Two follicular cysts. One of the most common problems in conception is the ovarian follicular cyst. Let's try to understand how to achieve pregnancy. Formation of a functional ovarian cyst

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

Content

If you have been diagnosed with ovarian follicular cystosis, this is not a sentence. Education is very common in women, it cannot go into a malignant tumor and often does not even harm health. However, this problem needs to be observed and treated, read more about it below.

What is a follicular cyst

A follicular cyst is a benign tumor that forms inside the ovary. It is formed from a follicle that did not ovulate during the last menstrual cycle. It occurs mainly in girls, women of reproductive age - from 12 to 50 years old, less often - during menopause or pathologically, from birth. Inside the neoplasm is a smooth single-chamber cavity filled with estrogen-saturated fluid, outside its dimensions range from 2 to 10 cm.

Follicular ovarian cyst - causes

During menstruation, the follicle should burst, releasing the egg out. If the rupture does not occur, the egg remains inside, dies over time, and the follicle increases, forming a cyst. Often this is due to hormonal disruptions, but it happens that more serious problems are to blame. There are such causes of the occurrence of a follicular ovarian cyst:

Violation of the hormonal background in the body.

Overvoltage of a physical or mental nature.

Falls, negative impact of external factors.

Ovarian dysfunction.

1. Sexual infections, inflammation.

Follicular cyst and pregnancy

Now the presence of cystic formation during pregnancy is not uncommon, often it does not threaten the course of the term and resolves itself, or undergoes laparoscopic removal at 17-18 months. If the tumor does not disappear for 2 or more months before conception, then it becomes the cause of temporary infertility, but if ovulation occurs naturally in the second, healthy ovary, fertilization can occur.

After the conception itself, the formation occurs extremely rarely, the follicular cyst and pregnancy are incompatible, because the corpus luteum, which becomes a cyst, at this time performs a different function and cannot be transformed. Therefore, if during pregnancy you were diagnosed with cystosis, most likely an error occurred, and it is worth studying the neoplasm in more detail.

Follicular ovarian cyst - symptoms

Formations of a small size, about 4 cm, are asymptomatic - they are discovered by chance during examination or ultrasound. Large cysts are more painful, can cause discomfort and provoke dangers to the female reproductive system and fertility. If any signs occur, you should immediately contact a gynecologist and understand what caused them. What symptoms of a follicular ovarian cyst can you find in yourself:

lack of menstruation, their delay;

bleeding between periods, after intercourse;

pain, the appearance of a feeling of heaviness, pressure in the lower abdomen, an increase in blood pressure;

increased pain in the second phase of the menstrual cycle (14 days after the end of the discharge) during physical activity, sexual intercourse, sudden movements.

low or high body temperature.

With constant physical activity or pregnancy, rupture of the follicular cyst, torsion of the leg or ovarian apoplexy may occur: these cases may be accompanied by internal abdominal bleeding and the subsequent inflammatory process - peritonitis. Signs of complications - a sharp pain in the lower abdomen and groin, dizziness, nausea and vomiting, weakness, tachycardia, noticeable pallor of the skin. With such symptoms, you should immediately seek help from a doctor, as the most serious consequences, including death, are possible.

Follicular cyst of the left ovary

The reasons for its formation are very different: early or late menopause, in girls - the untimely onset of puberty, a reaction to an injury, a violation of the development of embryonic tissues. The follicular cyst of the left ovary causes a woman to feel aching and pulling pain in the lower abdomen on the left side. In general, the main reason for the disease is a sharp hormonal surge in the body.

Follicular cyst of the right ovary

it is believed that due to the fact that the right ovary is directly connected by an artery to the main aorta, it is more active and more often produces dominant follicles, which often become a cyst. The follicular cyst of the right ovary is felt by heaviness, pain on the right side, occurs as often as on the left side. But localization is not connected with anything specifically, formations appear in response to a nervous surge in the cerebral cortex, psycho-emotional disturbance, prolonged stress, can be located on either side.

Diagnostics of the follicular cyst

The formation of small sizes is often detected by chance, during a routine examination by a doctor, or disappears without a trace within 2-3 menstrual cycles. If the patient came with specific complaints, she has an anovulatory cycle, perhaps she is worried about a large cyst, which needs intensive treatment and therapy. To determine the causes of the neoplasm, it may be necessary to take blood tests for hormones - estrogen, progesterone, pituitary hormones LH and FSH. To diagnose a follicular cyst, the following methods are used:

palpation of the abdominal cavity;

vaginal or recto-abdominal examination;

Ultrasound of the pelvic organs;

microbiological examination of a smear from the vagina.

Follicular ovarian cyst - treatment

How to treat a follicular ovarian cyst and what difficulties can there be? Modern medical equipment allows you to get rid of the problem simply if it is detected in a timely manner and proceeds without complications. The methods differ depending on the degree of the disease, the size of the formation, the condition of the patient. Treatment of a follicular ovarian cyst is as follows:

A patient with a small cyst is kept under observation, regularly examined by ultrasound. At the same time, drugs are prescribed to restore hormonal balance, stop inflammation, if they are found; in some cases, vitamin therapy and sessions with a physiotherapist. If such a tumor has not resolved itself, but has increased, then proceed to the next stage of treatment.

A large cystic ovarian follicle (about 8 cm or more) or one that has existed for more than 3 months must be surgically removed. In some cases, it can touch the fallopian tube, so intervention is necessary. There are two types of operations - laparotomy and laparoscopy, a more suitable option is prescribed by the surgeon, in consultation with the patient. In this case, only the cyst is removed, or part of the ovarian tissue along with it, or the entire affected ovary, if the risk of complications is too high.

Follicular ovarian cyst - treatment with folk remedies

How to cure a follicular ovarian cyst on your own, without the intervention of surgeons and gynecologists? Traditional medicine is unlikely to cope with large formations, but it can relieve symptoms with a small cyst. Methods of treatment of follicular ovarian cyst folk remedies:

1. Phytotherapy - collections of medicinal plants can be useful for any diseases and cystosis is no exception. Such treatment lasts at least a month, but affects the body more gently than hormonal drugs. Such sets as chamomile, coltsfoot, sweet clover help; celandine (separately); peony, burdock, golden mustache.
2. Herb Upland uterus - its use in gynecology is wide, it helps with conception and the treatment of hormonal imbalances.
3. Celandine and propolis juice tincture: mix 75 ml of propolis tincture with a glass of celandine juice, take 1 teaspoon before meals for a month.
4. Viburnum and honey: mix freshly squeezed viburnum juice with liquid flower honey, take 1 teaspoon in the morning and evening.
5. Dandelion root and fresh burdock juice.
6. Homeopathic remedies can also be effective, which, due to their anti-scientific properties, are classified as folk remedies.

Prevention of follicular ovarian cyst

Women who have already got rid of the problem often need to undergo a course of therapy to prevent the recurrence of the disease. After surgery, a regular check-up with a doctor is required. For self-prevention of a follicular ovarian cyst, you can use the following means:

• Taking the drug Duphaston for hormonal disorders is carried out on the recommendation of a doctor.
• Take vitamins, eat fresh seasonal fruits and vegetables.
• Stay calm in stressful situations, practice yoga, meditation.
• Exercise regularly, stay active.
• Take baths with water temperature not higher than 39 degrees.
• Do not stay in the open sun for a long time, do not sunbathe and do not visit the solarium.

A follicular ovarian cyst is a cavity formed at the site of a follicle and filled with fluid. Similar cysts are diagnosed with incomplete ovulation and in women with active menstrual function. As a rule, this corresponds to 20-35 years. ICD code N83.0.

According to statistics, 83% of all identified cysts are follicular. This type of cystic formations is considered the most harmless and belongs to.

The follicular cyst is considered benign, it consists of a single cavity containing a fluid with a high concentration of estrogens. The size of the formation can be quite large, reaching 10 cm.

It can be located on both ovaries, but unilateral cysts are more common. Usually, there are no signs of pathology, and the woman does not make any complaints, therefore, a cyst is detected during examination by a gynecologist or on a planned ultrasound.

Often, luteal cysts (cysts of the corpus luteum) are confused with follicular. These are completely different, having different causes and consequences.

A situation that can lead to the absence of ovulation is a risk factor for the formation of a cyst. Very often, hormonal disruptions occur in a woman's body, which adversely affect the functioning of the ovaries and provoke the formation of cysts.

The most common causes of cyst formation include:

• Disrupted follicle formation process;
• The onset of menstruation in children under 11 years of age;
• Frequent abortions;
• Functional disorders of the endocrine system;
• The presence of obesity;
• Instability of menstruation with fluctuating hormones;
• Long-term use of hormones associated with IVF preparation or infertility treatment.

Stress plays a huge role in the formation of dysfunction of the endocrine glands. For the proper functioning of the ovaries, the right commands must come from the brain structures. In severe stressful situations, failures occur in the process of transmitting commands. This is what can lead to the pathological functioning of the ovaries and the formation of not only benign, but also malignant tumors.

Hormonal drugs and follicular cyst

Often, women are interested in whether it is possible to use oral contraception and whether the drugs that are prescribed will provoke the formation of cysts. Hormonal agents help to suppress ovulation in order to prevent fertilization. Plus, they have a positive effect on hormonal levels.

There are a lot of them (duphaston, utrozhestan, novinet, etc.), so you should entrust the selection of medicine to the doctor. A competent specialist knows how to cure a follicular cyst as safely and quickly as possible. With self-selection of contraception, the risk of cyst formation in the future after discontinuation of the drug increases.

There are cases of detection of cysts in newborn girls, which is due to the influence of maternal estrogen and hCG during pregnancy and during labor.

The mechanism of formation of follicular cysts

The ovary is covered with a sufficiently strong outer shell, which actively protects it from negative external influences. In the cortical zone, located under this shell, there is a huge number of follicles of different maturity. Each follicle is covered with epithelial cells and filled with follicular fluid. The cavity of the follicle contains an egg, which matures simultaneously with it.

A mature follicle, also called a graafian vesicle, reaches 20 mm. Each month, only one follicle with one egg matures in the ovary. For fertilization to occur, a rupture of the follicle must occur, the field of which the egg will begin to move towards the uterus.

In place of the Graaffian vesicle, the corpus luteum is formed, which subsequently regresses before menstruation. If the follicle does not rupture, it increases in size, accumulating fluid, resulting in the formation of a cyst.

Symptoms of a follicular cyst

For each woman, the symptoms of a follicular cyst are different and depend both on the size of the formation and on the concomitant gynecological pathology. If there was a history of inflammation of the uterine appendages, endometriosis, fibroids or any other diseases, the woman will make much more complaints.

The main symptom is a delay in menstruation. As a rule, menstruation does not occur within 6-20 days, and sometimes more.

Signs of a follicular cyst include:

• Sufficiently intense pain in the groin, radiating to the lumbar region and lower limbs;
• Increased urination;
• Intestinal disorders (flatulence, loose stools, constipation);
• Discharge between periods, having a bloody character;
• Discomfort phenomena, more intense in the second phase of the cycle. It is especially painful to have sex, exercise, walk for a long time.

Often, women are interested in whether this cyst can resolve. With sizes of 4 cm or less, as a rule, it passes by itself after the next menstruation. The fact that the cyst is really gone can be confirmed by repeated ultrasound.

With a formation size of 8 cm or more, discomfort occurs in the lower abdomen. The follicular cyst of the right ovary causes pain at the bottom right, the follicular cyst of the left ovary on the left.

The symptomatology of cysts is non-specific enough to correctly diagnose and determine how to treat this pathology, it is necessary to consult an experienced doctor.

Signs of a ruptured cyst

When diagnosing a follicular ovarian cyst and the absence of drug treatment for this pathology, you need to know how dangerous this disease is and what to do if there are sharp unbearable pains in the lower abdomen.

If the cyst has burst, the following complications should be expected:

• Entry of liquid contents into the abdominal cavity;
• The development of hemorrhage of the ovary or its rupture.

Usually this unpleasant complication occurs between menstruation and corresponds to the period of ovulation.

Among the most common causes of rupture are chronic inflammation, hormonal imbalances, pathology of the coagulation system, excessive stress and sex.

Signs of a ruptured cystic lesion include:

• Unbearable pain in the lower abdomen in the projection zone of the cyst;
• Tension of the abdominal muscles;
• The appearance of cold sweat;
• The pain very quickly becomes spilled;
• The woman is sick, vomiting occurs;
• Falling blood pressure numbers;
• Fainting states.

In the hospital, the bleeding is initially stopped. Since the stomach hurts a lot, the patient is given painkillers.

Ruptures (apoplexy) of cysts can provoke:

• The appearance of anemia;
• The development of adhesions in the pelvis (suppositories with longidase are especially effective to prevent adhesions);
• The development of purulent peritonitis (body temperature is significantly increased).

Not only health depends on the timeliness of treatment, but also the ability to save the life of the patient.

Follicular cyst and pregnancy

If the pregnancy test showed a positive result, the woman is registered with a gynecologist. At the 12th week of pregnancy, a planned ultrasound is performed. When diagnosing a small follicular cyst, the decision is made to wait until the 18th week and perform laparoscopic removal of the formation. Previously, the operation is not indicated, as there is a high risk of abortion and negative effects on the fetus.

If a follicular cyst has formed on a thin stalk, removal is performed at any stage of pregnancy. This is due to the probable torsion of the cyst and its necrosis, which is dangerous not only for the child, but also for the woman.

Diagnostics of the follicular cyst

For the diagnosis of cysts use:

1. The use of a vaginal examination, in which a rounded tugoelastic formation with a smooth surface is determined in the anterolateral region from the uterus. Already at the first examination, the gynecologist may suspect the presence of a cyst. Additional studies are needed for a more detailed diagnosis.
2. Ultrasound of the uterus with appendages. On one of the ovaries, a single-chamber rounded cavity with anechoic contents is located.
3. laparoscopic examination. This is the most effective diagnostic method. During the operation, a puncture is taken to determine the type of cyst. A huge plus is the ability to remove the formation immediately during the operation.

The use of these methods makes it possible to quickly and accurately diagnose and resolve the issue of how to remove the cyst.

Follicular cyst treatment

A follicular cyst up to 5 cm in size is considered relatively small and most often resolves itself after 1-2 months, after which the woman continues to visit her gynecologist for about 3-4 months for strict observation.

If the formation does not resolve or its recurrence occurs, it is recommended to take combined oral contraception. Additionally, vitamins and anti-inflammatory drugs are prescribed. Most often, such treatment is prescribed for young women who have not given birth.

Physiotherapeutic methods of treatment are widely used, such as electrophoresis, magnets, ultraphonophoresis, and many others.

If after all the above measures there is no result, laparoscopy is recommended. This operation is planned and is less traumatic. Through incisions on the anterior abdominal wall, a special instrument equipped with a backlight and a video camera is introduced into the abdominal cavity. The surgeon monitors everything that he does during the operation through the monitor. The cyst is removed with minimal trauma to the ovary.

If the pedicle of the cyst is twisted and ovarian apoplexy develops, it is removed completely.

Folk remedies for the treatment of follicular cysts

Alternative treatment must be combined with medication. Before taking certain herbal preparations, you should consult a doctor, as there are often certain contraindications.

Recipes of folk remedies:

• Celandine is used to treat follicular cysts and any other formations. To do this, add honey to its fresh juice and mix with 50 ml of propolis infused with alcohol. The medicine is stored in a cool place. Drink 1 teaspoon 30 minutes before meals 3 times a day for about 3 months.
• Walnut partitions received good reviews, which can positively affect the female hormonal background. Add 2 tablespoons of partitions to 3 cups of boiling water and wait 30 minutes. Drink the resulting infusion in 1 day, dividing it into 4 parts.
• The use of viburnum and honey has also proven to be effective. Mix ½ cup of viburnum juice and honey and consume this mixture 30 minutes before meals three times for 2 months.

There are a lot of traditional medicine recipes, everyone can choose the most suitable one for themselves.

Complications of follicular cysts

More common complications include:

• Torsion of the cyst peduncle

Appears after sudden movements. The leg is twisted and the blood flow to the cyst is not supplied, which leads to its necrosis.

• The occurrence of a ruptured cyst

The content of the cyst penetrates into the abdominal cavity, irritates it and causes intoxication. Help must be provided immediately.

• Development of hemorrhage

This is due to traumatization of the vessels that feed the cyst.

Complicated formations are treated only surgically. Help must be provided as soon as possible.

Prevention of follicular cysts

Regular visits to the gynecologist will help prevent the development of a follicular cyst and its formidable complications. A significant role in the formation of such cysts is played by chronic gynecological inflammatory processes, as well as dishormonal pathology.

The prognosis of the disease is favorable, which means effective and rapid treatment of pathology. In case of recurrence of a cyst on the same or opposite ovary, it is necessary to carefully understand the causes of the disease.

Scheduled observation by a gynecologist will help prevent the disease and its unpleasant consequences.

Follicular ovarian cyst- a tumor-like, usually unilateral, benign formation that forms inside the ovary. It is one of the most common types of functional cysts that occur in response to various physiological processes in a normally functioning ovary. A follicular follicle is a follicle that has released a mature cell filled with fluid during ovulation.

Signs and symptoms of a follicular cyst

Follicular cysts up to 5 cm in diameter usually do not manifest clinically, but can cause an increase in the level of estrogens in the bloodstream, which leads to menstrual irregularities:

delayed menstruation - which is the main reason for a woman to see a doctor;

scanty bleeding between periods, passing in some cases into a "planned" menstruation;

discomfort during the second phase (14 days from the onset of menstruation) of the menstrual cycle.

There is a decrease in basal temperature - below 36.8 0 C. In girls under the age of 10, signs of false premature sexual development may be observed - a slight increase in the mammary glands, scanty sanious discharge from the genital tract.

The presence of a large cyst is also accompanied by the following symptoms:

feeling of "bursting", heaviness in the inguinal region (left or right);

dull or sharp pains that appear during the second phase of the menstrual cycle are aggravated during sexual intercourse, sudden movements, running and other types of physical activity.

increase in body temperature.

Patients complain of malaise, general weakness.

Causes of a follicular cyst

For a long time, the pathogenesis of "water sickness" of the ovaries was unknown. Modern medicine distinguishes two theories of its occurrence.

1. Changes occurring in the ovaries during inflammatory processes of the uterine appendages, caused by: - ​​oophoritis, salpingitis, adnexitis, caused by:

congestive hyperemia of the pelvic organs;

oophoritis, salpingitis, adnexitis;

abortions and other gynecological interventions;

acute infections.

2. Hormonal imbalance due to:

uncontrolled use of hormonal drugs, including contraceptives;

• dysfunction of the thyroid gland;

  hyperstimulation of ovulation, for example, in the treatment of infertility;

• Why is ovarian follicular cyst treatment necessary?

  If a follicular cyst rarely bothers a woman, and in most cases resolves by itself, then why treat it at all? With this approach, one could ask the question: why visit a gynecologist every 6 months if I feel fine? A follicular cyst, especially often recurrent, firstly, threatens to develop oncology in the future, secondly, it indicates a threat of miscarriage, and thirdly, it can end in terrible complications.

  Follicular cyst can give the following complications:

  Leg twist. If the cyst is a pedunculated blister, the base of the cyst may become twisted as a result of a fall, a sharp bend, an abdominal injury, or active sex. In this case, the blood supply to the body of the cyst stops, and it dies. The anesthetized cyst often has to be removed along with the diseased ovary;

  Rupture of the cyst. The shell may not withstand the pressure of the liquid, and burst. Then the contents of the follicular cyst will spill into the abdominal cavity, and this threatens with peritonitis and death;

  Hemorrhage into the cavity of the cyst. A sharp blow to the lower abdomen or trauma can cause a rupture of the blood vessels that feed the body of the cyst. As a result, it will fill with blood and burst, and then events will develop according to the scenario described above.

  If there is a complication of the follicular cyst, treatment is required immediately, and it can only be surgical.

  Depending on the type of complication, a woman may experience all or some of the following symptoms:

  Sharp, unbearable pain in the lower abdomen;

  Pale skin and blue lips;

  Sticky, cold sweat;

  In case of rupture and intoxication -.

  Methods of treatment of follicular ovarian cyst

  

  If the cyst does not exceed three to five centimeters in diameter, it usually does not bother the woman and goes unnoticed. But if a cyst was found during a gynecological examination or ultrasound examination, most doctors take a wait-and-see attitude. And only if after 2-3 months the follicular cyst not only did not resolve, but also showed a tendency to increase in size, they proceed to treatment.

  For young women of childbearing age, in whom the follicular cyst often recurs, or is discovered for the first time, but increases, modern contraceptive pills are great help to cope with this problem. They normalize the hormonal background and prevent the development of a cyst at the site of the follicle with an unfertilized egg. In addition to oral contraceptives, homeopathic and folk remedies, anti-inflammatory drugs may be recommended.

  Physiotherapy treatment of ovarian cysts

  It is possible to accelerate the resorption of the ovarian follicular cyst with the help of physiotherapeutic procedures: electrophoresis, magnetic therapy, smt-phoresis, ultraphonophoresis. The expediency of physiotherapy treatment is determined by the doctor, but practice shows that with large (7-8 cm in diameter) follicular cysts, such methods are unproductive, and it is better to resort to surgical intervention.

  Laparoscopic removal of an ovarian cyst

  

  In modern gynecology, laparoscopic follicular resection is practiced as the most reliable and safe method of treatment. The operation is planned, takes only about half an hour and does not leave any marks on the patient's body. Often, epidural anesthesia is used instead of general anesthesia.

  If complications are suspected, traditional surgery methods are used - an incision in the abdominal cavity:

  Cystectomy - only the neoplasm is excised. After healing, ovarian function is fully restored.

  Resection of an ovarian cyst - simultaneously with the removal of the cyst, damaged tissues of the ovary itself are removed. It is also possible to preserve childbearing functions.

  Ovariectomy - the damaged ovary is completely removed.

  The latter method is used for apoplexy (rupture) of the ovary.

  In the abdominal cavity, the doctor makes several holes through which a special gas is supplied, thanks to which the position of the internal organs becomes clearly visible. A laparoscope is inserted into the holes - a long tube with a video camera and a surgical instrument at the end. Seeing the image on the monitor, the surgeon can carefully excise the cyst along with the capsule and pedicle, if any.

  If the cyst was very large, during the next day after the operation, the punctures are not sutured, and the drainage system works. But usually the patient is discharged on the same day. The situation is much worse if the surgical intervention is abdominal and unscheduled - a complication of the cyst has arisen, for example, ovarian apoplexy, which has to be removed. Then the woman is under the supervision of doctors for much longer, and a noticeable scar will most likely remain on the body.

  Non-traditional methods of treatment

  About non-traditional methods of treatment of follicular ovarian cyst

  Prevention of recurrent follicular ovarian cyst

  emotional peace, timely going to bed - up to 23 hours;

  support of hormonal and vitamin balance;

  regular moderate physical activity - sports lovers are advised to exclude sharp bends, turns of the torso and other exercises that stimulate negative pressure in the abdominal cavity;

  If there is a history of cystic disease, it is recommended to exclude

  thermal, mud therapy and other procedures that stimulate blood circulation in the pelvic organs;

  tanning under the scorching sun, solariums;

  taking hot baths.

  A good preventive effect is given by jumping rope - 5-7 minutes 1-2 times a day.

  Early diagnosis is one of the best means of preventing complications of a follicular cyst.

  
  

  Education: Diploma "Obstetrics and Gynecology" received at the Russian State Medical University of the Federal Agency for Health and Social Development (2010). In 2013, she completed her postgraduate studies at the NMU. N. I. Pirogov.

Follicular ovarian cyst (cysta ovarii follicularis) is a type of functional formation in the ovarian tissue. A cyst is formed from folliculus ovaricus - a follicle that did not have time to burst, burst.

A follicular cyst is considered a benign neoplasm, ranging in size from 2.5 to 8-10 centimeters, consisting of a single-chamber cavity, inside of which there is a liquid rich in estrogen. Most often, this type of cyst develops in young women of reproductive age, but it is also diagnosed in the puberty, menopause. The frequency of diagnosed follicular cysts among all other cystic ovarian neoplasms is 80%.

Follicular cysts are capable of resolving on their own under certain conditions and cannot malignize, that is, transform into malignant formations.

ICD-10 code

N83.0 Follicular ovarian cyst

Causes of a follicular ovarian cyst

The first description of the pathological condition of the ovaries dates back to 1827, when the cyst was defined as an incurable "water sickness" in women over 40 years of age who did not have children. Since then, a more careful study of the pathogenetic properties of cystic formations has begun, but doctors have not developed a single version.

At the beginning of the last century, the causes of follicular cysts and other functional cystic neoplasms were divided into two categories:

1. Violation of the functioning of the hormonal system.
2. Inflammatory process of an infectious nature in the appendages.

In 1972, the term apoptosis (self-programming of cell death) appeared in scientific use, and many scientists rushed to study the relationship between apoptosis, steroidogenesis and the functioning of the ovaries. Thus, another version of the etiology of follicular cysts appeared, based on the hormone-genetic factor.

Currently, doctors in the development of a therapeutic and preventive strategy are trying to take into account all three theories, summarizing the most studied causes of a follicular cyst:

• Hormonal imbalance associated with natural age periods - puberty, menopause.
• Pathological disorders of neuroendocrine regulation, provoking hyperestrogenism.
• Inflammatory diseases of the appendages.
• Inflammation of the fallopian tubes, accompanied by oophoritis (inflammation of the ovaries) - salpingoophoritis.
• Ovarian dysfunction associated with abortion.
• STDs are sexually transmitted diseases.
• Long-term treatment of infertility, hyperstimulation of ovulation.
• Psycho-emotional stress.

How is a follicular cyst formed?

A normal monthly cycle, not burdened by treatment with hormonal drugs or other provoking factors, involves the production of follicles. The most active of them is the basis for the maturation of the egg, which is released as a result of the rupture of the follicle. The oocyte (ovum) enters the uterus through the fallopian tubes, and in place of the bursting follicle, a temporary endocrine gland is formed - the corpus luteum (luteal). The luteal formation produces progesterone until the onset of menstruation or until the formation of the placenta at the onset of conception. If the dominant follicle does not burst, the oocyte remains inside, the follicular fluid does not pour out, and a cyst forms.

Follicular ovarian cyst and pregnancy

A follicular cyst in a pregnant woman is an obvious gynecological phenomenon or a diagnostic error. Indeed, cystic formations are not uncommon during pregnancy, but, as a rule, do not pose a serious threat. This is due to the fact that a pregnant woman, or rather her body, needs much more progesterone than before, since it is involved in the formation of the placental "children's place", and also supports the pregnancy itself. Due to the intensive production of progesterone, the corpus luteum functions not for 10-14 days, but for about 3 months, that is, the entire first trimester. It is the luteal body that can transform into a cyst, which later resolves on its own.

Thus, based on the logic and physiological sequence of the formation of a corpus luteum at the site of a burst follicle, a follicular ovarian cyst and pregnancy, in principle, cannot “coexist”. In addition, a pregnant woman has an increased production of prolactin, which stops the development of new follicles in order to prevent them from forming a new pregnancy against the background of a conception that has already been carried out.

A cyst during pregnancy, defined as follicular, is rather a diagnostic error that needs to be corrected and the presence of potentially dangerous true tumors excluded.

Symptoms of a follicular ovarian cyst

Symptoms of a follicular cyst depend on its activity in the hormonal sense, as well as on possible concomitant pathologies of the pelvic organs - endometriosis, salpingitis, fibroids, adnexitis and others.

A hormonally active estrogen-producing follicular cyst can manifest itself as heavy bleeding during menstruation, early puberty in girls, and pain in the lower abdomen.

Inactive cysts develop asymptomatically and can resolve on their own without a trace so that the woman is unaware of their presence.

In addition, the clinic of follicular formations depends on the size of the cysts. Small follicular cysts do not manifest clinically and are diagnosed randomly during clinical examination. Larger cysts are more pronounced, which have pronounced symptoms.

The symptoms of a follicular ovarian cyst are as follows:

• Periodic feeling of fullness in the lower abdomen.
• Heaviness in the inguinal zone, at the site of the cyst (right or left).
• Pain in the side, lower abdomen during long walking, running, intense physical exertion, often during intercourse.
• Pain in the second half of the monthly cycle (15-16 days).
• Decrease in body temperature in the second half of the monthly cycle (up to 36.0).
• Uterine bleeding between menses.

A follicular cyst is not as safe as it might seem at first glance, it is fraught with various complications, such as torsion of the leg or rupture of the cyst.

Symptoms of a follicular cyst with torsion of the leg:

• Severe, sharp pain in the lower abdomen, on the right or left at the site of the cyst.
• Weakness, dizziness.
• Nausea, up to vomiting.
• Profuse cold sweat, drop in blood pressure.
• Tachycardia.
• Cyanosis, cyanosis of the skin.

Rupture of the cyst, signs:

• Body temperature unchanged.
• Nausea and vomiting.
• Fainting state.
• Dagger pain in the zone of localization of the cyst.

Rupture of the cyst capsule may be accompanied by internal bleeding:

• Sharp pain that subsides and causes a state of shock.
• Tachycardia.
• Drop in blood pressure, heart rate.
• Weakness, drowsiness.
• Pale skin, cyanosis (cyanosis).
• Fainting.

Acute conditions require emergency medical care, as torsion of the legs, rupture of the capsule can lead to peritonitis.

Follicular cyst of the right ovary

The issue of functional lateral asymmetry of the ovaries remains the subject of discussion, there are no reliable data that would confirm that the right ovary is more susceptible to pathological or benign neoplasms.

The follicular cyst of the right ovary, according to statistics, develops as often as the cyst of the left ovary. There are separate reports saying that the right ovary is in principle more active and forms dominant follicles more often. Perhaps this is due to its more intense blood supply due to the direct connection of the artery and the main aorta. The left ovary is supplied by the renal artery by a bypass route. There is also an opinion that the anatomically right ovary is slightly larger than the left one, however, such information is not clinically or statistically confirmed.

Indeed, right-sided apoplexy occurs two to three times more often and this is due to a natural cause - intensive blood supply and proximity to the aorta, but otherwise the follicular cyst is formed with the same frequency and according to the same pathogenetic principles as formations in the left ovary.

It should be noted that the peculiarity that the follicular cyst of the right ovary has is the symptoms similar to the clinic of inflammation of the appendix. Pain in the right side, a typical picture of an "acute abdomen" can confuse the diagnosis, but, as a rule, differentiation of nosologies occurs quickly.

A cyst is not a violation of the general ovulatory function, if there is no rupture of its capsule or torsion of the leg. The information that more often “get pregnant” with the right ovary, that the percentage of formation of cystic tumors in it is higher, is nothing more than a myth.

Follicular cyst of the left ovary

The follicular cyst of the left ovary is not much different from the right-sided cyst. It is formed as a result of unresolved potential ovulation and the growth of an active non-ruptured follicle. Symptomatically, a left-sided formation manifests itself at the site of the cyst in the form of transient pain in the lower abdomen, intermenstrual bleeding. A more serious complication may be a rupture of the capsule or torsion of the leg, when the pain becomes acute, dagger-like, a typical “acute abdomen” clinic develops, which requires immediate emergency medical care, surgical intervention.

The follicular cyst of the left ovary, not exceeding 5 centimeters, can develop asymptomatically and also disappear imperceptibly. Such cysts are diagnosed during preventive examinations or during examination for another pathology not associated with cystic formations. Often, cysts do not require specific therapy, treatment is limited to systematic monitoring and control of cyst size for 2-3 months.

Rupture of a follicular ovarian cyst

The rupture of the cyst is accompanied by two types of serious complications:

1. The outpouring of the contents of the cyst into the abdominal cavity.
2. Hemorrhage directly into the ovary and its rupture - apoplexy.

The rupture of the follicular cyst occurs spontaneously, more often in the middle of the monthly cycle during the period of ovulation. The cystic follicle grows in parallel with another, normal active follicle, which performs the function of forming an oocyte.

The cause of the rupture can be inflammatory processes in the abdominal cavity, in the ovary itself, hormonal disorders, changes in the level of blood clotting. In addition, excessive physical activity, sports, and sexual intercourse can be a provoking factor leading to a gap.

Signs of a ruptured follicular cyst:

• Sharp, dagger pain on the side, in the lower abdomen, in the zone of localization of the cyst.
• Tense stomach.
• Cold sweat.
• The pain quickly becomes diffuse, spilled.
• Nausea, vomiting.
• Drop in blood pressure and heart rate.
• Possible fainting.

To diagnose complications of follicular cysts, doctors use standard, proven methods:

• Ultrasound of the abdominal cavity and pelvic organs.
• Puncture to determine possible bleeding and blood sampling for analysis.
• Laparoscopy.
• The rupture of the follicular cyst is treated urgently and only surgically.

The first thing that is done in a hospital is to stop the bleeding, then the cyst is removed within healthy tissues. As a rule, the ovary itself is not operated on, resection or its removal is possible only in extreme cases.

The dangers that a cyst rupture carries:

• Anemia due to blood loss.
• Rarely - adhesions and infertility. The modern method of laparoscopy virtually eliminates adhesions.
• Purulent peritonitis.

It should be noted that timely medical care, surgery is literally vital, since with a hemorrhagic form of ovarian apoplexy, a fatal outcome is possible (blood loss of more than 50%).

Diagnosis of a follicular ovarian cyst

The detection of small follicular cysts often becomes an accidental finding during routine or spontaneous gynecological examinations. Small, less than 5 centimeters, cysts develop asymptomatically, which makes timely diagnosis difficult and sometimes impossible. More often, women with follicular neoplasms undergo an urgent examination for already formed complications - torsion of the cyst leg, rupture of the capsule.

The standard measures that involve the diagnosis of a follicular cyst are as follows:

• Collection of anamnesis.
• Gynecological examination, palpation (two-handed).
• Ultrasound procedure.
• Dopplerography.
• Diagnostic emergency laparoscopy.
• CBC - complete blood count.
• Analysis of urine.
• Blood test for hormones (progesterone, estrogen, FSH, LH).
• Blood test for tumor markers.

Follicular ovarian cyst on ultrasound

One of the most revealing and informative methods for determining the size, condition of the cyst and the surrounding pelvic organs is ultrasound. A corpus luteum cyst, a paraovarian cyst, a follicular ovarian cyst - ultrasound can detect almost all cystic formations.

Ultrasound echography is prescribed after a 5-7-year monthly cycle, as a rule, to assess the function of the ovaries, its follicular properties. Ultrasound is performed several times to see the picture in dynamics - at least three times a month.

Normally, the ovaries in size, structure, maturing follicles should have the following parameters (on average):

• Width - up to 25 mm.
• Thickness - 12-15 mm.
• Length - 28-30 mm.
• Follicles - from 1-30 mm.

The follicular cyst on ultrasound looks like a single-chamber formation of more than 25-30 millimeters, it is defined as functional. The dimensions of a non-bursting cystic follicle can reach gigantic sizes - up to ten centimeters in diameter, they have a different color and structure, the walls are even, rather thin. The larger the cyst, the thinner the wall of the capsule. Ultrasound shows behind the cystic lesion a clear, cyst-like effect of amplifying the dorsal ultrasound reflection.

It should be noted that the ultrasound diagnostic method is not the only one, since it determines the size, structure, but does not provide information about the etiological factors. Therefore, ultrasound should be re-appointed to monitor the dynamics of cyst development.

Follicular ovarian cyst two-chamber

As a rule, a follicular cyst in 95% of cases is diagnosed as a single-chamber cavity, two-chamber formations from follicles are a rarity, the actual causes of which are not fully understood.

Retention or functional cysts, a type of neoplasm, considered the most "harmless" and benign. Such a cyst has one chamber (cavity) filled with secretory fluid. The walls of the cyst capsule are extremely thin, although they consist of a stratified epithelium, this is due to the natural purpose of the follicle and its potential task - the rupture and release of the egg.

If the non-bursting follicle grows to an abnormal size, the capsule wall quickly becomes thinner and is held only by the connective outer tissue. It is assumed that possible proximity to cysts of another type, rapid growth, fusion of the adjacent walls of the capsule of two cysts can form such a rare phenomenon as a two-chamber follicular cyst.

In addition, the factor provoking the abnormal structure of the retention cyst may be an inflammatory process in the appendages, uterus, or hyperstimulation as a method of treating infertility. Syndromic phenomena of hyperstimulation are most often observed in women suffering from persistent infertility, striving for conception. Such patients, as a rule, are asthenic in body type and already have a history of polycystic ovaries.

Also, the result of the examination and the diagnosis - a two-chamber follicular cyst may be a mistake of an ultrasound specialist, most likely there is a different, more accurate and correct answer - a combination of retention, functional and true cysts, which on ultrasound may look like a single, two-chamber formation.

Follicular ovarian cyst 3 cm

The retention cyst is small in size, and this type includes a small ovarian follicular cyst (3 cm), has the properties of self-resolving. If a woman has a follicular formation up to 5-6 centimeters, as a rule, the doctor chooses expectant tactics, that is, the cyst is not treated, it is monitored by examination and regular ultrasound. Within 2-3 monthly cycles, a small follicular cyst (3 cm) is able to resolve on its own without the use of hormonal agents and other types of therapy.

The absence of clinical symptoms, complaints from the patient, makes it possible to simply monitor the condition of the cyst as the only correct method of treatment.

If the cyst persists, that is, it persists for more than 3 months and is not prone to self-resolving, it is started to be treated, and recurrent follicular cysts, both small and large, are also subjected to therapy.

A woman diagnosed with a small functional cyst (3 cm) only needs to follow these rules:

• Limit physical activity, you can not lift weights (more than 4-5 kilograms).
• You can not overheat the back, the pelvic area, take hot baths.
• It is necessary to reduce the activity of sexual contacts (frequency or intensity).

Otherwise, as gynecological practice shows, a small follicular cyst resolves on its own without the use of any treatment. The only way to protect yourself from possible complications that even a small three-centimeter cyst can give is regular gynecological examination and compliance with medical recommendations.

Treatment of a follicular ovarian cyst

The choice of tactics for the treatment of functional cysts depends on the parameters of the neoplasm, growth dynamics (increase, persistence, relapse) and the age of the patient.

As a rule, the treatment of a follicular ovarian cyst is not difficult. Such cysts are diagnosed mainly in young women of childbearing age, which determines both the treatment strategy and its possible prognosis.

The most common expectant management during 3-month cycles, provided that the cyst is small in size - up to 5 centimeters, it develops asymptomatically and does not cause functional disorders.

Also, as a therapy for a retention cyst, the doctor may prescribe hormonal drugs, more often oral contraceptives, which for 2-3 months (less often - six months) inhibit the activity of the ovaries, respectively, and the formation of new follicular cysts. In addition, oral drugs can reduce the growth rate of cystic formation and reduce its size, up to complete resorption. Thus, there is a normalization of the menstrual cycle as a whole, minimizing the risk of ovarian malignancy, which is possible due to concomitant pathologies (inflammation) and neoplasms. This treatment option is often used if a woman is under the age of 40-45 years.

Patients in the menopause, provided that the follicular cyst does not exceed 5 centimeters, and the analysis for CA125 (tumor markers) is normal, are also subject to observation, that is, the cyst is not subjected to either medical or surgical treatment. The only thing required is dynamic observation with ultrasound. It is possible to prescribe stimulating therapy with the help of oral contraceptives to accelerate the reverse development of the process, physiotherapy procedures - electrophoresis, ultraphonophoresis, vitamin therapy.

Surgical treatment of a follicular ovarian cyst is carried out only for specific indications, such as:

• Persistent form of cyst.
• The rapid growth of the cyst, the progression of the process.
• The diameter of the cyst is more than 7-8 centimeters.
• Cysts of a large (giant) size - 15 centimeters, which are removed in order to exclude torsion of the leg or rupture of the capsule.
• Emergency cases, complications - rupture of the cyst capsule, ovarian apoplexy, the clinical picture of "acute abdomen".

As a surgical method, a modern method is used, called the "gold standard" in surgery - laparoscopy, when the cyst is husked, its walls are sutured, resection of the ovary is possible. Oophorectomy (complete removal of the ovary) in women of childbearing age is indicated only in extreme cases when the patient's life is threatened, and it is also indicated in women over 45 years of age to reduce the potential risk of ovarian cancer.

How to treat a follicular ovarian cyst?

The attending gynecologist should answer the question - how to treat a follicular ovarian cyst, since each organism is individual, respectively, and the state of the cyst, its features may have specific properties.

However, standard treatments for follicular cysts may include:

• Dynamic monitoring of the development of a cyst, its growth or persistence. Ultrasound and gynecological examination are shown, that is, expectant management for 3 months, or until the cyst self-resorbs.
• Normalization of hormonal balance with the help of oral contraceptives and other drugs adequate to the condition and age of the patient.
• The appointment of homeopathic, vitamin preparations that strengthen the immune system, the general health of a woman.
• Normalization of body weight in overweight.
• Treatment of concomitant inflammatory diseases and disorders, this is especially important in relation to the endocrine system and organs of the digestive tract.
• Appointment of physiotherapeutic procedures, possibly herbal remedies. These methods do not affect the size and structure of the cyst, but have a general strengthening effect and create an opportunity for self-resorption of the cystic formation.

Surgical treatment is indicated in cases where the cyst significantly increases in diameter, disrupts the functioning of nearby organs, in addition, there is a risk of rupture of the cyst capsule, torsion of the leg, tissue necrosis, and apoplexy of the ovary itself. Operate cysts exceeding 5-6 centimeters in diameter, as well as inflamed formations prone to suppuration. The operation is performed using a gentle method - laparoscopy, in exceptional, complicated situations, laparotomy is indicated.

How to treat a follicular ovarian cyst should be decided by the doctor after a set of diagnostic measures. If a woman is diagnosed with a cyst, even a small one, the recommendations of the attending gynecologist should be the reason for their strict implementation. Self-treatment, treatment with so-called folk methods is unacceptable, as it can lead to serious complications and persistent infertility.

Dufaston with a follicular ovarian cyst

Most often, the reasons for the formation of a functional follicular cyst are a change in the functioning of the hormonal system and inflammatory processes in the appendages, the uterus, both individually and in combination with each other. The primary follicular cyst, which was formed as a single case as a result of a hormonal failure, is able to resolve on its own. However, hyperestrogenism against the background of insufficient production of progesterone creates conditions for intensive growth of the cyst or its recurrence. In addition, with such an imbalance, there is a risk of torsion of the cyst leg, rupture of its capsule, disruption of the normal regime of the menstrual cycle, hyperplasia, growth of the uterine mucosa, endometriosis. Long-term, more than 2-3 months, the predominance of estrogen is the reason for the appointment of specific, leveling hormonal balance, drugs - gestagens.

Duphaston is a drug that is an effective analogue of progesterone, that is, taking it, a woman activates the production of the missing hormone, helps the work of the yellow (luteal) body. Duphaston with a follicular ovarian cyst is considered one of the most effective means, which, without suppressing the ovulation process, is able to transfer the first phase of the cycle to the secretory, second. This action leads to the normalization of the synthesis of LH (luteinizing hormones), the collapse of the cyst membrane, to a decrease in its size. It is these properties of duphaston that contribute to the resorption of the follicular cyst (other functional formations).

Dufaston is an oral remedy that has a beneficial effect on the condition of the walls of the uterus, without causing the side effects inherent in synthetic analogues of progestins.

The main indication for the appointment of duphaston is a violation, a change in the hormonal balance, as well as any dysfunction in the menstrual cycle. Even pregnant women can take the drug, however, like any such remedy, duphaston with a follicular ovarian cyst requires medical supervision. Dydrogesterone, the main active ingredient of the drug, was developed relatively recently, therefore Duphaston belongs to the new generation of drugs, it is not a direct derivative of the main androgen - testosterone and does not have such side effects and complications as the previous androgenic drugs.

The method of application of Duphaston, dosage and mode of administration is the prerogative of the doctor, contraindications to the appointment of this drug are such conditions and pathologies:

• Suspicion of oncoprocess of various localization, malignant neoplasms.
• Rarely - individual intolerance to the main active substance - dydrogesterone.
• Pathological condition of the liver, hepatitis, cirrhosis.
• Poor blood clotting, hemophilia.

It should be noted that Duphaston cannot be considered a panacea in the treatment of follicular and other types of cysts. If after 2-3 months of treatment with the drug the cyst continues to grow, there is no positive dynamics, another treatment option is possible, including surgery.