Cystic change of the ovary. Cystic changes in the ovaries

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Ovarian cysts are a very common condition in women of reproductive age. Despite the fact that cysts are considered benign, they can be a source of big problems. To better understand the dangers of this pathology, you need to know the causes of its development.

What is a disease

A cyst is a vesicular pathological formation. In fact, it is a benign tumor.

Depending on their origin, cysts have a very different histological structure. The cells lining the cavity of the bladder and its contents are distinguished: liquid, mucous or jelly-like. Inside the cavity there may be an effusion of blood plasma, pus, blood cells.

It can form as one tumor, or several at the same time. This condition is called cystoma or polycystic. The size of the formations changes during development and can become very large.

The cyst is not a cancerous tumor, but it can be reborn into it.

ovarian cysts

The ovaries are small glands located on either side of the uterus. They are the primary sexual characteristics of a woman. Their main task is the production of female hormones, the production of eggs.

The formation of cystic tumors of the left or right ovary is typical for women of childbearing age. Less often, it is diagnosed in young girls and women who have overcome the menopause: in the first, the ovaries have not yet begun to function normally, the menstrual cycle and hormonal levels have not been established, and in the second, ovarian function is already reduced. However, a benign formation in the structure of the left or right organ may be congenital.

This pathological condition may not give itself away and be discovered by chance during a routine gynecological examination or ultrasound. Palpation of the abdomen makes it impossible to feel the tumor. Sometimes pathologies make themselves felt only when their size becomes very large.

The change may concern one ovary, for example, the left one. In this case, we are talking about a unilateral cyst. Bilateral tumor occurs in the area of the right and left ovaries.

A cyst can interfere with the normal functioning of the ovaries and even lead to the development of critical, life-threatening conditions. In such cases, its surgical removal is indicated. Some formations have a high risk of malignancy.

Each neoplasm must be subjected to careful analysis to determine whether radical treatment is required. Palpation can only diagnose that the size of the ovary exceeds the norm, but the type of cystic formation cannot be established in this way.

Types of cysts

Cystic formations in the structure of the female gonads are not similar to each other. They are united only by the shape of the bubble, and the cells that form the bubble and line its cavity, the composition and consistency of the liquid may differ. Also, pathological structures have different causes of formation, size, location (tissue of the right or left ovary).

Given the different comparison parameters, you can get the following, most complete, classification of benign ovarian tumors.

By education time:

congenital: cysts are formed in the embryonic period of development; by type, these are usually dermoids;
acquired: formations develop in the process of life.

Functional cysts

This type of cyst is the most common. Their other name is physiological. Such tumors are not pathogenic, treatment is usually not required. They are formed from the tissues of the ovary itself in violation of the mechanisms of ovulation. A functional cyst in most cases resolves on its own within one to three monthly cycles. If this does not happen, treatment is necessary.

Follicular. It is formed if the follicle does not break, but continues to grow, turning into a cystic structure.
Yellow cyst. It is formed if the corpus luteum is not destroyed for a long time.
Polycystic ovaries. A pathological condition in which many follicles do not burst in due time, continuing their growth and turning into cysts. Multiple small cystic changes in the ovaries are formed. Adequate treatment is necessary, since polycystic disease can lead to infertility.
Hemorrhagic cyst. The rupture of the vessel leads to the filling of the follicle with blood and its increase. This is a very painful and dangerous condition. If the bleeding does not stop, surgery is required.

Cysts are also distinguished by their histological structure.

Dermoid (teratomas). This is a very advanced tumor containing almost all tissues: it has nerves, muscles, cartilage, fatty tissue, even hair and sweat glands. Formations grow slowly and occur almost always on the right. Usually dermoid teratoma is congenital.
Serous (cystomas). The cavity of such formations has a transparent liquid content, and the cells of its walls are identical to the mucous membrane of the fallopian tubes or the outer surface of the ovary. There is a predominantly unilateral tumor (for example, of the left ovary).
Mucinous. Similar to serous cystomas, with the difference that the formation cells resemble the cells lining the vagina at the junction with the cervix. Serous and mucinous tumors grow rapidly, can reach a significant size and are diagnosed mainly in mature women after 45 years of age. The mucinous cyst has a high risk of malignancy.
Endometriosis (endometrioid). Tumor tissues are identical to the mucous membrane of the uterine cavity. The liquid content of the bladder has a chocolate color, since it is formed from blood clots that are released during menstruation. The size is usually small.
Papillary. This is a dangerous condition that is considered to be precancerous. A feature of the structure of such a cyst is the presence of papillary growths on the surface. Requires radical, surgical treatment.

By location, the cyst is paraovarian: the tumor does not occur on the ovary, but in the body cavity, between the gland and the uterus. Has a wide distribution. It is usually laid in the embryonic period, but develops in adulthood under the influence of stress factors (diseases, hormonal disorders). The size of the cystic formation can increase rapidly.

Cysts can have different etiologies.

Hormonal etiology. Almost any type of formation can develop against the background of hormonal disorders in the body. This is especially true for functional tumors.
Retention (functional) etiology. A cyst of this type can form in any gland if the outflow of its contents is disturbed. Retention tumors can occur on the salivary glands. This mechanism is also characteristic of the formation of functional tumors.

Whatever type of cyst is diagnosed, it requires attention and treatment. The main dangers: the large size of tumors, the risk of oncology and infection.

Causes of benign ovarian tumors

The global cause of the formation of cysts is almost always a hormonal failure in the body of a woman (or her mother, if the cyst is congenital). It is the instability of the hormonal background that leads to violations of internal mechanisms, causing cell migration.

Factors that increase the likelihood of the formation of cystic tumors:

puberty;
pregnancy, childbirth, abortion;
menopause;
diseases of the endocrine system, hormone therapy;
violation of sexual hygiene.

Decreased immunity and microbial infection of the reproductive system can be of great importance. These factors lead to various pathological conditions and processes, which in turn cause the formation of tumors.

Inflammation of the appendages due to a bacterial (rarely viral or mycobacterial) infection can also cause the formation of cysts of the left or right ovary. Edema develops, vascular exudate (effusion) fills the space between the cells, and the size of the ovary increases. Inflammatory cysts are accompanied by temporary infertility. Proper antibiotic treatment completely eliminates the problem.

Congenital dermoid cyst

In the process of intrauterine formation of the organism, three germ layers are involved: endoderm, ectoderm and mesoderm. There is a clear layout of organs and tissues, the violation of which leads to the development of various congenital pathologies. From each leaf, a specific organ system is formed at a certain time. Thus, the ectoderm and mesoderm form the tissues of the left and right ovaries.

If the germ layers are mixed, a cyst is formed. It may include the rudiments of teeth, nails, hair. From the word "dermis" it is called dermoid. - a violation of the embryonic mechanisms of development, which may be caused by hormonal problems in the mother's body or other factors. Such formation, as a rule, has a constant size.

Functional cystic formations

As the name implies, the formation of cysts can be caused by a dysfunction of the organ. The main purpose of the ovary is the formation of eggs, subject to a strict monthly cycle. If the course of one of its stages is disturbed, pathological changes are possible.

In a normal state, the egg during ovulation leaves the bursting follicle into the fallopian tube. The follicle turns into a corpus luteum, which is a temporary endocrine organ that prepares the body for a potential pregnancy. If this does not occur, the corpus luteum is reduced. Otherwise, it is also reduced, while other organs take over hormonal regulation.

However, the worked out scheme may be violated. For example, the follicle does not burst. The main reason for this pathology is the insufficient synthesis of luteinizing hormone in the body of a woman. The follicle continues to grow, forming a temporary (follicular) cyst. This sometimes happens in the body of healthy women and does not lead to serious disorders - the formation takes place over several cycles.

There may be an overgrowth of the corpus luteum instead of its destruction. It is extremely rare for a luteal cyst to reach a large size and provoke sharp pain.

If such violations occur from cycle to cycle, a cluster of unopened growing follicles is formed, the size of which increases. This phenomenon is called polycystic. Polycystic left and right ovaries is tantamount to infertility and requires serious treatment. At the same time, “menses” may continue, which are actually acyclic uterine bleeding.

Cell migration

In the tissues of the ovaries, there may be a focus of foreign cells, similar to the lining of the uterus - the endometrium. The reasons for this pathology lie both in embryonic disorders and in the banal non-observance of hygiene during menstruation (sex or bathing during menstruation), which contributes to the reflux of menstrually active cells from the uterus to the ovaries. During menstruation, bleeding occurs, in which the contents of the cystic bladder come out - chocolate-colored blood clots.

A cyst is a benign formation, but it cannot be left unattended. In most cases, surgical treatment is indicated.

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Among the gynecological questions that women turn to the consultation section of our portal, a significant part concerns the disease known as polycystic ovaries, ovarian sclerocystosis, Stein-Leventhal syndrome and polycystic ovary syndrome. Since the latter name is used most often, we will abbreviate this pathology as PCOS.

The consistently high interest in this disease is caused, on the one hand, by its fairly widespread prevalence, and, on the other hand, by the not always correct approach of doctors to the diagnosis of PCOS. Very often, the diagnosis of polycystic ovary syndrome is based only on the results of ultrasound, during which cystic changes in the ovaries are detected. This approach to diagnosis leads to overdiagnosis of PCOS (detection of the disease where it does not exist) and the appointment of unreasonable, expensive treatment (sometimes even unnecessary surgery). To help women understand the situation, we felt it necessary to write an article about polycystic ovary syndrome.

The concept of cystic ovaries and criteria for the diagnosis of polycystic ovary syndrome (PCOS)

First, let's define the concept of "cystic ovaries". Cystic ovaries is an ultrasound report that implies the presence in the ovaries (one or both) of multiple small cystic formations. The formation of multiple cysts in the ovaries occurs in many pathological conditions, among which are endocrine diseases, tumor processes, chronic inflammation of the ovaries, etc. Polycystic ovary syndrome (PCOS) is just one of them.

The very name of the disease - polycystic ovary syndrome - indicates that it is impossible to diagnose this disease on the basis of the ultrasound result alone. After all, a syndrome is a collection of symptoms, i.e. signs of illness! Therefore, to diagnose PCOS in a woman, at least two of the following criteria must be met. So, the criteria for the diagnosis of polycystic ovary syndrome are:

lack of ovulation (anovulation), and, as a result, menstrual irregularities and infertility;
increased formation of androgens - male sex hormones (hyperandrogenism) and, as a result, increased hair growth (hirsutism), acne (acne), increased skin greasiness and seborrhea;
enlargement and cystic changes in the ovaries according to ultrasound.

Thus, the diagnosis of PCOS, made only on the basis of ultrasound signs in the absence of other symptoms, is absolutely incompetent!

Now let's take a closer look at what constitutes polycystic ovary syndrome.

Polycystic ovary syndrome: causes and frequency of detection

Despite the fact that polycystic ovary syndrome as a disease has been known to doctors for a long time (since the 30s of the previous century), there are still disputes among scientists about the cause of its occurrence.

According to the latest ideas, PCOS is a genetically determined (congenital) pathology. Moreover, the changes leading to the development of the disease relate to a whole group of genes responsible for the proper functioning of the organs of the endocrine system, including the synthesis of a number of hormones (androgens, insulin, pituitary hormones, etc.). Violation of their production contributes to the occurrence of hyperandrogenism (from "hyper" - increase, "andros" - a man and "genos" - to give birth) - i.e. excessive production of male sex hormones (androgens) by the ovaries.

Androgenism stops the development of ovarian follicles, which leads to a change in the structure of the ovaries themselves (an increase in the size of the ovaries and a significant thickening of their capsule, under which multiple follicular cysts are formed - immature follicles), menstrual disorders and infertility. With obesity (which occurs in 40% of women suffering from PCOS), all the described processes proceed with even greater intensity.

Polycystic ovary syndrome is a fairly widespread disease: it occurs in about 5-10% of women of childbearing age. Even more significant is the fact that PCOS is detected as the cause of the absence of pregnancy in 25% of women examined for infertility.

Diagnosis of polycystic ovary syndrome

One of the main characteristics of polycystic ovary syndrome is the multivariance of its manifestations. However, all women who have been diagnosed with PCOS necessarily have violations of the ovulation process (most often anovulation - the absence of ovulation), accompanied by menstrual irregularities and infertility. It is characteristic that menstrual irregularities occur with PCOS already in adolescence - with the onset of menstrual function. Cycle disorders occur in the form of long delays in menstruation or in the form of a complete absence of independent menstruation (amenorrhea).

Infertility that occurs with polycystic ovary syndrome is primary - it is characterized by the absence of pregnancies in a woman's history (in contrast to secondary infertility, in which reproductive dysfunction develops after pregnancies ended in childbirth, miscarriages or abortions).

hirsutism(increased male pattern hair growth) with PCOS also has its own characteristics. As a rule, hair growth is moderate and is noted on the legs, inner thighs, perineum and along the white line of the abdomen (the line running from the pubis to the navel). The growth of facial hair is most often limited to the formation of a "mustache" above the upper lip. The increased formation of androgens also leads to an increase in oily skin, the formation of acne, and the development of seborrhea.

Obesity, as already mentioned, occurs in 40% of patients with PCOS, is a manifestation of metabolic disorders and is characterized by either an even distribution of body fat throughout the body (universal type of obesity), or a predominant deposition of fat in the abdomen and waist (male type of obesity).

In addition to obesity, polycystic ovary syndrome also often has insulin resistance (this term means pathological cell resistance to insulin, which underlies the formation of type 2 diabetes mellitus) and laboratory signs of carbohydrate and lipid metabolism disorders.

With a long-term polycystic ovary syndrome, there is an alternation of delayed menstruation with uterine bleeding arising from endometrial hyperplasia (excessive growth of the uterine mucosa) under the influence of inadequately formed sex hormones. It should be noted that long-term, uncorrected PCOS is a risk factor for the development of uterine cancer. When PCOS is combined with obesity, the risk of developing uterine cancer is more pronounced than in polycystic ovary syndrome without obesity.

Laboratory and instrumental research methods in the diagnosis of polycystic ovary syndrome

The variety of clinical manifestations of polycystic ovary syndrome made it necessary to confirm the diagnosis using a number of laboratory tests and instrumental diagnostic methods. Therefore, when diagnosing PCOS, the following are used:

Gynecological examination, which allows you to determine bilateral enlargement and unusual density of the ovaries.
Ultrasound of the pelvic organs. With PCOS, an increase in the size of the ovaries (always bilateral!) Up to 5-6 cm in length and 4 cm in width, a dense ovarian capsule is found. An important diagnostic sign is the presence of 8 or more small follicular cysts located on the periphery of the ovaries (“necklace symptom”) and an increase in the volume of the ovarian stroma (medulla located inside the organ). In addition, an increase in blood flow in the vessels of the ovarian stroma is also recorded (according to Doppler data).
Study of the hormonal profile. To confirm the diagnosis of "polycystic ovary syndrome", the levels of the following hormones are studied: LH, FSH, progesterone, estradiol, prolactin, testosterone (free and bound), androstenedione, DHEA-S and 17-hydroscyprogesterone, cortisol.
Functional hormonal tests. For the differential diagnosis of polycystic ovary syndrome with diseases that occur with similar symptoms, but have other causes (for example, tumors of the ovaries and adrenal glands), special drug tests are performed to track the dynamics of the production of the corresponding hormone.
To exclude tumor lesions, magnetic resonance imaging (MRI) is also performed.
If necessary, laparoscopy is performed.
Study of the lipid spectrum of the blood (detection of lipid metabolism disorders).
Determination of glucose and insulin levels in the blood, glucose tolerance test (to detect disorders of carbohydrate metabolism).

Treatment of polycystic ovary syndrome (PCOS)

The nature of the treatment of polycystic ovary syndrome depends on the duration of the existence of the pathology, clinical manifestations, the effectiveness of previous therapy, etc. The main goal in the treatment of PCOS is the restoration of ovulation, and, as a result, the normalization of menstruation, the restoration of reproductive function and the prevention of hyperplastic processes and endometrial cancer. The restoration of ovulatory menstrual cycles also contributes to the gradual elimination of manifestations of hyperandrogenism and the elimination of metabolic disorders. To achieve these goals, conservative and surgical methods of treatment are used.

Conservative therapy polycystic ovary syndrome (PCOS) consists in prescribing the following groups of drugs: antiestrogens, gonadotropins (to stimulate ovulation), combined oral contraceptives with an antiandrogenic effect (to restore the menstrual cycle, fight hyperandrogenism). In some cases, antidiabetic tablets are prescribed to normalize tissue sensitivity to insulin (eliminate one of the factors leading to the development of the disease).

A very important component of conservative treatment in women suffering from PCOS in combination with obesity is the normalization of body weight. The diet and diet of such patients must meet the following requirements:

Limiting the caloric content of the diet to 1200-1800 kcal / day (subject to the principles of a balanced diet). To achieve a feeling of satiety, it is necessary to increase the consumption of low-calorie, but significant food (vegetables, sour fruits).
Increased protein content in the diet (meat, fish, cottage cheese, seafood).
Significant restriction of the use of easily digestible carbohydrates (sugar, honey, jams, sweet drinks, flour and confectionery products).
Replacing animal fats with vegetable ones. Limiting fat intake to 80 g per day.
Exclusion of foods and dishes that stimulate the appetite: spices, spices, strong broths and sauces, pickled and smoked foods.
Complete abstinence from alcohol.
5-6 meals a day in small portions.
Unloading days (kefir, apple, cottage cheese, meat and vegetables, etc.) - up to 3 times a week.

Adequate physical activity and an active lifestyle are a prerequisite for an effective fight against obesity.

If conservative therapy does not give the desired result, as well as in the case of the development of endometrial hyperplasia, it is indicated surgery.

Surgical treatment of polycystic ovary syndrome consists in laparoscopic wedge resection of the ovaries (removal of part of the ovarian tissue, which leads to a decrease in the formation of androgens, normalization of blood circulation in the organ and, as a result, restoration of ovulation) or in cauterization (cauterization) of the ovarian tissue, which is also performed using laparoscopic access. After surgical treatment, 80% of patients restore a regular menstrual cycle, and 65% become pregnant.

However, we must remember that the effect of the operation is temporary, it lasts no more than 5 years (usually 1-3 years), after which the disease recurs. Therefore, operated women need constant monitoring and timely administration of hormonal therapy - usually combined oral contraceptives - in order to prevent hyperplastic processes and endometrial cancer.

Thus, polycystic ovary syndrome (PCOS) is, although intractable, but completely correctable pathology. The main thing is the correct diagnosis, timely appointment of treatment, strict implementation of doctor's prescriptions and regular medical examinations. Be healthy!

Author: Reproductologist, Candidate of Medical Sciences, Chief Physician of the Medical Center "Rodinne Dzherelo" Strelko Galina Vladimirovna

The ultrasound doctor just gave you a conclusion on the results of ultrasound diagnostics, he did not diagnose you, much less prescribe you treatment. For further treatment, you should visit your attending gynecologist with the results of the ultrasound, who, based on the conclusion of the ultrasound and other tests, will prescribe you the treatment.

KIA means a diagnosis of cystic changes in the ovaries, which indicates the presence of one or more cysts on the ovaries.

An ovarian cyst is a small formation on the surface of the ovary that is filled with fluid. There are several types of cysts that can form on the ovary.

Follicular ovarian cysts are formed in the process of ovulation disorders from the follicle maturing in the ovary.

The cyst of the corpus luteum is formed after the rupture of the follicle in its place, if the corpus luteum continues to grow, that is, its reverse development does not occur. A parovarian cyst is usually located on the side or above the fundus of the uterus near the ovary.

Dermoid cyst is a violation of embryonic development, which manifests itself already in adulthood. The composition of such a cyst may include various tissues of an undeveloped embryo.

An endometrioid cyst is formed due to the growth of endometrial tissue in the ovaries.

Some ovarian cysts can go away on their own, without treatment, the so-called functional cysts, but the danger is cysts that grow in size and exist for a long period of time. Treatment of ovarian cysts can be both medical and surgical, and in most cases a sparing method of laparoscopy is used. In case of complications caused by rupture or torsion of the cyst, abdominal operations are used.

Also, cystic changes in the ovaries can indicate a disease such as polycystic ovaries.

Polycystic ovary syndrome is a disease that is accompanied by the formation of a large number of small cysts on the surface of the ovaries. The main cause of this disease is a violation of the hormonal background of the body, due to improper functioning of the internal secretion organs. The main symptoms of this disease are menstrual irregularities, changes in the body associated with an increase in the level of male hormones, such as male pattern hair, changes in the condition of the skin and hair.

This disease can be the reason why conception does not occur. This is due to the fact that due to changes in the hormonal background of the body, ovulation does not occur on time. Therefore, the main manifestation of polycystic ovary syndrome is a violation of the menstrual cycle, expressed in its increase, lack of ovulation, longer and more painful menstruation.

Usually, polycystic ovaries develop in adolescence, the so-called primary polycystic ovaries. Secondary polycystic ovaries manifests itself in adulthood, and may be the result of inflammatory diseases in the genital area, etc.

Treatment of polycystic ovaries is aimed primarily at eliminating the causes that caused it, and consists in eliminating inflammatory diseases, normalizing the hormonal background of the body, and stimulating ovulation.

Now, after receiving the results of the ultrasound, contact the gynecologist. It is this doctor who should give you the final diagnosis and prescribe treatment. Cystic changes in the ovaries are not yet a sentence; with timely and proper treatment, a woman has a chance of becoming pregnant. But if you start the disease, especially if complications arise, you can not only lose the ovary, but also the opportunity to have children.

Additionally

Cystic degeneration of the ovaries is a serious gynecological disease that often leads to infertility. As a result of the disease, cysts form in the ovaries, which leads to an increase in the internal genital organs. About 23% of women with a regular cycle aged 20-35 years have experienced this disease. The likelihood of finding cystic degeneration of the ovaries increases in women taking hormonal birth control pills.

What is cystic ovarian degeneration

In modern medicine, cystic degeneration of the ovaries is also called polycystic, ovarian multicystic, cystic degeneration. At a certain point in the menstrual cycle, the mature follicle ruptures and an egg is released from it, ready for fertilization. This is how ovulation occurs. If, for some reason, the fertilization process does not occur, then the organ is not functioning properly. =

The follicle that did not burst in due time begins to grow. In appearance, it resembles a bubble filled with liquid. This is how an ovarian cyst is formed. The bubble begins to stretch, and can reach alarming sizes. In the event of a malfunction of the internal organs, even a healthy woman may experience small cystic degeneration of the ovaries. If the failure is repeated periodically, all follicles can go into the category of cysts. In this case, ovulation does not occur and there is a problem with pregnancy.

When many cysts occur, the genitals increase in size. Follicular cysts on an ultrasound scan look like a bunch of grapes. If the disease has spread to only one ovary, a woman has a chance to become pregnant, because the other ovary continues to function normally. If cystic degeneration has spread to both ovaries, the woman becomes infertile.

The first signal of the occurrence of polycystic disease is the reduction of menstrual bleeding to two days or their cessation altogether.

Causes

The exact cause of the appearance of cystic ovarian degeneration has not yet been established, but doctors agree that there are a number of factors that provoke the onset of the disease:

Increased production by the body of a woman of male hormones - androgens. This can manifest itself in the growth of hair on parts of the body that are characteristic only for men;
Thickening of the ovarian capsule;
Violation of the thyroid gland, adrenal glands, hormonal disruptions;
Strong nervous shocks;
Obesity. Increased body weight can provoke the occurrence of cystic degeneration of the ovaries;
Increase in blood sugar;

Most often, girls in the childbearing period, but who have not had a single pregnancy, turn to a specialist for help. It is also possible the occurrence of primary multicystosis in girls during puberty.

The adjusted hormonal background is very important for any woman. A slight deviation from the norm can provoke a number of gynecological diseases. The impetus for the occurrence of cystic degeneration of the ovary can be:

Treatment of other diseases with hormone therapy;
Taking birth control pills;
puberty;
A sharp change in climate;
Wrong diet;
Complicated course of a previous pregnancy;
Abortions, artificial childbirth;
Disruptions in the endocrine system.

Symptoms

When the first signs of polycystic disease appear, a woman may notice the following symptoms:

Violation of the monthly cycle. Bleeding may occur within a couple of days or disappear altogether. If this is repeated systematically, a woman should urgently contact a gynecologist;
If during menstruation bleeding is very strong and accompanied by sharp pain;
Lack of ovulation, and as a result of this, the resulting infertility;
Deterioration of a woman's condition for no apparent reason. There is a headache, increased fatigue, the woman becomes irritable and often falls into depression;
A sharp increase in body weight;
Dark hair begins to grow on the legs, arms;
The skin in the face and neck becomes oily, acne appears;
Constant aching pain in the ovaries;
Mastopathy may appear.

A woman most often explains the appearance of these symptoms by the menstrual cycle, changing weather conditions, moving to a new place of residence, and so on. And only severe pain or unsuccessful attempts to get pregnant lead a woman to a gynecologist.

Diagnostics

The earlier a woman turned to a doctor with complaints of deteriorating health, the better. Timely diagnosis will help to identify the disease at the initial stage of the disease and quickly begin its treatment.

To make an accurate diagnosis and begin treatment, the doctor will refer the patient to the following studies:

Laparoscopy. This type of diagnosis allows during the study to immediately carry out the necessary manipulations to eliminate the cause of the disease;
Inspection with an ultrasound machine. With ultrasound, a doctor can diagnose almost any disease of a woman's small pelvis. On the screen, the doctor will see a decrease in the size of the uterus, and the ovaries will be greatly enlarged. The ovarian membrane will be compacted, gray in color;
Biochemical study of blood. This analysis will show the content of fats in the blood, the indicator of which is likely to be overestimated;
Blood test for the number of male hormones, insulin content.

Treatment

Cystic ovarian degeneration is a rather insidious disease. An untimely visit to a doctor can lead not only to infertility, but also to the appearance of other diseases:

Cancer of the uterus and ovaries;
endometriosis;
Obesity;
Vascular disease.

At the beginning of treatment, the gynecologist sets the following tasks to perform:

Reducing the amount of male hormones;
Normalize the monthly cycle of the patient;
Reduce the risk of cardiovascular disease;
Normalization of hormonal levels;
Help the patient to get pregnant.

A few decades ago, there were only two types of treatment: surgery and hormone therapy. To date, the picture has changed - there are several types of treatment that can be used alternately or in combination:

Decrease in body weight. It has been clinically proven that irreparable processes occur in a woman's body when overweight. The first step in the treatment process is getting rid of obesity. The decrease should take place smoothly, without exposing the body to additional stress. With gradual weight loss, patients notice that the menstrual cycle begins to return to normal. To get rid of extra pounds, the gynecologist will advise you to seek help from a nutritionist or independently develop a diet. Swimming, running and other sports will only help speed up the process of losing weight.
Stimulation of ovulation. This method applies to those patients who are trying to get pregnant. Stimulation is carried out with the help of various drugs. It is best to use weak drugs at the beginning of treatment, and only then, if they are ineffective, switch to stronger ones. Stimulation is best done after drug treatment, so the chance of getting pregnant increases.
Hormonal contraceptives. In addition to the main task of preventing unwanted pregnancy, hormonal drugs help the amount of male hormones.
Prescribing drugs that reduce androgens. Preparations containing antiandrogens can be prescribed as a separate type of treatment, and in combination with contraceptives.
The use of metroformin. This drug is prescribed primarily for diabetes mellitus. Improper work of insulin provokes not only diabetes mellitus, but also cystic degeneration of the ovaries. According to statistics, women taking metroformin noticed that the menstrual cycle began to recover on its own, without the use of additional treatment. The course of treatment with this drug lasts at least six months, and positive dynamics can be observed after three months.
Surgical intervention in the form of laparoscopy or abdominal surgery. Surgical solution of the problem is applied only after the ineffectiveness of drug treatment. Also, the rapid growth of cysts and a sharp increase in the ovaries can serve as a reason for the operation. During the operation, with an advanced course of the disease, a decision can be made to completely or partially remove the ovary.

According to the symptoms of the disease and methods of its treatment, cystic degeneration of the right ovary is no different from cystic degeneration of the left ovary. At the first symptoms, you should consult a doctor, do not self-medicate. The diagnosis will help to realistically assess the situation and choose the right treatment.

A cystic change in the ovary is a gynecological disease that appears due to impaired functioning of the female body due to hormonal factors.

Cysts can be different in their characteristic highlights and be determined by what structures of the ovaries produced hormones in each individual case.

The largest part of the total number of cases in which a cystic change in the ovary is noted is represented by functional cysts or, as they are also called, false. They are characterized by spontaneous occurrence, not provoked by any obvious visible circumstances, and have a tendency to the same spontaneous disappearance. Their origin is not associated with the occurrence and spread of cellular atypia, which is characteristic of cancer. The formation of functional cysts leads to dysfunction of the ovaries, they do not differ in huge sizes, in some cases they can provoke clearly localized unilateral pains and lead to violations of the monthly cycle.

One of the types of false cysts is the follicular cyst. With it, after 14 days of the cycle, the egg is not released from the follicle, but the production of estrogen continues. This leads to delayed menstruation and lack of ovulation.

It happens that the corpus luteum does not resolve after ovulation has occurred, and estrogen and progesterone continue to be produced in it. This phenomenon provokes the origin of the corpus luteum cyst. All indicators inherent in the state of pregnancy begin to appear, but the test results indicate that the lady is not pregnant.

With this cystic transformation, surgical intervention is not necessary.

Cysts of an organic nature are not related to hormonal imbalances in the body; spontaneous remission does not occur if they are present. If the cyst is of a huge size, it can put pressure on nearby organs - the rectum, intestines, bladder. The existence of a small cyst may be asymptomatic.

Dermoid organic cysts are formations that contain fluid with the presence of sebum. Pseudomucinous cysts are filled with a yellowish liquid, a thick, viscous liquid resembling gelatin in consistency. Serous cysts have light yellow serous contents.

Circumstances of cystic transformation of the ovary

The circumstances of the cystic transformation of the ovary are mainly associated with a violation of the hormonal balance in the body. For the most part, this refers to the overproduction of androgen, the male sex hormone. Ladies of various age groups can be susceptible to this disease. It can develop both during the puberty of a girl during the formation of the menstrual cycle, and in older women. In the latter case, cysts can appear as a result of chronic genitourinary diseases.

Negative factors contributing to an increase in the possibility of developing diseases are: heredity, various stressful situations, acute respiratory diseases, unnatural termination of pregnancy, especially if abortions were performed in the youthful period of a woman's life. The circumstances of the cystic transformation of the ovary can also be due to trips or moving to a new place of residence in areas located in a different climatic territory. Also, cysts in the ovaries can develop as a result of the fact that there are other diseases characterized by impaired functioning of the hypothalamus, pituitary gland, adrenal glands or thyroid gland.

Symptoms of cystic transformation of the ovary

There are a number of characteristic indicators, transformations and disturbances in the functioning of the female body, the appearance of which allows us to suggest that they are symptoms of cystic transformation of the ovary.

Evidence of the presence in order for the disease may be a violation of the regularity with which menstruation occurs. The processes of formation of cysts in the ovaries can lead to disruption of ovulation up to its complete absence - anovulation. This has as its manifestations the transformation of the monthly cycle, prolonged, more than a month delay in menstruation or amenorrhea - their absence. From time to time, delays in menstruation for a long time can be replaced by periods of uterine bleeding.

Symptoms of cystic transformation of the ovary are also manifested in the origin of a tendency to increase the skin and hair, acne, acne and seborrhea can appear. The phenomenon accompanying the development of cysts in the ovaries is a sharp increase in weight from 10 to 15 kilograms. Obesity can be both a temperament of even distribution of deposits throughout the body, and occur in a male pattern - with an increase in fat mass, mostly in the abdomen and waist. In addition, the amount of hair on the body increases: in the perineum, on the abdomen, thighs and legs, the appearance of antennae above the upper lip is noted.

There are regular pain symptoms of a pulling nature, of moderate severity, covering the lower abdomen and possibly radiating to the lower back and pelvic region.

Conducting a study on the content of hormones shows the following results. Hormones produced by the pituitary gland, thyroid gland and ovaries exceed the norm of their content.

Cystic change of the right ovary

During the normal healthy functioning of all organs of the female body, the ovaries produce sex hormones in the right ratio, both female - progesterone and estrogen, and male - androgens. A cystic change in the right ovary, and equally in the left, destroys homeostasis, which is the state of the optimal balance of hormones in the human body. Increasing along with this, the amount of male hormone produced, which prevails over female ones, leads to inhibition of the processes of monthly maturation of the egg, in other words, ovulation does not occur.

Lack of ovulation, and due to this - a symptom of primary infertility due to cysts that occur in the ovaries, is one of the characteristic indicators inherent in this disease. In addition, a cystic change in the right ovary leads to menstrual irregularities (oligo-amenorrhea), and growth of body hair, and may also appear overweight.

The origin of cystic transformation in the right ovary is possibly due to impaired functioning of the pituitary-hypothalamus, female gonads, thyroid gland, adrenal glands. In addition, a hereditary factor can play a certain role in increasing the risk of developing this disease. In addition, the prerequisites for the appearance of cysts in the ovary can be covered in an excess of insulin, which promotes the active production of androgens.

Cystic change of the left ovary

Cystic change of the left ovary is a disease associated with hormonal imbalance in the body, and appears due to a malfunction in the regulation of the menstrual cycle due to impaired functioning of the hypothalamus, pituitary gland or adrenal glands.

Currently, there is a classification of this female ailment into two of its varieties. The first form is genuine or primary polycystic. It is caused by the presence of a congenital disease or certain hereditary factors of predisposition to this disease. The secondary form of the disease has ovarian disease as a circumstance of its origin.

Factors representing a risk group that a cystic change in the left ovary may develop are susceptibility to stressful situations, an unexpected change in body weight in the direction of both increase and decrease, it can also appear against the background of taking contraceptives and breastfeeding.

It is necessary to pay attention to the fact that this disease, if timely appropriate measures are not taken to cure it, can lead to infertility.

Otherwise, its detection, in many cases, occurs precisely during examinations and diagnostic measures to determine the circumstances of infertility.

But the diagnosis, which states the presence of cystic transformations in the ovaries, should by no means lead to panic and plunge into despair. Currently, there are a sufficient number of different therapeutic methods that will help to cope with this disease. The main thing is to start treatment in a timely manner.

A comprehensive diagnosis is performed using a comprehensive examination using ultrasound, laboratory blood tests for hormone levels and the presence of hidden infections, and a smear to determine the microflora.

Cystic change in both ovaries

Cystic change in both ovaries - a female disease, which also has the name polycystic ovaries, is characterized by the fact that small cysts grow a lot on the surface of the ovaries. A circumstance to the formation of a pathological process is a hormonal imbalance in the female body. The course of the disease may differ in the absence of any signs, in some cases, a violation of the function of menstruation by the type of oligomenorrhea is likely. Distinctive indicators indicating the presence of this disease, in addition, there is the growth of body hair, an unexpected large increase in body weight, the appearance of acne.

Polycystic congenital type or - primary may first appear in adolescence, during puberty during the formation of menstrual function. In subsequent age periods of a lady's life, the circumstances that a cystic change in both ovaries appears can be a chronic pathology associated with the functions of the endocrine system, or due to infectious and inflammatory processes in the female genitourinary system. This type of disease is called secondary polycystic ovaries.

The formation of cysts in the ovaries, and especially if both the left and the right are involved in such processes at the same time, requires the earliest possible start of appropriate treatment. Otherwise, there is a high possibility of infertility.

Cystic ovary and pregnancy

Cystic change in the ovary and pregnancy - an approach to this issue requires very close consideration and care, because cysts in the ovaries represent a danger to the health of a lady at any age. It does not matter whether the woman gave birth before she was recognized and ascertained the presence of this disease. If the disease is diagnosed during puberty, a woman, in order to avoid the possibility of all sorts of complications, must systematically undergo therapeutic courses of hormone treatment. A positive result of such therapeutic measures, and the removal of the cyst by the laparoscopic method, is that this is why the possibility of a favorable prognosis for the bearing and birth of a healthy child is improved, in addition, if the expectant mother has such a disease. So, it is possible to argue that a cystic change in the ovary and pregnancy - in the realities of the present moment in time, are not something out of the ordinary.

It is only necessary not to forget when planning a child that the effectiveness of treatment and the possibility of a speedy recovery depend on how early the disease is recognized and how appropriate measures are taken in time in order to prevent the upcoming development of pathological progress. In addition, it is important to take care of that in order to protect yourself from hypothermia, the progression of chronic diseases, avoid stress factors and situations.

Diagnosis of cystic transformation of the ovary

Diagnosis of cystic transformation of the ovary and the detection of this disease for the most part occurs during the passage of a preventive gynecological examination by a lady. Based on this, it is extremely important to visit the appropriate medical expert on a regular basis, who, on the basis of a regular examination of the state of the genitourinary system of the female body, is able to notice indicators that may indicate the onset of the formation of cysts in the ovary, in one or both at once. And, based on the positive results of the necessary additional diagnostic measures, appropriate treatment should be prescribed as soon as possible.

The diagnosis, ascertaining the presence of cysts in the ovaries, is made in cases at the time when a combination of at least two of the following factors takes place:

The presence of impaired functioning of the ovary, the consequence of which is a failure in the regularity of the menstrual cycle, and the absence of ovulation and the inability to become pregnant
The phenomenon of excessive production of male androgen hormones for the female body. Hyperandrogenism leads to the appearance of an increased amount of hair on the body, provokes acne, leads to increased greasiness of the skin and seborrhea.
Found during an echoscopic or laparoscopic study, an increase in the size of the ovary and the presence of cystic transformations in it.

Diagnosis of cystic transformation of the ovary is carried out using a number of methods of instrumental studies and laboratory tests. Their use is preceded by a non-specialized examination in order to find out the type of physique, the condition of the mucous membranes and skin, the temperament of hair growth, etc .; and passing by the lady of the vaginal-abdominal examination on the gynecological chair to detect the transformation of the size of the ovary and the presence of seals.

Ultrasound examination suggests that the ovary is enlarged, has a dense capsule, and there are many small follicular cysts on the periphery. According to the results of doplerometry, increased blood flow in the vessels of the ovary is noted.

A laboratory blood test is done to find out the content of hormones produced by the ovaries, pituitary gland, adrenal glands.

It allows to give confirmation of cystic transformations of the ovary, in addition to carrying out laparoscopy.

Echo-signs of cystic transformation of the ovaries

Ultrasound examination of the pelvic organs allows a visual assessment of the condition of the ovaries, and helps to identify probable transformations in the thickness of the mucous membrane of the uterine membrane. The transvaginal method of conducting ultrasound of the pelvic organs in women is contained in the introduction of a special ultrasound probe into the vagina. This diagnostic device, emitting special sound waves of a very high frequency range, transmits the reflected signal to the screen of a computer monitor, where an image of the internal organs located in the small pelvis is recreated, among which are also the ovaries. The use of transvaginal echography makes it possible to achieve a greater degree of information in the study, if compared with the transabdominal type of ultrasound diagnostics. When the sensor is placed in the vagina, it becomes possible to visually analyze the contents that take place in the preovulatory follicles, find out the stage of oocyte maturity, and diagnose endometriosis in its small forms. In addition, this method of study is effective in polycystic ovaries, and allows diagnosing uterine pregnancy in obese women in the presence of adhesion formation processes in the pelvic area.

Echo signs of cystic transformation of the ovaries when visualized on the screen of an ultrasound device look like a so-called string of pearls. This designation was used to describe what the ovarian follicles look like on ultrasound. Any of the black circles on the computer image is an image of an ovarian cyst.

Treatment of cystic transformation of the ovary

Treatment of cystic transformation of the ovary is based on a comprehensive approach and is prescribed after a comprehensive diagnosis has been completed. The courses of treatment for this disease are long and include, if there is such a need, the use of drugs that affect the hormonal sphere of the female body. The main directions on which all therapeutic measures are oriented are the promotion of the restoration and normalization of the processes associated with ovulation and the menstrual cycle, the woman's ability to bear children.

Depending on the indications, the stage and severity of the disease, and other concomitant factors, the treatment of cystic transformation of the ovary can be performed conservatively, or by the method of timely intervention.

The essence of conservative treatment lies in the fact that hormonal drugs are prescribed: anti-estrogens; combined oral contraceptives of anti-androgenic action, which manifests itself in the restoration of the menstrual cycle, and due to which hyperandrogenism passes; gonadotropins - ovulation stimulants.

In those cases, at a time when treatment with conservative methods may not be effective enough, and in addition, if endometriotic hyperplasia begins, the surgical method of treatment becomes relevant. Today, operations for cysts in the ovary are mostly performed by the laparoscopic method and are characterized by a low degree of trauma. During the surgical intervention, a wedge-shaped resection is created, the essence of which is the partial removal of ovarian tissue that has undergone cystic transformations. Another type of timely intervention is cauterization, or cauterization, of the affected areas of the ovary. Due to this, there is a decrease in the level of androgen production, and ovulation is normalized.

At the end of the surgical intervention, the possibility of becoming pregnant remains in 65% of women who have undergone this operation. The most favorable period for this is during the first six months after the end of treatment.

More about treatment

Prevention of cystic transformation of the ovary

Prevention of cystic transformation of the ovary is of great importance due to the fact that a complete cure for this disease, if it occurs, does not seem likely. The main task of treatment is mainly to provide the maximum favorable conditions and to help increase the possibility of becoming pregnant. Ladies who live with this disease, at the time when they are planning a child, are prescribed a treatment course aimed at restoring and stimulating the development of the egg. Because with increasing age, cystic transformations of the ovaries tend to progress, pregnancy should be planned as early as possible.

Prevention of cystic transformation of the ovary is a series of mandatory rules and regulations, following which will reduce the risk of the onset of this disease. In order to be as safe as possible from such a possibility, it is enough to adhere to recommendations on preventive measures similar to those in relation to all other diseases of the female genitourinary system. One of the very first and simple rules to follow is the need for a regular visit by the appropriate medical expert to undergo a gynecological examination. Detection of the disease at its early stage increases the possibility of a favorable ending in time for the prescribed treatment, and allows you to avoid many side effects and complications associated with its progress. The most formidable of which is infertility.

An important reason besides this is the prevention of infections, inflammations and diseases that can adversely affect the functioning of the ovaries.

During the puberty of girls, it is their mothers responsibility to take an interest in the state of their women's health, and if there is a suspicion of the possibility of cysts in the ovaries, take the daughter to a qualified gynecologist as soon as possible.

Prognosis of cystic transformation of the ovary

The prognosis of cystic transformation of the ovary is favorable to the extent that the timely recognized symptoms and transformations in the body of the lady made it possible to assert that this disease is taking place. If the diagnosis is made in the early stages, at the beginning of the development of the pathological process and the necessary treatment is prescribed without delay, this disease can be effectively cured.

In the event that the disease, as it progresses, has managed to reach its rather severe stages, this causes the prognosis of cystic transformation of the ovary of a very negative nature. One of the main aggravating factors along with this is such a feature of the mechanisms of development and course of this disease as its carcinogenic properties. This indicates that if untimely or untreated, it can cause malignant processes in the endometrium of the uterus.

In addition, cysts in the ovary act as a factor provoking bleeding in the uterus. But the most important result of neglected and timely measures against cystic transformations in the ovary is a significantly increased risk of infertility.

Otherwise, despite the fact that it is usually believed that this disease and the ability to become pregnant, bear and give birth to a child are mutually exclusive phenomena, this is by no means a court decision. With proper treatment, the lady has every chance to experience the euphoria of motherhood.