Genetics: A genetic aspect may be present. A woman who has an endometriosis with a nearby family member is more likely to develop endometriosis herself.

Hormones: Endometriosis is stimulated by the hormone estrogen.

Immune system: Immune problems can prevent the destruction of endometrial extrauterine tissue.

Risk factors

Endometriosis may be developed in anyone but certain risk factors raise risk.

These include:

  • Age: It is most common in women aged 30 to 40 years
  • Nulliparity: Never giving birth
  • Genetics: One or more relatives having the condition
  • Medical history: Having a pelvic infection, uterine abnormalities, or a condition that prevents expulsion of menstrual blood.
  • Menstrual history: Menses lasting more than 7 days or menstrual cycles of less than 27 days.
  • Caffeine, alcohol consumption, and lack of exercise: These can raise levels of estrogen.

Endometriosis has linked some of the health conditions. That include allergies, asthma and other chemical sensitivities, certain autoimmune disorders, chronic fatigue syndrome, and cancer of the ova and breast.

Researchers have found links to some chemicals, including phthalates, between endometriosis and exposure.

Endometriosis

Deeply infiltrative endometriosis: What to know

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Deeply infiltrative endometriosis is an uncommon and severe type of endometriosis. It, like other types of endometriosis, causes the growth of uterine lining-like tissue in other parts of the body.

Deeply infiltrative endometriosis is a type of severe endometriosis that has progressed to organs close to or inside the pelvic cavity. This has the potential to harm the bladder, intestines, reproductive system, and other organs. It causes inflammation, which results in scar tissue known as adhesions.

Excruciating menstrual periods, pain during sex, chronic pelvic pain, difficulty peeing, and digestive difficulties are all indications of deeply infiltrative endometriosis. It may also have an impact on a person’s fertility. Although the condition can be severe, doctors find it difficult to diagnose because symptoms overlap with those of other health concerns.

This article discusses the symptoms, diagnosis, and treatment of profoundly infiltrative endometriosis. It also examines problems and fertility.

Definition

deeply infiltrative endometriosis

Endometriosis of the deep infiltrative kind is a type of endometriosis. Endometriosis causes endometrial tissue to grow in locations other than the uterus, such as the pelvis or abdomen.

These tissues function similarly to the endometrium in that they accumulate and shed during the menstrual cycle. However, because there is no route for this tissue to exit the body, it becomes stuck, causing inflammation, scarring, and cysts.

Endometriosis is classified as kind and stage based on its location, depth, and amount of tissue affected.

Endometriosis is classified into four types:

  • deeply infiltrative endometriosis
  • abdominal wall endometriosis
  • superficial peritoneal endometriosis
  • endometrioma

The American Society of Reproductive Medicine defined four phases of endometriosis severity in 1996:

  • Stage 1 (minimal): At this stage, there are few implants and little to no scar tissue.
  • Stage 2 (mild): There are implants deeper in the tissue at this stage, as well as some scar tissue.
  • Stage 3 (moderate): At this point, there are several deep implants, maybe with cysts on the ovaries and thick regions of scar tissue known as adhesions.
  • Stage 4 (severe): At this stage, there are several implants, some of which are deep, with dense adhesions and big cysts on one or both ovaries.

Deeply infiltrative endometriosis is uncommon, affecting just around 1% of women of reproductive age. It is a severe form of endometriosis in which endometrial tissues invade organs within the pelvis, abdomen, and other areas, such as:

  • ureters
  • lungs
  • umbilicus
  • diaphragm
  • peritoneum
  • abdominal surgical scars
  • ovaries
  • vagina
  • cervix
  • fallopian tubes
  • bowel
  • rectum
  • bladder

Symptoms

When it comes to endometriosis, a person’s disease stage does not always correspond to their amount of pain. A person, for example, may have few adhesions but excruciating cramping pain. A person may have severe profoundly infiltrative endometriosis with no symptoms.

Endometriosis symptoms vary depending on the location of the body affected. Lesions linked with profoundly infiltrative endometriosis frequently damage nerve-rich areas, causing significant discomfort and pain.

Reproductive tract

Endometriosis people frequently endure significant cramping and pain during menstruation. Doctors call this dysmenorrhea.

They may also have pain during sexual activity as well as nonspecific pelvic pain. This pain could be chronic or just occur at certain points of the menstrual cycle.

Because the condition can change the structure of the pelvis and cause scar tissue to form, deeply infiltrative endometriosis can also impact fertility.

Urinary tract

Endometriosis of the bladder or urinary tract can cause the following symptoms:

  • experience burning sensations when urinating
  • have blood in their urine
  • feel pain when the bladder is full
  • often feel the need to urinate urgently

Endometriosis of the bladder can also cause pelvic and lower back pain.

Bowel

Endometrial tissue can grow anywhere in the intestine, but according to 2014 research, approximately 9 out of 10 occurrences of bowel endometriosis affect the rectum or sigmoid colon.

Among the symptoms are:

  • constipation
  • painful bowel movements
  • diarrhea
  • general pelvic pain
  • pain during sexual intercourse

Symptoms frequently vary across people and with the menstrual cycle.

Diagnosis

Doctors may struggle to diagnose endometriosis because there is no single test that can confirm the condition. Symptoms may also be similar to those of other health issues.

A laparoscopy is often the best technique to diagnose endometriosis, but it is fraught with complications. As a result, doctors may employ a combination of the following:

Laparoscopy is most typically used by doctors to confirm the presence of endometriosis and to assess the severity of the condition. During the operation, a surgeon inserts a camera or laparoscope through a small incision in the pelvis to see if endometriosis is present.

Treatment

Although there is no cure for endometriosis, there are numerous treatment methods that may provide relief from severe symptoms.

The goal of treatment may be to alleviate pain, increase fertility, limit the growth of endometriosis tissue, or prevent it from reoccurring.

Conservative surgery

The surgeon’s goal with conservative surgery is to remove only affected tissue while leaving healthy tissue alone.

A surgeon can utilize a variety of procedures to treat endometriosis, but laparoscopic surgery (laparoscopic excision) is the gold standard. During this operation, the surgeon uses as little heat and electricity as possible to remove or cut the entire lesion from wherever it is in the body.

Laser ablation is frequently used by surgeons to eliminate endometriosis lesions, however there is a danger of harming surrounding healthy tissue. In most cases, ablation is not long-term beneficial. The best approach is laparoscopic excision.

Definitive surgery

If endometriosis affects a specific organ, a surgeon may recommend surgical removal of the affected organ. During a hysterectomy, for example, the surgeon may remove the uterus. The ovaries and cervix may also be removed. It is critical to remember, however, that a hysterectomy does not cure endometriosis because the implants frequently arise in other locations.

Medication for pain relief

To relieve pain, anti-inflammatory medications such as paracetamol or ibuprofen may be used. If these over-the-counter solutions do not provide relief, they may choose to consult with a doctor about prescription options.

Hormone therapy

A doctor may advise hormone therapy to reduce estrogen production in the body, as this hormone promotes the development of endometriosis tissue.

The combined oral contraceptive pill, progesterone-only options such as the minipill, Depo-Provera, the progesterone intrauterine system, and the contraceptive implant are all hormone treatment choices. Injections of leuprolide acetate (Lupron), a more potent hormonal therapy, are also a possibility.

Complications

Complications like as adhesions and a frozen pelvis are possible in people with deeply infiltrative endometriosis.

Adhesions are fibrous bands of scar tissue that occur as a result of injuries, surgery, or the body’s reaction to the inflammation caused by endometriosis implants.

A frozen pelvis occurs when the organs of the pelvis become linked to one another by adhesions and “frozen” in position. Operating on a frozen pelvis is extremely difficult since the anatomy is deformed, increasing problems.

Fertility

Endometriosis that is deeply infiltrative can impact a woman’s fertility. Adhesions can, for example, hinder eggs from traveling or implanting in the uterus. They can also block off the ovaries’ blood supply or trap blood in the ovaries, resulting in cysts.

According to studies, 30–50 percent of people with endometriosis are unable to conceive. Experts, on the other hand, have yet to confirm the link between the two.

Another thing worth mentioning is that if a person with deeply infiltrative endometriosis becomes pregnant, her chances of having a cesarean section are doubled when compared to people without endometriosis.

Questions to ask a doctor

If a woman has deeply infiltrative endometriosis, it’s critical to have an open and honest conversation with her doctor about her diagnosis and treatment options.

The questions below are an excellent place to start:

  • Can I have surgery to remove the adhesions?
  • Is the surgery risky for my situation?
  • Where are the adhesions located?
  • What are the treatment options?
  • Do I have extensive adhesions?
  • Will the endometriosis implants affect my fertility?

People can get support and information from organizations like the Endometriosis Association to assist them advocate for their own health. People with endometriosis can get help, education, and support from this organization.

Conclusion

Endometriosis with deep infiltrative endometriosis is an uncommon but serious type of endometriosis.

Endometriosis is a condition in which tissues that mimic the uterine lining grow and implant in other parts of the body, such as the bladder, lungs, and digestive tract.

These implants can cause scar tissue adhesions, causing pain and affecting a person’s fertility.

These implants have spread outside of the pelvis in cases with profoundly infiltrative endometriosis. As a result, it may cause problems with bladder and bowel function, as well as chronic pelvic pain, penetrative sex pain, and severe period cramps.

Pain medicines, hormone therapies, and surgery to remove adhesions are some of the therapeutic choices that may help an individual’s symptoms.

Sources:

  • https://pubs.rsna.org/doi/full/10.1148/rg.2018170093
  • https://www.endofound.org/endometriosis-treatment-support
  • https://academic.oup.com/humrep/article/24/4/827/632224
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2905889/
  • https://www.karger.com/Article/FullText/339519
  • https://www.medicalnewstoday.com/articles/what-to-know-about-deeply-infiltrative-endometriosis
  • https://www.jmig.org/article/S1553-4650(20)30093-5/fulltext
  • https://www.fertstert.org/article/S0015-0282(97)81391-X/pdf
  • https://www.nhs.uk/conditions/endometriosis/treatment/
  • https://www.ncbi.nlm.nih.gov/books/NBK567777/
  • https://gynecolsurg.springeropen.com/articles/10.1186/s10397-019-1065-9
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4229526/
  • https://www.endometriosis-uk.org/your-laparoscopy

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Endocrinology

What to eat during your period to help you feel better

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Some studies suggest that dietary adjustments may help minimize period symptoms, while research is still in its early stages.

Over-the-counter (OTC) drugs can help reduce period symptoms like bloating and pain in some circumstances. During menstruation, however, a person may choose to take additional efforts to ease symptoms and maintain their overall health.

This article examines foods that people should consume during their period to help alleviate symptoms.

Best foods to consume

doctor discussing period symptoms with a lady

Specific meals may help ease certain period symptoms, according to some data. According to the Office on Women’s Health, around 90% of women suffer from premenstrual symptoms such as:

The foods listed below have been shown to help with period-related symptoms.

Vegetables and fruits

Fruit and vegetables are an important source of nutrients and fiber for everyone, but they may be especially beneficial during menstruation.

In a 2018 research of Spanish university students, vegetarian diets and just eating more fruits and vegetables were linked to fewer cramps and less menstrual pain.

This was true in several of the trials examined by the authors, but it did not appear to help people with endometriosis.

Water

Drinking adequate water is vital for good health, and it can help prevent dehydration headaches during menstruation. It can also help you avoid bloating and water retention.

The American Dietary Guidelines for 2015-2020 do not include a daily water intake. The National Health Service (NHS) of the United Kingdom, on the other hand, suggests consuming 6–8 glasses of water per day.

Seafood and fish

Omega-3 fatty acids are abundant in salmon, tuna, sardines, and oysters. These nutrients can help with period pain by reducing inflammation in the body.

The effect of omega-3 supplementation on the degree of menstruation pain in women aged 18–22 years old was investigated in a study published in 2012.

The omega-3 supplements were given to one group, while the placebo was given to the other. The pain severity of the omega-3 group participants was significantly reduced. They also took fewer ibuprofen doses to manage their pain.

Omega-3s may also help with depression, according to a 2014 study. Those who endure mood swings and poor mood around their period may benefit from this.

Omega-3s can also be found in the following foods:

Dark chocolate

Dark chocolate is delicious and high in iron and magnesium.

Iron deficiency can be avoided by eating adequate iron. Menstruation causes a drop in iron levels as a person sheds blood, which can lead to anemia in those who have very heavy periods. People who have heavy periods or menorrhagia lose much more iron during their menstrual cycle than those who have “regular menstrual bleeding,” according to the National Institutes of Health (NIH).

3.4 milligrams (mg) of iron are found in a 1 ounce portion of dark chocolate. This amounts to around 19% of the recommended daily consumption of 18 mg for adult females.

Dark chocolate also delivers a boost of magnesium. According to a 2015 study, people who are deficient in magnesium are more likely to have severe PMS symptoms.

Lentils and beans

Lentils and beans are high in protein and a good source of iron. Protein is vital for good health, and it may also help control cravings for less healthful foods during menstruation.

Legumes also contain zinc, which is an important mineral. Zinc was reported to help relieve unpleasant menstrual cramps in a 2007 study.

Foods to avoid

Some meals can help with period symptoms while others can make them worse. These are typically foods that cause bloating or inflammation.

Foods to stay away from include:

  • highly processed foods, also known as ultra-processed foods
  • foods high in sugar
  • goods baked using white flour, such as white bread or pasta
  • foods that cause gas, such as cauliflower or Brussels sprouts

Additionally, limiting sodium consumption can aid in the reduction of bloating and weight gain associated with menstruation. According to a 2019 study, increasing sodium intake may increase the likelihood of bloating. It’s important noting, however, that this study focused on bloating in general, not period-related bloating.

According to the American Heart Association, most people should consume no more than 1,500 mg of sodium per day. Maintaining salt levels below this level can aid in bloating reduction.

Foods to shorten periods

Despite the scarcity of study in this area, it appears that foods containing specific nutrients may help to shorten the duration of a period.

Vitamin B6 is one such example. According to a 1983 study, this vitamin balances menstrual hormones by lowering estrogen and increasing progesterone. This could perhaps shorten a period and alleviate PMS symptoms.

Vitamin B6 can be found in a variety of foods. Fish, organ meats, potatoes, and starchy vegetables are among the best sources.

Myrtle fruit syrup may also aid, though it’s not frequent. In a 2014 research of 30 people, daily doses of syrup were found to reduce the amount of bleeding days while also reducing pain. Because of the small sample size, more research is needed to determine whether myrtle fruit syrup can help with bleeding and pain.

When to contact a doctor

While many menstruation symptoms are common, people should see a doctor if they have any of the following:

  • bleeding after sex
  • irregular periods
  • spotting or bleeding between periods
  • bleeding after menopause
  • heavy bleeding
  • bleeding that lasts longer than 7 days
  • severe pain or pain that does not go away with OTC pain relievers

Conclusion

When a person is losing blood, for example, consuming iron-rich meals can help replenish iron levels. Magnesium and zinc, among other minerals, may assist to alleviate discomfort.

Severe or irregular periods should be discussed with a doctor, since they may indicate an underlying condition that requires medical attention.

Sources:

  • https://health.gov/our-work/food-nutrition/previous-dietary-guidelines/2015
  • https://pubmed.ncbi.nlm.nih.gov/6684167
  • https://www.ncbi.nlm.nih.gov/pubmed/28707491
  • https://academic.oup.com/aje/article/177/10/1118/100730
  • https://fdc.nal.usda.gov/fdc-app.html#/food-details/170273/nutrients
  • https://pubmed.ncbi.nlm.nih.gov/27346251/
  • https://pubmed.ncbi.nlm.nih.gov/17289285/
  • https://www.medicalnewstoday.com/articles/what-to-eat-on-your-period
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6086430/
  • https://www.hindawi.com/journals/omcl/2014/313570/
  • https://www.cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html
  • https://www.ncbi.nlm.nih.gov/pubmed/24190696
  • https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/
  • https://ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer/
  • https://www.ncbi.nlm.nih.gov/pubmed/31206400
  • https://www.womenshealth.gov/menstrual-cycle/premenstrual-syndrome
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4079189/
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4667262/
  • https://www.nhs.uk/live-well/eat-well/the-eatwell-guide/
  • https://ods.od.nih.gov/factsheets/VitaminB6-HealthProfessional/#h3

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Endometriosis

Ovarian cysts: Things you need to know

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An ovarian cyst develops as the fluid builds up within the ovary inside a thin membrane. The size can vary from as small as a pea to greater than an orange.

A cyst is a closed structure that resembles a sac. This is separated by a membrane from the surrounding tissue. It is an abnormal fluid pocket, similar to that of a burn. It comprises material which is either liquid, gaseous or semi-solid. The outer or capsular portion of a cyst is called the cyst wall.

It’s different from an abscess, because it’s not pus-filled. A pus-filled sac is an abscess.

The majority of ovarian cysts are small and harmless. They occur most commonly during reproductive years but at any age they can appear.

Sometimes there are no signs or symptoms, but occasionally the ovarian cysts may cause pain and bleeding. When the cyst has a diameter of more than 5 centimetres, it may need to be removed surgically.

Important facts about ovarian cysts:

  • An ovarian cyst is a buildup of fluid within an ovary surrounded by a thin shell, or membrane.
  • Ovarian cysts are usually harmless, but a large one may need to be removed.
  • There are two main types of ovarian cysts: functional ovarian cysts and pathological cysts.
  • In most cases, ovarian cysts will cause no signs or symptoms.

Causes

There are two main types of ovarian cysts:

A doctor working with microscope
Cysts can develop anywhere on the body, some may be microscopically small and others very large.
  • Functional ovarian cysts – the most common type. These harmless cysts form part of the female’s normal menstrual cycle and are short-lived.
  • Pathological cysts – these are cysts that grow in the ovaries; they may be harmless or cancerous (malignant).

The causes are different for each type. We will look at each type in turn.

Functional ovarian cysts

There are two types of functional ovarian cysts:

1) Follicular cysts

The most common form of follicular cysts is. A woman does have two ovaries. The egg travels into the womb from an ovary, where it can be fertilized by sperm. The egg is produced in the follicle, containing fluid that protects the growing egg. The follicle bursts, as the egg is released.

For certain cases, after release of the egg, the follicle either does not lose its fluid and contract, or it does not release an egg. The follicle swells with blood, becoming an ovarian follicular cyst.

Usually one cyst emerges at any given time, and it usually goes away within a few weeks.

2) Luteal ovarian cysts

These are less common. This leaves tissue behind, known as the corpus luteum, after the egg is released. Luteal cysts can form when blood is filled in to the corpus luteum. Typically this form of cyst goes away within a few months. Often, however, it may split, or crack, causing sudden pain and internal bleeding.

Pathological cysts

There are two types of pathological cysts:

1) Dermoid cysts (cystic teratomas)

In general, a dermoid cyst is benign. They are created from the cells which produce eggs. Such cysts ought to be surgically removed. Dermoid cysts are the most common form of pathologic cyst for women under the age of 30.

2) Cystadenomas

Cystadenomas are ovarian cysts that grow out of cells covering the outer ovary. Others are filled with a thick, mucous substance while others are filled with a watery liquid.

Cystadenomas are normally connected to the ovary by a stem, instead of developing inside the ovary. They can grow very large by living outside of the ovary. They are rarely cancerous but need surgically removed.

Cystadenomas are more common in women over 40 years old.

Signs and symptoms

Most cysts are non-symptomatic. If signs are present, they are not necessarily helpful to diagnose an ovarian cyst since other disorders have similar symptoms, such as endometriosis.

Symptoms of an ovarian cyst may include:

  • Irregular and possibly painful menstruation: It may be heavier or lighter than before.
  • Pain in the pelvis: This may be a persistent pain or an intermittent dull ache that spreads to the lower back and thighs. It may appear just before menstruation begins or ends.
  • Dyspareunia: This is pelvic pain that occurs during sexual intercourse. Some women might experience pain and discomfort in the abdomen after sex.
  • Bowel issues: These include pain when passing a stool, pressure on the bowels or a frequent need to pass a stool.
  • Abdominal issues: There may be bloating, swelling, or heaviness in the abdomen.
  • Urinary issues: The woman may have problems emptying the bladder fully or she may or feeling the need to urinate frequently.
  • Hormonal abnormalities: Rarely, the body produces abnormal amounts of hormones, resulting in changes in the way the breasts and body hair grow.

Some symptoms may resemble those of pregnancy, for example, breast tenderness and nausea.

Complications

An ovarian cyst often causes no problems, but sometimes it can lead to complications.

  • Torsion: The stem of an ovary can become twisted if the cyst is growing on it. It can block the blood supply to the cyst and cause severe pain in the lower abdomen.
  • Burst cyst: If a cyst bursts, the patient will experience severe pain in the lower abdomen. If the cyst is infected, pain will be worse. There may also be bleeding. Symptoms may resemble those of appendicitis or diverticulitis.
  • Cancer: In rare cases, a cyst may be an early form of ovarian cancer.

Treatment

Treatment will depend on:

  • the person’s age
  • whether they have undergone menopause or not
  • the size and appearance of the cyst
  • whether there are any symptoms

Watchful waiting (observation)

Watchful waiting is often recommended , especially if the cyst is a tiny, functional cyst (2 to 5 centimeters) and the woman has not yet had a menopause

An ultrasonography scan will check the cyst a month or so later to see if it has gone

Birth control pills

The doctor can prescribe birth control pills to reduce the risk of new cysts forming in future menstrual cycles. Oral contraceptives may also reduce the risk that ovarian cancer can develop.

Surgery

A female doctor with her patient
Surgery may be used as a treatment for persistent cysts.

Surgery may be recommended if:

  • there are symptoms
  • the cyst is large or appears to be growing
  • the cyst does not look like a functional cyst
  • the cyst persists through 2 to 3 menstrual cycles.

Two types of surgery are:

  • Laparoscopy, or keyhole surgery: The surgeon uses very small tools, to remove the cyst through a small incision. In most cases, the patient can go home the same day. This type of surgery does not usually affect fertility, and recovery times are fast.
  • Laparotomy: This may be recommended if the cyst is cancerous. A longer cut is made across the top of the pubic hairline. The cyst is removed and sent to the lab for testing. The patient usually stays in the hospital for at least 2 days.

Cancer treatment

Unless the cyst is cancerous, a biopsy can be performed for examination.

When the test indicates cancer, more organs and tissue, such as the ovaries and the uterus, can need to be removed.

Diagnosis

Ultrasound is a common method of diagnosis of ovarian cyst.
Ultrasound is a common method of diagnosis of ovarian cyst.

Most ovarian cysts do not exhibit signs or symptoms, so they still remain undiagnosed.

A cyst not causing symptoms may often be detected through an unrelated pelvic or ultrasound scan.

Diagnosis is aimed at determining the cyst ‘s form, size and composition, whether it is filled with solid or liquid.

Tests for Diagnosis can include:

  • an ultrasound scan
  • a blood test
  • a pregnancy test
  • laparoscopy

Prevention

There is no way to prevent development of the ovarian cysts.

Regular pelvic checks, however, may allow early treatment where appropriate. This can also avoid complications from happening.

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