What hormones are prescribed for follicular ovarian cyst. How to get rid of a follicular cyst? Signs of a ruptured follicular ovarian cyst

A woman of the childbearing period, faced with a functional neoplasm on the ovary, wonders how to remove the follicular cyst. Unfortunately, pathology often occurs due to hormonal failure and, if it does not resolve on its own after several cycles, poses a threat to the patient. We will talk about the methods of treating the disease with this article.

Follicular cyst (functional, retention) - a benign formation on the ovary, is a thin-walled cavity with a liquid mass inside. Cystic sizes vary from 1 to 4 centimeters, but it happens that the neoplasm grows up to 7 cm. As a rule, pathology appears due to hormonal disorders that are closely related to the interaction of two systems - endocrine and reproductive, where the ovaries are not the last.

Interesting! The disease mainly affects young women, but cases of cystic formation have been recorded in representatives of the menopausal period. It happens that a cyst appears in utero, when the baby has a follicle in the ovary that can be stimulated by maternal estrogen.

During a normal menstrual cycle, the follicle, reaching a certain size, ruptures and promotes the release of the egg. If this does not happen, the structural component of the ovary increases in size, and a neoplasm appears instead, and ovulation, of course, does not occur.

The follicular cyst is formed in one ovary, but it happened to diagnose neoplasms in both paired glands. Both cavities formed independently of each other and, most likely, in different menstrual cycles. The tumor in the right ovary is observed much more often than in the left. This indicates that the right gland is more intensively supplied with blood, so women become victims of rupture of the right ovary more often than the left.

More often, a woman is diagnosed with one cyst on the ovary, but sometimes many cysts form on the endocrine glands, which are visualized on ultrasound as bunches of grapes. Such a phenomenon is called.

Causes of the disease

The exact causes of the disease are unknown, but experts identify several factors that contribute to the formation of neoplasms. Among them:

1. External factors - physical stress, stressful situations, nervous exhaustion, exposure to cold and others;
2. Internal factors - infections of the genitourinary system, chronic diseases, functional disorders and others.

Influences from inside and outside contribute to hormonal disruptions, inhibit ovulation and promote follicular growth.

Let us clarify which factors provoke the anovulatory cycle, favoring the modification of the follicle into a cyst:

• frequent stressful situations, depressive disorders;
• ovarian dysfunction;
• artificial termination of pregnancy;
• inflammatory processes in the pelvis;
• use of oral contraceptives without medical indications;
• STDs;
• endocrine diseases;
• hereditary factor.

Note! With the normalization of the hormonal background, the follicular cyst tends to self-resorb.

Symptoms of a follicular cyst

At an early stage, the cyst is characterized by an asymptomatic course and usually a woman learns about the pathology during a routine gynecological examination or ultrasound. But with the growth of cystic parameters, there is pressure on neighboring organs and tissues, so pain in the abdomen is considered the first sign of a neoplasm.

Among the manifestations of cystic signs, the following can be distinguished:

• violation of the menstrual cycle;
• vaginal bleeding not associated with menstruation;
• an abundance of cervical fluid;
• discomfort during intercourse;
• pain in the abdomen during physical exertion (on the right or on the left - depending on which ovary the cyst is located in);
• bouts of nausea, vomiting;
• migraine;
• state of nervousness;
• prostration.

It's important to know! In rare cases, a follicular cyst contributes to baldness. In this case, urgent hormonal treatment and hair restoration procedures are necessary.

Complications

If you ignore the signs of a follicular cyst for a long time and do not consult a gynecologist, complications may develop, the most dangerous of which is. The outflow of the contents of the cystic capsule into the abdominal cavity leads to peritonitis. If surgical care is not provided in time, a fatal outcome is possible, since the pathology is fraught with a rupture of the ovary itself due to its tissue.

Another complication is due to a sharp change in position, abdominal trauma. Torsion causes cessation of blood supply to the leg, so necrosis may develop.

Signs in which it is clear that a cystic rupture or torsion of the cyst leg has occurred:

• sharp pain in the lower abdomen;
• bouts of nausea, weakness, fainting or fainting;
• tension of the muscles of the peritoneum;
• lowering blood pressure, tachycardia;
• pale skin color;
• increase in body temperature.

Diagnostics

In most cases, women accidentally learn about the anomaly on ultrasound of the pelvic organs, some are urgently hospitalized due to complications. If a representative of the weaker sex regularly visits a gynecologist, a cyst is recognized when the pathology does not exceed the allowable size.

It is easy for an experienced obstetrician-gynecologist to grope for a neoplasm during examination on a chair - when palpating, a smooth elastic cyst with thin walls is felt, there is no pain when pressing on a small formation. To confirm the diagnosis, the doctor sends the patient to an ultrasound examination. Doppler ultrasound determines the localization, parameters, stage of pathology.

The most effective diagnostic method is a laparoscopic examination, during which, if necessary, surgical treatment can be performed immediately.

How to remove a follicular cyst

Small follicular cysts usually resolve on their own within 2-3 cycles. But women who have been diagnosed with a neoplasm should be observed by a gynecologist for another six months.

If the cystic formation has not regressed, but is growing, the doctor, based on the analyzes and individual indicators of the patient, prescribes drug therapy or surgery. Treatment should not be postponed until later, because there is always a risk of complications: pressure on nearby organs and tissues, torsion of the cyst leg, breakthrough of the neoplasm into the abdominal cavity, degeneration of a benign tumor into a malignant one. Often, pathology requires hormonal, antibacterial, antiviral and immunostimulating treatment.

Conservative treatment

Therapy includes the following ways to get rid of the cyst:

• hormone therapy - hormone treatment is carried out under the clear guidance of a doctor, since with malignant anomalies there is a risk of accelerating the growth of cancer cells;
• immunotherapy;
• treatment with non-steroidal anti-inflammatory drugs;
• multivitamins;
• homeopathic remedies.

Physiotherapy is also effective for neoplasms not exceeding 5 cm (if more than 5 cm, read this article). Physiotherapy treatment includes the following types of procedures:

• magnetotherapy;
• SMT-phoresis;
• electrophoresis;
• ultraphonophoresis and other methods.

Attention! As a rule, young nulliparous girls are treated with therapeutic methods. But if the follicular cyst is fraught with complications, an operation is prescribed.

Laparoscopy

It is used if the doctor is sure that the cystic tumor is benign. The procedure is performed under general anesthesia. At this time, gas is injected into the patient's abdominal cavity through small holes made, with the help of a special laparoscope apparatus, all surgical procedures are viewed on the monitor screen.

With special tools, the surgeon removes the cystic formation along with the stalk and capsule without damaging healthy tissues. After removal of the neoplasm, the gas is released from the peritoneum, the damaged area is sutured with surgical threads and a sterile dressing is applied. Sometimes it is required to install a drain for a maximum of 24 hours.

The method is considered minimally invasive, so the recovery period is faster than after a conventional operation, there are no postoperative traces, and complications are extremely rare.

Other surgical methods for removing a follicular cyst

With a progressive cystic formation that has reached a large size, a planned operation is prescribed. Depending on clinical factors, the neoplasm is removed in several ways:

1. A cystectomy is the removal of a cyst. During the operation, only the capsule with cystic contents is removed, without affecting healthy tissues;
2. Wedge resection is performed with a more complicated pathology. The operation involves excision of a part of the ovary in the form of a wedge along with the capsule;
3. Adnexectomy - removal of the ovary. Surgical intervention is relevant if irreversible changes have occurred in the ovary due to a follicular cyst.

After all types of these operations, a rehabilitation period is required, during which the use of combined oral contraceptives and multivitamins is recommended, aimed at restoring ovarian function. During rehabilitation, it is advisable to avoid stressful situations, do not take a hot bath, refrain from cold and ultraviolet rays.

Treatment with traditional medicine

If a small follicular cyst is found, it is not necessary to immediately resort to surgical treatment. In combination with therapeutic measures, folk remedies are effective. It should be remembered that potions of traditional healers will not get rid of cystic formation, but they help increase immunity, improve blood supply in the small pelvis, which favors a decrease in the size of the cyst or complete resorption.

For the treatment of folk remedies, methods such as:

• infusions of horsetail, hog uterus;
• mud treatment;
• vaginal tampons with honey, aloe, mummy;
• brewing herbal teas from chamomile, calendula, celandine, nettle, red brush, celandine;
• milk baths;
• lotions from potato broth;
• daily chewing of a piece of propolis.

Conclusion

To prevent the formation of a follicular cyst, it is necessary to treat inflammatory processes in the pelvis in a timely manner and consult a doctor at the first signs of hormonal disorders. Most often, the disease is completely cured, but cases of relapse are not excluded when the anomaly appears in the same or another ovary. In this situation, the woman is subjected to more careful observation and identification of the cause contributing to the development of the follicular cyst.

The follicular ovarian cyst is a retention formation of the gonad and occurs as a result of impaired functioning of the body. Pathologies are exposed to menstruating women, mainly aged 20 to 35 years.

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In most cases, the cyst does not pose a danger to the health of the patient and is detected suddenly. However, in combination with other endocrine and hormonal disorders, the neoplasm can cause infertility.

Every month, a woman's body undergoes hormonal changes. With the beginning of the next menstrual cycle, the active production of follicle-stimulating hormone, which is responsible for the maturation of the egg, begins.

In the cavity of the ovary there are many primordial follicles ready for gradual development. Of these, only one (rarely two) mature to the formation of a Graaffian vesicle.

Timely production of LH provokes the opening of the dominant follicle, as a result of which a mature and ready for fertilization egg enters the abdominal cavity. If for some reason the Graafian vesicle did not open, then a follicular ovarian cyst is formed.

Important! A follicular cyst is a small benign neoplasm located in the ovary. Its dimensions usually do not exceed 7-10 cm. All ovarian tumors account for up to 80% of follicular tumors. A feature of such a neoplasm is that it will never turn into a malignant form.

The neoplasm has a single-chamber or two-chamber structure, and inside it is a fluid accumulation saturated with estrogens. Despite the ease of diagnosis, functional tumors are determined infrequently.

About 70% of patients are unaware that they have ever had a similar problem. The uniqueness of the neoplasm lies in the possibility of reverse transformation and the tendency to disappear.

For the treatment and prevention of various kinds of gynecological diseases (cyst, erosion, fibroids, endometriosis, endometritis), our readers successfully use the proven method. Having carefully studied, we bring to your attention.

Left

The follicular cyst of the left ovary occurs quite rarely. This gland is supplied with blood through the renal artery. As a result of the greater passage of the blood path from the heart, the Graafian vesicles on the left mature less frequently, which reduces the likelihood of a tumor appearing here.

This pattern is a medical observation and does not guarantee the absence of neoplasms in the left gland throughout life.

For the left ovary, the causes of the appearance of a neoplasm are no different from the right. The appearance of a neoplasm is due, first of all, to hormonal disorders. Only a doctor can establish what became the reason for the formation of a large unopened Graafian vesicle.

Right

The right side of the power system is different from the left. This gland is inextricably linked with the aorta. Improved blood supply causes accelerated maturation of follicles.

This pattern explains the fact that the follicular cyst of the right ovary in women is found more often.

Another feature is the size of the neoplasm. The average cysts on the right have a larger volume than tumors on the gland located on the left.

The mechanism of development of a functional neoplasm on both sides has no differences. Despite the statistical data, the probability of tumor formation in the right and left gland remains in all women of reproductive age.

Causes

It is believed that the follicular ovarian cyst occurs due to hormonal disorders. Unstable changes can be caused by:

• inflammatory and infectious diseases of the genital organs;
• puberty or menopause;
• hormonal treatment;
• self-administration of oral contraceptives;
• stress and emotional experiences;
• ovarian dysfunction;
• endocrine disorders.

Important! The absence of ovulation in a healthy woman for 1-2 months per year is a variant of the norm. Therefore, diagnosing 1-2 cases of the formation of an overgrown and unopened follicle is not a cause for concern.

With the development of medicine, experts found new causes of the appearance of functional neoplasms. Back in the 19th century, it was suggested that the tumor appears only in nulliparous women after 40 years. Then the disease was called dropsy.

After a while, a hypothesis was put forward that the woman's body self-destructs cells at the genetic level. Modern medicine recognizes that the cause of the tumor is not only hormonal disorders.

A follicular neoplasm can grow due to excessive blood supply to the gonad, which, in turn, occurs due to inflammation, benign or malignant tumors, and other unnatural processes in the pelvis.

Types

Follicular ovarian cyst has two types:

• single-chamber - visually resembles a round-shaped cavity without internal partitions (accounts for 95% of all cases);
• two-chamber - looks like two neoplasms that have merged together (occurs with the simultaneous growth of two Graafian vesicles).

Determining the type of functional adnexal tumor is the starting point for choosing a treatment technique.

Symptoms of a follicular cyst

Small neoplasms, reaching a maximum size of 4 cm, are characterized by an asymptomatic course. An important role is played by the sensitivity and pain threshold of the patient. The same tumor may present differently in different women. Large neoplasms, reaching a size of 6 cm or more, are accompanied by the following clinical signs:

• prolonged and unusually heavy menstrual bleeding;
• delayed menstruation and lengthening the cycle;
• pain and a feeling of fullness in the lower abdomen (right or left, depending on the location of the bubble);
• hormonal changes.

One of the reliable signs of cystic formation is the absence of ovulation. Women who measure basal temperature and lead the chart can independently determine this indicator.

The rupture of the follicular ovarian cyst becomes a vivid symptom of the pathology, developing according to the type of "acute abdomen".

Signs of torsion

Cystic follicle torsion is a condition in which the tumor is pulled out, forming a stalk, and unfolds in the other direction. In such a situation, there is a violation of the nutrition of the tumor, from where tissue necrosis originates.

This complication rarely develops. Excessive physical activity, sexual contact and other factors become a provocateur.

Signs that the leg of the tumor vesicle is twisted cannot be overlooked. The pathological condition is accompanied by strong cutting sensations that cannot be tolerated even with a high pain threshold.

The woman turns pale, and perspiration appears on her face. An additional clinical sign will be a decrease in blood pressure.

Gap

The rupture of the cystic capsule is characterized by a vivid clinical picture. The patient feels pain on the side of the abdomen where the tumor is located. Blood pressure drops, fainting occurs.

It is possible to increase body temperature to high values. Vomiting and nausea appear due to the involvement of the digestive tract in the process. This may cause diarrhea or, conversely, constipation.

Against the background of low blood pressure, the patient feels an increased heartbeat, an increase in pulse.

If the ovary ruptures along with the follicle (the capsule of the gland ruptured), then intra-abdominal bleeding develops. Bloody discharge from the genital organs is also noted when a vessel is damaged, located near the cystic neoplasm.

Diagnostics

Identifying a cyst is not difficult. It is enough to perform an ultrasound examination, which allows you to find out not only about the presence of a neoplasm, but also to establish its size.

Additional Doppler imaging, establishing blood flow, will help to obtain more information about the neoplasm.

During a gynecological examination, as with a visual examination, it will not be possible to identify a cyst. If the tumor is large (from 6 cm), then it can be palpated.

How to treat a follicular cyst

Treatment of a follicular cyst is carried out only if it causes discomfort to the patient, has a large volume and does not go away on its own within three menstrual cycles.

Before taking measures aimed at eliminating the tumor, doctors choose expectant tactics. In most patients, the formed capsules undergo involution within 3-4 cycles.

If the reverse transformation does not occur, then the gynecologist selects hormone therapy for a period of 3 to 6 months. When traditional methods are powerless, cardinal actions are taken - surgical treatment.

The operation is performed on an emergency basis if there is torsion of the leg, rupture of the capsule or ovarian apoplexy.

waiting method

It is assumed that functional neoplasms resolve themselves. If such a pathology is detected, doctors give the patient up to 3 months.

At the same time, ultrasound scans are regularly performed in order to assess the state of the neoplasm in dynamics. Expectant management is chosen in the case of an asymptomatic course of the pathology, as well as with a tumor size of not more than 5 cm.

If, after 3 cycles, the tumor has not resolved or has begun to increase in size, manifesting itself with clinical symptoms, then the attitude to treatment is reviewed.

Medication use

It is customary to treat an ovarian cyst with hormonal agents. Therapy involves the appointment of oral contraceptives for a period of 6 months. It is expected that during this time the reproductive function will be conserved, and the neoplasm will undergo regression.

At the same time, the drugs will improve the hormonal background of the woman, which will prevent the recurrence of the problem in the near future. After the abolition of oral contraceptives, the chances of successful conception increase in the first 2-4 months.

Simultaneously with hormonal therapy, the patient is recommended to take vitamins that strengthen the immune system and non-steroidal anti-inflammatory drugs.

Physiotherapy

Clinical symptoms and treatment of a woman are interconnected (treatment of small neoplasms is prescribed when signs of pathology appear). A popular and safe technique is physiotherapy.

Its effectiveness is noted in the presence of small neoplasms. Electrophoresis, magnetotherapy and other means are used when the tumor tends to grow.

Laparoscopy

Treatment of a follicular ovarian cyst that is increasing in size is carried out through laparoscopy.

The low-traumatic procedure involves making three punctures in the abdominal cavity, through which miniature manipulators are inserted. Depending on the condition of the affected gonad, one of the methods is performed:

• cystectomy - removal of a neoplasm;
• resection - excision of an enlarged vesicle with the removal of damaged tissues;
• ovariectomy - a thorough removal of the gland (performed with apoplexy).

Laparoscopy is performed under general anesthesia using a ventilator.

Surgical intervention

If the follicular ovaries have torsion or apoplexy, then a laparotomy is performed - a strip surgical intervention that involves making an incision on the abdominal wall.

The procedure is quite traumatic and may be accompanied by various complications (from adhesions to heavy bleeding and death).

Laparotomy is usually performed when laparoscopy is not possible. One of the circumstances that can influence the choice of surgical treatment is obesity.

Psychological factor

It has long been known that the parts of the central nervous system - the hypothalamus and the pituitary gland, located in the brain - are responsible for the work of the ovaries. It is assumed that a functional ovarian cyst can be cured by psychological influence.

When the patient uses the same parts of the brain (when thinking about an urgent problem, stress, nervous experiences), other functions fade. This pattern determines the psychosomatic causes of the appearance of an overgrown follicle.

In order to solve a health problem, you just need to switch. Some women may need to consult a psychologist for this.

Complications

For most patients, the prognosis of functional neoplasms is favorable. Complications, consequences should be feared with a tendency to growth and clinical manifestations of the tumor. Among the most dangerous are torsion and apoplexy.

Also, a large tumor that does not go away for a long time can cause infertility. A neoplasm can cause an adhesive process, which is also fraught with disruption of the reproductive organs.

Forecast and prevention

Due to the fact that many patients are unaware of their diagnosis, and the tumor disappears on its own, the outlook is good. Even with the appointment of drug treatment, the prognosis remains favorable. Hormone therapy shows good results.

The prognosis of the treatment of complications directly depends on the time of seeking medical help. The sooner the operation is performed, the better for the patient.

There is no definite prevention of the formation of functional ovarian cysts.

A proper lifestyle, moderate physical activity, maintaining a natural hormonal background (refusal to use drugs on your own) and timely examination will help prevent the unpleasant consequences of pathology.

Monastic collection helps with such diseases and conditions

1. Diseases of the uterus (myoma, erosion, endometritis, bends and prolapse of the uterus);
2. ovarian cysts, inflammation of the appendages;
3. thrush and bad smell;
4. pain during sex;
5. infertility;
6. discomfort when urinating.

An ovarian cyst is a common disease of the fair sex. It is a benign formation, the place of formation of which is the gonads. The danger of developing a tumor lies in its asymptomatic course and the frequent development of complications. The most dangerous of them are cancer and infertility.

What causes

There are several reasons for the appearance of a cyst. The main one is hormonal imbalance. Among the factors that lead to the onset of the disease, there are:

• development of diabetes;
• early onset of menstruation, from the age of 9 years, which indicates a clear violation of the hormonal background;
• a history of abortions that adversely affect the production of hormones;
• metabolic pathologies;
• pathological changes in the process of maturation of follicles;
• various diseases of the female genital organs.

Varieties of education

The direction of the therapeutic effect is largely determined by the type of tumor. After all, the success of recovery depends on whether the medicine helps or not. Isolate cysts:

• Functional.

They are divided into two subtypes: follicular and luteal. The specificity of their occurrence lies in the fact that they can independently regress for some time. The main reason for their development is a violation of the ovulation stage, when the formed follicle degenerates into a cyst, and a change in the process of resorption of the corpus luteum (its location becomes the site of the tumor).

• Endometrioid.

The reason for their appearance is the growth of the endometrium in the tissue of the gonad.

• Dermoid.

They are thick-walled formations that are filled with other tissues, such as hair or fat cells. Differ in slow and constant growth.

• True cysts (cystadenomas).

Relate to benign formations.

Of these varieties, almost all are treated with surgery. In addition, the intervention of the surgeon is mandatory in the presence of complications in the form of rupture or necrosis.

Signs of cyst development

Due to the fact that the disease does not have clear signs, in most cases, women skip the initial stage of cyst formation. Usually, a woman receives news of a diagnosis after a scheduled visit to a gynecologist. As a result, the lack of treatment becomes the cause of undesirable consequences.

Symptoms of an ovarian cyst include:

• the presence of painful appearances during movements, often in the process of intimacy (due to twisting of the cyst leg or compression of the formation);
• the appearance of a feeling of tension in the abdominal wall;
• with a protracted course: the appearance of nausea, vomiting, fever, a change in heart rate in the direction of amplification.

Diagnostic procedures

First of all, timely diagnosis is aimed at a preventive visit to the gynecologist at least twice a year. If the diagnosis was made earlier, then a visit to the doctor should occur every three months. A test is done to rule out pregnancy.

An important diagnostic measure for the detection of ovarian cysts is ultrasound. Its implementation allows you to determine the size of the formation and the place of its growth. In addition, the doctor can send for a study and a tomography procedure.

This will eliminate the malignant nature of the formation and determine the tactics of treatment. A complication of the cyst will require a puncture of the posterior vaginal fornix. This will help to detect the presence of any fluid in the abdominal cavity, including blood.

Possible Complications

Unfortunately, it is not always possible to detect the disease before the development of complications. The most common of these include:

• miscarriage in the absence of therapy during pregnancy;
• development into a malignant formation;
• rupture of the cyst and further development of peritonitis or sepsis;

The occurrence of these conditions requires immediate medical attention.

Directions of therapeutic influence

Treatment of an ovarian cyst is associated with the elimination of its root cause - hormonal imbalance. Assign hormonal drugs that have a beneficial effect on the functioning of the appendages. Depending on the specifics of the disease, the doctor prescribes drugs of one of the following groups:

Gestagens

They belong to the sex hormones, among which the main representative is progesterone. These drugs for the treatment of ovarian cysts normalize the body's performance of its functions and reduce the likelihood of formation of formations.

Most often prescribed Utrozhestan. This contraceptive allows you to normalize menstruation, reduce the size of already formed formations. Utrozhestan is also a prophylaxis against the degeneration of follicles into a cyst. A special place in the group is occupied by drugs - antigonadotropins. They have an overwhelming effect of the pituitary gland on the female sex glands. These include: Danoval, Danazol.

It should be noted that treatment with hormonal pills is individual. A particular patient is prescribed exactly the medicine that will be the most optimal in the treatment process, for example, Yarina or Logest. The use of Norkolut in the treatment of ovarian cysts has shown its effectiveness.

The action of the drug is to increase the secretion of the mucous membrane of the uterus, reducing the tone of its muscle layer. In addition, it normalizes the activity of the pituitary gland, the disruption of which affects the process of cyst formation. Any pharmacy will offer a prescribed remedy in a different price range.

Oral contraceptives

Their use is based on the effect of drugs on the size of the resulting cyst, and the process of formation of new tumors. Contraceptive pills belonging to this group and widely used in the treatment of the disease are Diane-35, Logest.

Regulon with an ovarian cyst is also effective, and therefore it is often prescribed by a doctor. If there are problems with nails and hair, the doctor may prescribe the use of a remedy called Qlaira. It should be noted that the choice of the drug is determined by the gynecologist based on the examination data of the woman.

Hormonal treatment of ovarian cysts, video

In addition to the two main groups, the list of substances prescribed additionally includes:

• anti-inflammatory drugs that help to cope with inflammatory processes and speed up the recovery of a woman (often, in addition to cysts, other diseases of the female genital area are detected);
• immunocorrective drugs that are prescribed if a low level of immunity is noted;
• sedative drugs;
• multivitamin preparations that help strengthen the defenses in order to cope with the pathology that has arisen;
• enzymes (longidaza with an ovarian cyst is a widely used drug in this group);
• antibiotics that are prescribed in the presence of pathogenic microorganisms (the most effective in the complicated course of the disease is Ceftriaxone due to the parenteral route of administration and rapid absorption by the body);

The treatment in which pills are prescribed for cysts refers to conservative methods. At the same time, the peculiarity of the drug effect on the female body is that it is prescribed for a certain period of time. Usually it is no more than 4 menstrual cycles. It does not matter which of the drugs is prescribed: Janine, Qlaira, Danazol or Yarina.

In the absence of the effect of the therapy, surgical intervention is prescribed. This is due to the fact that cysts are capable of degenerating a malignant formation.

The main goal of the doctor is to prevent the development of complications and maintain the functioning of the appendages.

The diagnosis of the presence of an ovarian cyst is not a sentence. Timely diagnosis and the correct treatment regimen will allow you to cope with the disease before the development of negative consequences. The decision on how to treat the disease with medication is made by the doctor based on data from various analyzes. In this case, a woman, as a rule, is given the opportunity to choose a drug in the price range that is most attractive to her. After all, the treatment of any disease is a significant material cost.

A follicular cyst is a formation that arises from a follicle that has not passed ovulation. Pathology is detected mainly in adolescent girls with irregular menstrual cycles and young women, less often in the late reproductive period. Does not occur during menopause. It has a benign course. Not malignant, prone to spontaneous regression. In rare cases, it requires surgical treatment - removal of the formation or the entire ovary.

To diagnose a follicular cyst, commonly available methods are used - bimanual examination, ultrasound, in special cases - laparoscopy. After determining the pathology, a treatment regimen is selected taking into account the size of the formation and the age of the woman. With the development of complications, emergency surgery is indicated.

Let's take a closer look at where the follicular cyst comes from and what to do when it is detected.

Causes of the development of pathology: basic theories and risk factors

In the century before last, ovarian follicular cysts were known as watersickness. Nobody knew the exact cause of the pathology, but doctors assumed the influence of lifestyle on the occurrence of such formations. It has been known that ovarian disease occurs in women over 35-40 years of age who do not have children. Pathology was often detected in nuns who devoted themselves to the service of God and renounced worldly affairs. The disease was considered incurable and put an end to the further fate of the woman.

At the beginning of the 20th century, a different theory of the origin of the disease appeared. Doctors of that time considered inflammatory diseases of the pelvic organs - the uterus and appendages - to be the main cause of the appearance of ovarian cysts. Today, this theory is not the main one, but deserves some attention from gynecologists.

In 1972, with the development of the theory of apoptosis (programmed cell death), they began to talk about the relationship between hormonal disorders and ovarian pathology. In those years, it was not only about a failure in the production of hormones, but also genetic breakdowns. It was believed that the tendency to develop the disease is inherited.

Today, the main reason for the formation of a follicular cyst is considered to be a hormonal failure, followed by anovulation. This theory does not explain all aspects of the development of the disease. Even in healthy women, ovulation does not occur every month, but not everyone develops cystic cavities.

The process of ovulation.

In addition to the version of hormonal failure, there are several other reasons why the follicle develops into a cyst:

• Sexually transmitted infections. Inflammatory processes in the appendages disrupt their work and contribute to anovulation. The follicle does not burst, and a cyst appears - a cavity filled with fluid;
• Natural hormonal changes. It is noted that pathology is detected during critical periods of development - during puberty and before the onset of menopause;
• Diseases of the endocrine system. Particular importance is attached to disorders of the thyroid gland and adrenal glands;
• Heredity. The exact mechanisms are not understood, but a breakdown in the genetic code is suspected;
• Taking medications that affect the functioning of the ovaries. Often, follicular cysts form before the IVF protocol (with ovulation stimulation);
• Postponed abortions and spontaneous miscarriages. There is an effect on the hormonal background of a woman, the formation of cavities in the ovaries on the left or right;
• Psycho-emotional overload, prolonged stress. It is assumed that at this moment the body's natural defenses are activated. While a woman is under stress, she should not reproduce offspring (there are no favorable conditions for bearing and giving birth to a child). The work of the ovaries is inhibited, ovulation does not happen, and a cyst grows in place of the follicle.

Symptoms of a hormonal imbalance that can lead to the development of ovarian follicular cysts

On a note

The influence of two more factors is considered: irregular sexual life and dissatisfaction with sexual relations. So far, no confirmation of this theory has been found.

Psychosomatics explains the formation of cystic cavities by focusing on one thought, and in particular on issues of relationships with men. According to experts, the development of the disease leads to the suppression of certain emotions, including those associated with sex and childbirth. As a preventive measure for the appearance of cysts, it is recommended to close certain stages of your life in time, competently live your own feelings and enjoy every day without looking back at the past.

How is a follicular cyst formed?

Normally, in a healthy woman who does not take hormonal drugs, follicles in the ovaries mature monthly throughout the entire reproductive period. Among all follicles, one dominant one stands out (less often two or more). It becomes the basis for the formation of the egg. The maturation of the follicles lasts 6 days, after which the capsule bursts and the egg is released from the ovary. This process is called ovulation and indicates that the woman's body is ready to conceive a child.

A mature egg lives in the abdominal cavity for up to 24 hours. If fertilization does not occur, it dies, and a corpus luteum forms in its place. The temporary gland begins to produce progesterone and starts the process of growth of the endometrium - the mucous layer of the uterus.

Physiological menstrual cycle.

If the follicle does not burst in due time, the egg remains inside. The formation continues to grow and fills with fluid. A cyst appears - a cavity surrounded by a thin capsule. The growth of formation is associated with the gradual leakage of blood serum, as well as with the continuous secretion of fluid by the cells of the granular epithelium.

Distinctive features of the follicular cyst:

• It is usually detected on one side, but can also be found on both ovaries;
• Reaches large sizes - up to 10 cm in diameter. The literature describes cases of the development of giant formations;
• It often forms on the right ovary - where ovulation occurs in 60-70% of cases.

The photo shows a schematic representation of a follicular cyst. Such a formation can be several times larger than the size of the ovary:

Symptoms of the disease

Small follicular cysts (up to 4-5 cm) may remain asymptomatic. They do not disturb the woman, do not change the menstrual cycle and are not accompanied by pain in the lower abdomen. Severe symptoms of the disease occur with the growth of the cyst (up to 5-6 cm or more).

There are three main signs of pathology:

Menstrual irregularities

Characteristics:

• Prolonged delay in menstruation. According to the reviews of women who have encountered such a pathology, menstruation is absent for 1.5-2 months. The delay is up to 30 days and is completely unpredictable - it is not known when the cycle will be restored. Failure of menstruation is associated with the predominant influence of estrogens against the background of a relative lack of progesterone;
• Increased volume and duration of menstrual flow. Against the background of cystic formation of the ovary, menstruation comes late, and their nature always changes;
• The appearance of pulling pain in the lower abdomen is associated with heavy menstruation and intense rejection of the mucous layer of the uterus;
• The appearance of acyclic bleeding. Insignificant spotting occurs between menstruation on the 12-18th day of the cycle. Blood smearing can last up to two weeks and turn into a full menstruation.

Violation of the menstrual cycle can serve as a symptom of the presence of cystic formation.

In menopause, such symptoms are not always taken into account. Entering menopause is accompanied by a change in the menstrual cycle. Menstruation becomes irregular, and it is not easy to distinguish the norm from the pathology during this period. At the age of 45-50 years, the main role in the diagnosis belongs to ultrasound.

Bleeding from the genital tract

The absence of menstruation for 1.5-2 months leads to an increase in the endometrium and uterine bleeding. The discharge becomes copious, with clots. There is a deterioration in the general condition, there is a pronounced weakness. Possible nausea and vomiting, chills. With the development of uterine bleeding, immediate hospitalization in a gynecological hospital is indicated.

It's important to know

Follicular cyst is one of the leading causes of bleeding in adolescence. Hormonally active education can also lead to premature puberty.

Uterine bleeding is an emergency and requires immediate treatment.

Lower abdominal pain

If the follicle has grown into a cyst, it makes itself felt by the appearance of pulling and aching pain in the lower abdomen. It is important to understand that it is not the education itself that hurts. Unpleasant sensations occur when the ovarian capsule is stretched, nerves are compressed, blood vessels are clamped, and tissue ischemia develops. The pain is localized on the right or left in the lower abdomen, depending on the side of the lesion. There is irradiation to the sacrum and coccyx, lumbar region, buttocks and thigh. Symptoms occur in the second phase of the cycle (12-14 days after menstruation).

It's important to know

The appearance of a sharp pain in the projection of the right or left ovary indicates the development of complications. You need to call an ambulance.

Complications arising from the long course of the disease

Conditions requiring emergency medical attention:

Torsion of the leg

A dangerous complication occurs when certain factors are influenced:

• Physical activity, including weight lifting;
• Sports activities, including jumps and turns;
• A sharp change in body position;
• Intimate intimacy.

Quite often, torsion of the cystic leg occurs during pregnancy. The complication develops in the II and III trimester and is associated with displacement of the ovary by the growing uterus.

The symptomatology of the complication depends on the degree of torsion of the leg. With partial torsion, symptoms increase gradually over several hours. The appearance of pain in the lower abdomen, which increases with time, is noted. With complete torsion, the pain becomes sharp, cramping, unbearable from the first minutes.

Schematic representation of torsion of the pedicle of an ovarian cyst.

Other symptoms:

• Nausea and vomiting;
• Constipation, rarely diarrhea;
• urinary retention;
• Tension of the muscles of the anterior abdominal wall;
• Increased heart rate and respiration;
• Increase in body temperature;
• Pale skin and mucous membranes;
• Loss of consciousness.

Torsion of the leg threatens the development of ovarian necrosis. With timely assistance, you can save the organ by unwinding the cyst and restoring blood flow. Without treatment, necrosis passes to neighboring tissues, leading to the development of peritonitis and sepsis.

Capsule rupture

The main cause of cyst rupture is called violent sexual intercourse, as well as physical activity. If the cyst bursts, its contents come out into the abdominal cavity. Symptoms of an acute abdomen:

• Cramping pain on the side of the lesion - on the right or left. The pain can be acute, unbearable, leading to loss of consciousness;
• Tension of the abdominal muscles;
• Nausea, vomiting;
• Paleness or cyanosis (blue) of the skin;
• A sharp drop in blood pressure;
• Bloody discharge from the vagina.

This is what a ruptured ovarian cyst looks like.

Rupture of a cyst is a dangerous condition leading to severe blood loss and shock. Perhaps the development of adhesions and infertility. The consequences can be unpredictable. At the slightest suspicion of a rupture of the formation, emergency hospitalization in the gynecological department and surgical treatment are indicated.

infection

Rarely, a complication that occurs in women after an abortion and against the background of pelvic inflammatory processes. Accompanied by the following symptoms:

• Drawing or cramping pain in the lower abdomen;
• An increase in body temperature to 37.5 degrees and above;
• Signs of general intoxication: chills, weakness, headache.

Without treatment, suppuration of the cyst threatens the development of peritonitis - inflammation of the peritoneum. The process can move to neighboring organs. The spread of pathogenic microorganisms with blood flow (sepsis) is not excluded. Treatment is only surgical - removal of the cyst (often along with the ovary).

Is pregnancy possible with a follicular ovarian cyst?

A persistent ovarian cyst prevents the conception of a child. As long as there is a cavity in the appendages, new follicles do not mature. The egg does not develop and pregnancy does not occur. You can get pregnant only after spontaneous regression of the cyst or its surgical removal.

In rare cases, pregnancy occurs against the background of a follicular cyst. The maturation of the egg occurs in a healthy ovary, and the conception of a child proceeds without any features. Under the influence of hormonal changes, the cyst should disappear within 2-3 months. If this does not happen, the development of complications (torsion, rupture of the capsule) is possible.

A small follicular cyst does not interfere with the course of pregnancy and usually regresses spontaneously. Reaching a large size (from 10 cm), the formation can lead to compression of the pelvic organs and disruption of their function. In this situation, the cyst is removed. The operation is prescribed for a period of 16-20 weeks, when the likelihood of miscarriage and other complications is minimal.

The photo shows a follicular cyst and a pregnancy of 6-7 weeks:

The occurrence of a follicular cyst against the background of a developing pregnancy is nonsense. During gestation, there is an increased synthesis of progesterone and prolactin. The production of these hormones prevents the maturation of the follicles, and the cyst cannot form. If such a pathology is detected during pregnancy, you need to undergo a second examination. In most cases, we are talking about a diagnostic error, and a dangerous ovarian tumor can be hidden under the guise of a cyst.

Diagnostic search

The following methods are used to detect pathology:

1. Gynecological examination. On palpation, the cyst is defined as a unilateral, mobile, painless, elastic formation measuring 4-10 cm. A cavity of a smaller diameter is not always felt during bimanual examination;
2. Laboratory research. CA-125 - a marker of malignant neoplasms of the ovary - remains within the normal range;
3. ultrasound. On ultrasound, the follicular formation is seen as a rounded cavity with a thin capsule. The formation is homogeneous, the content is echo-negative;
4. Doppler. When color mapping pathological blood flow around the formation is not detected.

The above methods are sufficient to conduct a differential diagnosis and distinguish a follicular cyst from another pathology. In doubtful cases, laparoscopy is performed. Sometimes the final diagnosis can be made only after a histological examination of the removed tumor.

The photo below shows a 3D image of a follicular ovarian cyst:

Follicular cyst and PCOS: is there a link?

It is important to distinguish between three concepts:

• A follicular cyst is a cavity filled with fluid. This is a single ovary. May be multi-chamber, but more often does not have a cellular structure;
• Multifollicular ovaries - the physiological state of the appendages, detected by ultrasound in the first phase of the cycle. It is characterized by the appearance of a large number of follicles in the form of echo-negative inclusions up to 10 mm in size;
• Polycystic ovary syndrome (PCOS) is a severe endocrine disease accompanied by dysfunction of the appendages and leading to infertility. Ultrasound shows the appearance of a large number of follicles ranging in size from 8-10 cm and an increase in the ovary.

Patients of gynecologists often confuse these concepts, but there is a difference between them, and it is very significant. Multifollicular ovaries is not a disease, but only an ultrasound symptom. It is not related to the follicular cyst, but may indirectly indicate polycystic ovaries. Differences on ultrasound are not always clearly visible, and high-quality equipment is needed to make a correct diagnosis. Finally, PCOS is determined only after an assessment of the hormonal background.

Distinctive features are presented in the table:

On a note

According to ICD-10, the follicular cyst belongs to class N83.0. PCOS goes under the code E28.2.

Difference between normal and polycystic ovary.

Tactics in detecting pathology and methods of treatment

The follicular ovarian cyst refers to retention formations. It is characterized by a benign course and tends to spontaneously regress. Education takes place after the next menstruation or during it. Less commonly, the cyst persists for up to 2-3 months, after which it resolves without a trace.

Observational tactics are indicated within 3 months after the detection of the disease. No medications are prescribed in this case. A woman is advised to monitor her feelings and, if the condition worsens, immediately consult a doctor. To prevent the cyst from rupturing and twisting, it is important to follow simple rules:

• Do not have sex (or at least exclude violent intimacy, be careful during intercourse);
• Avoid heat treatments. You can not visit the bath, sauna, go to the solarium, take a hot bath or shower;
• It is contraindicated to lift weights of more than 3 kg and play sports with serious stress on the body;
• It is recommended to avoid sharp turns of the body, jumps.

Not all gynecologists adhere to expectant management with a follicular ovarian cyst. There are recommendations according to which all women with this pathology are shown hormonal treatment. Combined oral contraceptives are prescribed for a period of 3 months. Progesterone preparations may be used to induce menstruation.

Hormone therapy is justified in the presence of complaints of pain in the lower abdomen, bleeding, or significant menstrual irregularities. With an asymptomatic course of the disease, taking hormones does not make sense.

The regulation of the hormonal background with the help of COC allows you to achieve rapid regression of the follicular cyst.

To accelerate the resorption of the cyst, non-drug methods of exposure are used:

• Oxygen therapy with modulation of brain rhythms;
• Electrophoresis and magnetophoresis;
• Sonophoresis.

Physiotherapy methods help to normalize blood flow in the ovaries, stabilize the hormonal background and remove the cyst without the use of hormones.

If the liquid follicular cyst itself has not resolved within 3 months of observation, its removal is indicated.

Methods of surgical treatment:

• Excision of the cyst. The best option for education on a thin leg. Healthy ovarian tissues are practically not affected, the function of the organ is not disturbed;
• Resection of the ovary - removal of the cyst along with part of the organ. It is possible when a formation is detected on a wide base and intact intact tissues;
• Ovariectomy is the removal of an ovary. It is carried out if there is no healthy tissue left.

Schematic representation of the stages of removal of an ovarian cyst laparoscopically.

Before operating on an ovarian cyst, it is necessary to prepare a woman for a serious intervention. General clinical examinations are carried out, concomitant pathology is detected, and the type of anesthesia is determined. The surgery is performed as planned. Emergency intervention is justified in the development of complications.

In modern gynecological hospitals, priority is given to laparoscopic methods. After the operation, the patient recovers quickly. With a preserved ovary, reproductive function is not disturbed. If one ovary has been removed, then the other takes over its task, and in the future there are also no problems when conceiving a child.

According to women, laparoscopic surgery is well tolerated and usually does not cause complications. In the postoperative period, it is recommended to observe sexual and physical rest, avoid stress and overexertion. You can plan pregnancy 3-6 months after treatment.

The prognosis for a follicular cyst is favorable. In 80% of cases, the formation spontaneously regresses within three months without the use of medications. Relapse of the disease is rare and is often associated with hormonal disorders.

Prevention of ovarian cysts has not been developed. Gynecologists advise on time to treat all emerging diseases of the reproductive sphere, avoid abortions and take hormonal drugs only if indicated. For timely detection of pathology, it is recommended to undergo an annual examination by a doctor. Often, a cyst becomes an accidental finding during a physical examination.

An interesting video about the follicular ovarian cyst

Reasons for the development of functional cysts and their treatment

A follicular ovarian cyst is a cavity formation filled with fluid. Pathology is detected mainly in young women, often found in adolescence. It is accompanied by violations of the menstrual cycle in the form of a delay in menstruation and acyclic bleeding. With active growth, it can cause abdominal pain and other associated symptoms.

Treatment of a follicular ovarian cyst is predominantly conservative. Expectant tactics are allowed. The appointment of hormones that contribute to the regression of the focus is practiced. Other drugs are used when indicated and only as symptomatic agents. Surgical treatment is justified with the rapid growth of the neoplasm and the absence of the effect of conservative therapy.

Consider the various methods of treating a follicular ovarian cyst and see if all of them are worth putting into practice.

Is it necessary to treat a follicular ovarian cyst?

With regard to the follicular ovarian cyst, controversy among practicing gynecologists does not cease. A cavity filled with serous fluid is formed in the first phase of the cycle under the influence of estrogen. It is formed from a follicle that has not managed to go through all the stages of its development and reach ovulation. The altered follicle does not burst and does not come out of the ovary, ovulation does not occur, fertilization does not occur. The follicle continues to grow, turning into a cavity formation - a cyst.

Diagnosis of pathology is carried out using ultrasound. There are several criteria for the disease:

• Hypoechoic thin-walled formation without foreign inclusions;
• The size of the focus is more than 3 cm;
• Absence of pathological blood flow according to dopplerometry;
• Absence of the corpus luteum in the second phase of the cycle.

The photo below shows what a follicular cyst looks like on ultrasound:

Follicular formations can grow up to 10-12 cm. With the growth of the focus, the wall of the cavity atrophies, and the epithelial lining is lost. This cyst is not sensitive to hormones and does not respond to drug therapy. To get rid of such a pathology is possible only by surgery.

The follicular cyst of the left and right ovaries is considered a functional formation. It may resolve spontaneously within a few months. Spontaneous regression of the focus occurs more often in adolescent girls (12-18 years old). In late reproductive age and approaching menopause, pathology usually requires treatment.

Scheme of therapy for follicular ovarian cyst:

1. Observation for 3 months and / or conservative treatment to accelerate the regression of the focus;
2. Surgical treatment in the absence of the effect of conservative therapy.

The method of treatment is chosen after a complete examination of the patient.

Refusal of treatment: dangerous consequences and possible complications

A follicular ovarian cyst is considered an absolutely benign formation. It is not able to turn into cancer for the reason that in its structure there are no cells capable of malignant degeneration. Even with a large value, such a formation is not dangerous in terms of possible malignancy.

It's important to know

Under the guise of a relatively harmless follicular cyst, another pathology may be hiding. It is necessary to unambiguously make sure of the benign nature of the formation before deciding on one or another treatment option.

Cancer is not the only danger that awaits a woman. A growing ovarian cyst can lead to the development of such conditions:

• Menstrual disorders. There is a delay in menstruation up to 1 month. There may be acyclic bleeding. After a long delay, menstruation comes profuse and can turn into uterine bleeding. Such a reaction is associated with the active growth of the endometrium against the background of hormonal imbalance;

A follicular cyst can provoke a failure of the menstrual cycle - up to uterine bleeding.

• Pain syndrome. Discomfort and pain in the lower abdomen are usually localized on one side, aggravated by movement and intimacy;
• Dysfunction of the pelvic organs. Symptoms of compression of the bladder and intestines are observed with large neoplasms (from 8-10 cm). There is frequent urination, stool retention.

An untreated ovarian cyst can lead to the development of complications:

• Suppuration of the hearth. Accompanied by fever, pain in the lower abdomen, general weakness;
• Rupture of the neoplasm capsule. Leads to hemorrhage in the ovary, bleeding from the genital tract and the appearance of severe pain in the lower abdomen;
• Torsion of the cyst leg. It is characterized by the appearance of sharp pain, tension in the abdominal muscles.

With the development of complications, emergency surgical intervention is performed.

Expectant management in functional ovarian masses

Observation of the ovarian cyst is carried out for 3 months. During this period it is recommended:

• Refuse to play sports that involve jumping, sharp turns, intense movements, stress on the muscles of the abdomen and pelvis;
• Do not lift weights (more than 3 kg);
• Avoid heat treatments. Do not visit the sauna, bath, solarium, do not sunbathe on the beach, do not take a hot bath or shower;
• Limit the impact of stressful situations.

While monitoring the dynamics of the follicular cyst, it is necessary to avoid intense physical exertion, stressful situations, thermal procedures are not recommended.

Particular attention in non-drug therapy of ovarian cysts is given to proper nutrition. The diet involves the rejection of dishes that can potentially increase the concentration of estrogen in the blood. Under the ban are foods rich in trans fats, methylxanthines, preservatives. It is recommended to give up sweet pastries, fatty and fried foods, alcohol. Allowed the use of fresh vegetables and fruits rich in fiber and vitamins. You can eat lean meat and fish. Dairy products will benefit.

On a note

It is not known for certain whether diet affects the growth of ovarian cysts, however, the expected benefit allows this technique to be used in terms of non-drug treatment of pathology. Even if education does not go away, proper nutrition will help boost immunity and improve a woman’s health.

The focus in the ovary can resolve after the next menstruation, but more often this happens within 1-2 months. After 3 months, a control ultrasound examination is scheduled. If the cyst persists or continues to grow, it is removed.

3 months after the discovery of a follicular cyst, a woman needs to undergo a follow-up ultrasound examination.

Conservative treatment of follicular ovarian cyst

Indications for prescribing drug therapy:

• Newly diagnosed follicular ovarian cyst;
• Definitely benign nature of the neoplasm;
• Absence of complications that threaten health and life;
• Planning for pregnancy.

There is no consensus regarding the size of the focus. Large formations do not respond well to hormone therapy. If a cyst is detected with a size of 8-12 cm, the doctor can immediately suggest surgical intervention.

In the treatment of ovarian neoplasms, priority is given to hormonal drugs. Non-hormonal agents are used only as an auxiliary measure and serve to eliminate the symptoms of the disease.

hormone therapy

Hormonal preparations are used in a short course for 3 months. The goal of treatment is to achieve regression of the follicular cyst and eliminate the associated unpleasant symptoms. Since the main cause of the pathology is hormonal imbalance, means are selected that can stabilize the situation in the shortest possible time.

Hormone therapy in the treatment of follicular cysts often gives a positive result, but the choice of treatment is always individual.

The principle of action of hormonal drugs:

• Reduce the production of estrogen and eliminate excess hormone in the blood;
• Prevent the production of endogenous progesterone by a feedback mechanism;
• Normalize the hormonal background and restore the menstrual cycle.

Some drugs have a contraceptive effect.

Hormonal drugs used in the treatment of ovarian follicular cysts:

• Combined oral contraceptives;
• Preparations based on progesterone.

Combined oral contraceptives

Combined oral contraceptives (COCs) are the method of choice for young women, including those planning a pregnancy. Against the background of taking birth control pills, stabilization of the hormonal background is observed. The ovarian cyst resolves and completely disappears. The pain in the lower abdomen goes away, the menstrual cycle is restored. After discontinuation of the drug, ovarian activity increases, and ovulation starts. After a course of COCs, the likelihood of conceiving a child increases.

For the treatment of a follicular ovarian cyst, drugs with a strong progestogen (levonorgesterel, gestodene, desogesterel), as well as drugs based on new generation progestins (drospirenone) are used. The estrogen component in the COC ensures a stable cycle and prevents premature rejection of the endometrium.

Examples of drugs:

• Based on drospirenone: Jess, Yarina, Midiana, Modell pro, Angelik;

Combined oral preparations based on drospirenone.

• Based on gestodene: Femoden, Logest;
• Based on desogestrel: Regulon, Marvelon;
• Based on levonorgestrel: Microgynon, Tri-regol, Minisiston;
• Based on dienogest: Jeanine, Silhouette;
• Based on cyproterone acetate: Diane-35.

The appointment of COCs containing natural estrogens (Klaira) is practiced.

The treatment regimen is standard and depends on the content of tablets in the package: 21 + 7 or 24 + 4. In the first case, a break is made for 7 days in taking the drug, in the second case, you need to take all the tablets daily (including empty ones). During a break or taking empty pills, menstrual-like bleeding occurs - rejection of the endometrium.

The course of COC treatment lasts 3 months, after which an ultrasound is done. Further tactics will depend on the results obtained.

In the treatment of follicular ovarian cysts, the use of vaginal combined contraceptives, such as the NovaRing ring, is practiced. The ring is inserted into the vagina for 21 days, where it secretes the required dose of the hormone daily. The systemic effect of the drug is minimal, the dose is the smallest possible. The use of NuvaRing allows you to reduce the frequency of unwanted side effects and complications.

NovaRing ring (combined vaginal contraceptive) containing etonogestrel and ethinyl estradiol.

Progesterone preparations

Progestins are used in gynecology to suppress the production of one's own progesterone. Getting into the blood of the drug leads to a decrease in the synthesis of hypothalamic hormones (FSH and LH), which helps to reduce the concentration of progesterone. At the same time, a drop in estradiol is observed. There is a regression of the ovarian cyst, sensitive to the action of hormones.

Examples of drugs:

• Means based on natural progesterone: Utrozhestan;
• Preparations based on a synthetic analogue of progesterone: Duphaston, Norkolut, Byzanne, etc.

Other gestagens with a pronounced androgenic effect are not used in the treatment of functional ovarian cysts.

Progesterone preparations should be taken from the 5th to the 25th day of the cycle or continuously. The course of therapy is 3 months, after which a control ultrasound is performed.

Progesterone preparations used in the treatment of ovarian follicular cysts. The course of therapy is 3 months.

On a note

Progesterone preparations are more commonly used to treat premenopausal ovarian cysts.

Hormonal agents are not always well tolerated by patients. Against the background of their use, dyspeptic symptoms, headaches, decreased libido and mood are observed. The risk of developing thrombosis increases. For this reason, many women refuse hormones, preferring other means. It is important to remember that only hormonal drugs affect the cause of the disease and can lead to regression of the cyst. Other means eliminate the symptoms, but do not cure.

Non-hormonal therapy

In the treatment of ovarian pathology, the following agents are used:

• Anti-inflammatory drugs. They are prescribed for pelvic pain that occurs with the growth of the focus. They are used in a short course - up to 10 days. Used in the form of tablets and suppositories (paracetamol, ibuprofen, indomethacin, nimesulide, ketorolac, ichthyol);
• Sedatives. Reduce pain, normalize mood, eliminate anxiety. Preparations based on natural herbs are used for a course of 2-4 weeks;
• Vitamins. For the benefit of an ovarian cyst, vitamin E and C will be taken. You can drink multivitamin complexes. Women planning a pregnancy after getting rid of an ovarian cyst should start taking folic acid;
• Phytopreparations (Cyclodinone, Mastodinone, Time factor). Contribute to the normalization of hormonal levels, improve well-being. Used as biologically active additives.

Phytopreparations that help stabilize the hormonal background. They are used as concomitant agents in the treatment of follicular cysts.

Non-hormonal drugs are prescribed together with hormones for 3 months. At the end of therapy, ultrasound is mandatory.

Physiotherapy for ovarian neoplasms

Physiotherapy is prescribed against the background of drug therapy. The following methods are applied:

• Ultrasound - exposure to the focus with high frequency waves;
• Electrophoresis - the introduction of drugs and vitamins using electric current;
• Magnetotherapy - the influence of magnetic waves on the pathological process.

Recommended 5-10 sessions daily or every other day. You can repeat the course after a break. Physiotherapy is also prescribed after the removal of an ovarian cyst. The impact of various waves and active substances contributes to the restoration of tissues and prevents the development of the adhesive process.

Alternative medicine methods

Proponents of alternative medicine offer the following treatment options:

• Herbal therapy. Herbal preparations based on the upland uterus, red brush, yarrow, celandine, St. John's wort and other herbs have a positive effect on the hormonal background and contribute to the restoration of the woman's reproductive system. Phytotherapy also strengthens the immune system and increases vitality;

Herbs in the treatment of follicular ovarian cysts are used only as an aid.

• Hirudotherapy. The introduction of leeches into the vagina improves blood flow in the pelvic organs and contributes to their normal functioning, but can lead to the growth of neoplasms;
• Homeopathic remedies can be used as a symptomatic remedy, but their effectiveness has not been proven. In traditional medicine, such medicines are prescribed extremely rarely.

It's important to know

Folk remedies and methods of alternative medicine are used only as an additional measure in combination with other doctor's prescriptions. No herbal preparations, leeches, needles and other procedures can remove the tumor-like formation of the ovary. Refusal of traditional treatment in favor of alternative methods of therapy threatens the progression of the disease and the development of complications.

Surgery

Indications for operation:

• There is no effect from the conservative therapy after 3 months (under the control ultrasound data);
• The appearance of complications dangerous to the health and life of a woman;
• Difficulties in diagnosis when it is impossible to unambiguously identify a follicular cyst (including suspicion of malignancy).

The indication for surgical treatment of ovarian cysts is the ineffectiveness of drug therapy.

In a planned manner, the operation is carried out after examination and preparation. With the development of complications, surgical intervention will be urgent.

Treatment options:

• Organ-preserving operations: cyst exfoliation or ovarian resection. Performed in the presence of functional ovarian tissue;
• Radical surgery to remove the ovary. It is indicated if the cyst has completely replaced the healthy tissue of the organ, and only the pathological focus cannot be removed.

The choice of treatment method largely depends on the age of the woman. In the reproductive period, priority is given to organ-preserving operations. In postmenopause, it is not advisable to leave the ovaries, and they are removed.

The gold standard for surgical treatment of ovarian cysts is laparoscopic surgery. Recovery after minimally invasive intervention is much faster than after laparotomy. There is no need to be afraid of endoscopic surgery. It is not done blindly. The doctor monitors all his manipulations on the screen, getting a good overview of the pelvic organs. An experienced surgeon can completely remove the focus using a minimally invasive technique, while preserving healthy tissue.

On a note

If an ovarian cyst is detected during pregnancy, surgical treatment is carried out only with the development of complications. Medications are not used. Monitoring of the development of the cyst and the condition of the fetus is shown.

Surgical intervention allows you to quickly and reliably get rid of the follicular ovarian cyst, however, any operation threatens with the development of complications:

• Decreased ovarian reserve in case of damage to healthy ovarian tissues;
• The development of adhesions (the risk is high with laparotomy);
• Blood loss and development of anemia as a result of intraoperative bleeding;
• Inflammatory processes in the pelvic organs against the background of tissue infection.

• Compliance with the rules of personal hygiene, including in relation to postoperative sutures;
• Taking antibacterial and anti-inflammatory drugs;
• Taking enzyme preparations (Longidaza) for the prevention of adhesive disease;

After surgical treatment of an ovarian cyst, the patient is recommended to use Longidaza to prevent adhesive processes in the abdominal cavity.

• Compliance with a postoperative diet in order to normalize bowel function;
• Passing control examinations at the gynecologist (+ ultrasound) on time: 1, 3 and 6 months after the operation;
• Gradual return to the usual rhythm of life. In the first month after the operation, it is recommended to observe sexual and physical rest.

Disease prevention

Follicular formation can recur if the factors contributing to its appearance have not been eliminated. For the prevention of pathology, it is recommended:

• Observe intimate hygiene and protect yourself from casual sexual intercourse;
• Timely treat inflammatory diseases of the genital organs;
• Refuse to have an abortion;
• Take hormonal drugs only as prescribed by a doctor and under his control;
• Avoid stressful situations.

For the timely detection of ovarian cysts, you need to visit a doctor at least 1 time per year. The sooner a problem is detected, the easier it will be to cope with its consequences and maintain health.

What is important to know about the treatment of ovarian follicular cysts

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