Diseases

Ovarian cysts - symptoms, development and therapy

Ovarian cysts - symptoms, development and therapy



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Cysts in or on the ovaries

Fluid buildup in a tissue cavity is commonly referred to as cysts. If these structures arise on or in the ovary, they are also called ovarian cysts in medical jargon. Since hormonal changes often act as triggers, mostly women after puberty and during menopause are affected. In addition to the functional cysts, which usually recede on their own, other ovarian cysts (retention cysts) and other diseases (such as tumors) are possible symptoms with similar symptoms, but which require immediate treatment.

Definition

In medical circles, cysts located in the ovary (ovary) are commonly referred to as ovarian cysts. Different types are distinguished due to the diverse causes. The functional cysts include mainly follicular cysts, corpus luteum cysts, lutein cysts and endometriosis cysts (chocolate cysts). Retention cysts are less common.

A special form of functional cysts are polycystic ovaries (polycystic ovary syndrome), which represent an independent clinical picture. Cystic ovarian tumors (ovarian tumors), which are similar in symptoms but are real neoplasias (cell growths), should also be distinguished.

Symptoms

The cysts are often so small that those affected do not experience any symptoms. From a certain extent, however, they take up so much space that pressure is put on neighboring structures and pelvic or abdominal pain is the result. The pain can also radiate and lead to complaints in the lower back, for example. Some of the women affected also describe the occurrence of ovarian pain very precisely.

Sometimes bladder and bowel emptying disorders and cycle disorders can occur. The latter is particularly evident through a longer absence of menstrual bleeding (amenorrhea) or spotting.

If colic-like or acute abdominal pain (acute abdomen) occurs and there is a rapid deterioration in the general condition, this usually indicates complications (tearing or turning the style).

Origin and causes

A variety of causes and mechanisms of origin allow a professional division between different ovarian cysts. The most common types with the corresponding triggers are described in the following section.

Functional cysts

The most common causes of functional cysts on the ovary are hormonal changes that almost exclusively affect sexually mature women and are increasingly associated with puberty and menopause. In addition to disturbances in the normal body's own hormone cycle (monthly cycle), other hormonal control cycles or hormone therapy can also lead to changes in the ovaries. The following subdivision enables a more precise description of the cause:

  • Follicular cysts: These types of cysts are the most common and arise due to a Graaf follicle that has not cracked and contains the egg. So there is no ovulation and the follicle obtained can develop into a cyst. These structures are usually only a few centimeters in size and spontaneously recede or shatter over time. But you can also reach a size of over ten centimeters. In particular, these structures appear during early sexual maturity and in the transition to menopause.
  • Corpus luteum cysts: If ovulation takes place, the Graaf follicle creates the so-called yellow body (corpus luteum), which is responsible, among other things, for the production of the female sex hormone (estrogen). Without fertilization of the egg cell, the yellow body shrinks and menstruation follows. On the other hand, if fertilization occurs, the hormones produced regulate implantation and pregnancy. If there is bleeding or fluid accumulation in the luteal body, a corpus luteum cyst develops. As a rule, these also recede on their own.
  • Endometriosis cysts (chocolate cysts): With endometriosis, tissue similar to the endometrium (endometrium) arises outside the uterus - for example, also on the ovary. During the breakdown process of menstruation there is no drainage option for this tissue and cysts can occur. The term chocolate cyst describes the typical brownish secretion from the breakdown products of the blood inside the cyst. The term tar cyst also occurs in this context.
  • Lutein cysts: The so-called lutein cysts often occur on both sides with an increased production of pregnancy hormones (human chorionic gonadotropin, short: HCG), for example in multiple pregnancies. Hormone therapies for fertility treatment can also lead to the formation of these cysts. After normalization of the corresponding hormone levels, these mostly regress.

Retention cysts

If a secretion jam (retention) triggers an enlargement of the gland, it is generally a matter of retention cysts. This can also affect the sex glands and thus the ovaries. These also include dermoid cysts. These congenital malformations that arise from the germ cells are mostly benign structures. They can contain different types of tissue (sebum, cartilage or bone). A malignant tumor very rarely develops in succession.

Diagnosis

Since no complaints are often triggered, random findings regularly occur, for example during a (routine) ultrasound examination of the ovaries.

If symptoms such as irregular menstrual bleeding, the absence of a desired pregnancy or pain are present, these are important indications that should be clarified as part of the patient survey and gynecological examination.

As a rule, ovarian cysts can be identified by vaginal tactile examinations and by means of ultrasound (through the vagina or over the abdomen).

In addition, further tests of blood samples or other imaging procedures (laparoscopy) may be necessary to make a reliable diagnosis. Because other diseases must also be ruled out without any doubt, such as an ectopic pregnancy or cancer (ovarian cancer).

Treatment

In principle, the treatment plan is very different individually and depends on many circumstances. This includes not only possible complaints and risks (e.g. degeneration) but also personal factors, such as an existing desire to have children.

Most of the cases are functional cysts that require no treatment without symptoms, since spontaneous regression can be expected. A change in the condition is initially observed over weeks or even months. Hormonal support for this process is rarely advised.

However, if the cysts do not regress after a longer period and grow to a size that causes problems for the women concerned, or if complications arise, appropriate individual therapy measures are necessary.

As a rule, the cyst is then removed via an abdominal mirroring. This procedure is recommended for newly developed ovarian cysts after the menopause due to the increased risk of cancer without a previous observation period. Endometriosis cysts and dermoid cysts are also surgically removed. Only in serious cases can the affected ovary be removed. Basically, organ preservation is always sought and is usually also possible.

Prevention

After the complete removal of endometriosis cysts, a subsequent hormone treatment can be advisable for this clinical picture. This also reduces the risk of recurrence.

With other functional cysts, hormone preparations (such as birth control pills) can be used to prevent new cysts from forming. Basically, there is only a slight risk of recurrence with these forms, which contrasts with the possible side effects.

Naturopathic treatment

Naturopathy offers the use of medicinal plants. In particular, preparations made from the fruits of the monk's pepper (Vitex agnus-astus) can balance the female hormone level and thus promote the regression of cysts and prevent possible new development. This effect is scientifically proven.

Treatment methods of holistic medicine

Further support can be provided through measures to activate the self-healing powers. Stress relief through relaxation methods can have a positive influence on the body's balance and also contribute to the normalization of hormone systems. Traditional Chinese medicine (TCM), for example by means of acupuncture, also offers complementary therapy options to help the body achieve a balanced and resilient state. (jvs, cs)

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dr. rer. nat. Corinna Schultheis

Swell:

  • Pschyrembel: Clinical dictionary. 267th, revised edition, De Gruyter, 2017
  • Bühling, Kai Joachim and Friedmann, Wolfgang: Intensive course: gynecology and obstetrics. Urban & Fischer, 1st edition, 2004
  • Uhl, Bernhard: Gynecology and Obstetrics compact. Thieme Verlag, 5th unchanged edition, 2013
  • Professional association of gynecologists (publisher): www.frauenaerzte-im-netz.de - EIERSTOCKZYSTE / OVARIALZYSTE (available on July 5th, 2019), Frauenaerzte-im-netz
  • Arbeitsgemeinschaft gynäkologische Endoskopie e.V. (Ed.): Www.ag-endoskopie.de - Cysts of the ovary (access: 05.07.2019), ag-endoskopie.de
  • Royal College of Obstetricians and Gynecologists (ed.): The management of Ovarian Cysts in Postmenopausal Women, Green-top Guideline No. 34, July 2016, rcog.org.uk

ICD codes for this disease: N83.0, N83.1, N83.2 ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.


Video: Treatment of Ovarian Cysts (August 2022).