How to treat constantly appearing follicular cysts. Symptoms and treatment of follicular ovarian cyst

Many girls are quite frivolous about the appearance of an ovarian cyst. There is no particular pain or severe discomfort, so some people believe that there is no need to treat it. However, a completely different attitude towards it arises when it breaks, because it can lead to very serious consequences and complications.

Diagnosis of ovarian cyst. What is this?

The essence of the disease is the appearance of a tumor in the ovary of a girl or woman. It is a sac or vesicle (by the way, the word “cyst” is exactly how it is translated from Greek) with fluid, which is located in the ovary and therefore significantly increases its size.

There are several types of such formations:

Functional. This includes follicular and luteal types of cysts. Follicular cells are formed inside the ovary, and luteal cells are formed on the corpus luteum. The main reason for their appearance is the presence of excess fluid in the ovary. As a rule, they form immediately after ovulation and, with favorable developments, disappear after a few months.
Endometriotic. It occurs as a consequence of endometriosis, that is, the spread of cells of the inner mucous membrane of the uterus beyond its boundaries. This leads to the formation of various cavities, which over time fill with blood. Next, the blood thickens and begins to resemble chocolate in appearance. For this reason, such cysts are called chocolate cysts in the professional jargon of doctors.
Cystic or, in other words, a tumor. The most dangerous neoplasm because it can lead to the formation of cancer cells.

Where does an ovarian cyst come from?

Unfortunately, there are currently no clear causes for the occurrence of this disease, which complicates its prevention. At the same time, a number of disorders in the body often lead to the appearance of neoplasms:

Firstly, various gynecological diseases. Therefore, if a girl has suffered any disease of the genital area, it is recommended to be constantly monitored in order to notice the presence of a cyst in time and take measures to eliminate it, preventing rupture.
The second common cause is hormonal imbalance. This means that if there are failures of the endocrine system, you should be observed not only by the appropriate specialist, but also do not forget about the gynecologist. Otherwise, unpleasant consequences may occur.
The likelihood of illness is also high if you have unprotected sex and frequently change partners. In addition to sexually transmitted diseases, promiscuous sexual relations can also lead to the appearance of tumors in the body. After all, the reproductive system also needs time to adjust and get used to the partner, and their frequent changes unbalance it and lead to significant problems with the woman’s health.
Finally, regular stress can cause the appearance of ovarian cysts. Therefore, this disease has become more common nowadays, when many girls and women strive to make a career, perform leadership work and for this reason find themselves unnecessarily exposed to stress. This can be avoided by a proper work and rest schedule, as well as regular exercise and walks in the fresh air.

Reasons for the breakup

It should be noted that rupture most often occurs in functional types of cysts (for example, follicular). This is due to their physiological characteristics. In particular, they have a very thin outer shell. On the one hand, this is good, since there is a possibility of spontaneous resorption of the cyst, without intervention from specialists, but on the other hand, this can lead to rupture under the influence of external or internal factors.

Among the main factors (in addition to inflammatory processes within the body, hormonal imbalances), as a result of which a rupture of an ovarian follicular cyst can occur, are:

Abdominal injuries are bruises resulting from a fall or other impact (it may be quite enough to accidentally bump your stomach into the corner of a table or chair).
Regular intense exercise, which can lead to overstrain of the abdominal muscles, compression of the cyst and its rupture. Therefore, if you have such a disease, you should carefully evaluate the load during training.
Significant physical activity. Lifting and carrying heavy objects and performing heavy physical work must be avoided.
Intimate connection. During illness, you should also approach issues of sexual life with caution. An increase in intra-abdominal pressure during sexual intercourse can lead to rupture of the cyst and serious consequences.

Symptoms

It is almost impossible not to notice the rupture of a follicular ovarian cyst:

Firstly, a sharp pain immediately appears in the lower abdomen. Moreover, you can clearly determine where the cyst ruptured - in the left or right ovary. This will be indicated by the side of the abdomen that is very painful.
At the same time, there is a sharp increase in temperature. It can reach 39 degrees.
In this case, there is weakness throughout the body, caused by possible severe internal or external bleeding.
Blood pressure also drops and the heart rate increases.

In such a situation, the girl or woman should be taken to the hospital immediately. If a follicular cyst bursts, then most likely, surgery will not be required and treatment will take place quickly and without any special consequences. In some cases, the pain in the lower abdomen may not be severe, or the girl may have a low pain threshold and will endure it for several hours or days. In addition, a follicular cyst most often ruptures during the period of ovulation, so sharp pain during this period may not be frightening, and delay in such a situation can lead to negative consequences. Therefore, if bleeding and a sharp rise in temperature occur, it is better to play it safe and seek help from specialists.

Diagnostics

A standard examination by a gynecologist rarely allows one to diagnose the presence of a neoplasm. Moreover, the described formation does not create any particular discomfort for the woman and does not cause pain. Therefore, the presence of even minor pain in the lower abdomen should be reported to the doctor during the examination. A more thorough examination may reveal a tumor in the pelvic area, and the doctor will prescribe a puncture procedure. Its results will allow you to see whether there is fluid or blood inside the cyst, and will also help assess the level of blood loss and the presence of inflammation inside.

A more effective and reliable method is ultrasound. It allows you to quickly see new formations in a woman’s body and take timely measures. Therefore, an effective measure for the prevention of various gynecological diseases is regular ultrasound of the pelvic organs. In some cases, the doctor may prescribe a tomography. It will more clearly determine the presence, size and nature of neoplasms in the ovaries.

During the diagnostic process, consultation with an endocrinologist may be required. Most often this occurs in the presence of hormonal disorders.

Methods and methods of treatment

Treatment technologies depend on symptoms and test results. If there is bleeding, then cold treatment is mandatory to stop it. After the patient has completed all procedures for collecting tests and stopping bleeding, the specialist must determine the type of cyst that has burst. If it is follicular, then prescribing hormonal drugs may well be sufficient. Taking them during several menstrual cycles will lead to the patient’s recovery. To monitor the progress of treatment, you should definitely undergo an ultrasound.

In some cases, surgery may also be required. Most often, resection or suturing of the ovary is performed for therapeutic purposes. However, it cannot be performed in case of pregnancy, since such an operation can cause a miscarriage.

In very severe cases, complete removal of the ovary may be necessary. This is a more complex operation with negative consequences (reducing the likelihood of pregnancy), which they try to perform only in extreme cases.

Laparoscopy

If a cyst is detected, the doctor may decide to remove it. Also, such a decision can be made if the cyst has not resolved as a result of drug treatment. Surgery to remove a tumor can be performed using two methods:

Laparoscopy;
Laparotomy.

The first method is used if only the cyst is removed. The operation is not complicated, lasts from twenty to forty minutes, and is performed using special equipment and tools. This procedure causes minimal harm to the woman’s body and does not require long-term rehabilitation.

If the decision is made to remove the cyst along with the ovary, then the laparotomy method is used. It is also performed under general anesthesia, but its duration is already more than an hour, which requires a certain recovery period for the patient and her being under the supervision of doctors.

Depending on the complexity of the disease, laparotomy can be of three types: with removal of the cyst only, with removal of the cyst and part of the ovary, with removal of the ovary along with the neoplasm.

In some cases (for example, with severe internal bleeding), abdominal surgery may be required. It is important to remember that in the event of a cyst rupture, doctors need to act quickly and all tests and decisions about the method are made promptly.

Contraindications for surgery

In some situations, treatment can be much more complex than just medication or surgery. Thus, hormonal drugs cannot be prescribed for the treatment of a disease if there is a suspicion that the neoplasm may be malignant. In this case, it is necessary to first determine the nature of the cyst, and then decide on the method of treatment. Resection is contraindicated during pregnancy as it increases the likelihood of miscarriage.

Laparoscopy or laparotomy cannot be performed if the patient has vascular and heart diseases or chronic kidney problems. In such a situation, the operation may jeopardize the life and future health of the patient in the future, which means it is not worth the risk (except in cases where the situation is hopeless). Also, laparoscopy or laparotomy should not be performed if the patient is experiencing the acute stage of any infectious disease, since the operation, firstly, reduces immunity, and, secondly, during the operation the infection can affect any internal organ.

The presence of anemia is an obstacle to the operation. After all, a low number of red blood cells indicates a weakness of the body, so if you have such a disease, difficulties may arise during the rehabilitation period.

Consequences of a ruptured ovarian cyst

When the first symptoms of this phase of the disease appear, you should immediately consult a doctor. If you do not provide help to a woman in time, the following negative consequences are possible:

The body is poisoned. After all, when a cyst ruptures, all the fluid contained in it ends up inside the woman’s abdominal cavity and affects the internal organs. If assistance is not provided in a timely manner, intoxication can reach a critical level and begin to threaten the patient’s life.
There is a possibility of the neoplasm turning into a malignant tumor. Fortunately, in medical practice there are very few such cases, but, nevertheless, they exist. You should also not self-medicate, since untimely assistance caused by relieving pain in the acute period, coupled with taking the wrong medications chosen independently, can lead to a threat to life and extremely negative health consequences.
Infertility. Untimely medical care can lead to the need to remove the ovary, which sharply reduces the likelihood of getting pregnant.
The emergence of new gynecological diseases. It must be remembered that all organs, and especially the pelvic organs, are connected to each other. Therefore, if the cyst ruptures, the infection can enter another internal organ, which will lead to the development of a new disease.

Rupture of an ovarian follicular cyst is a rather dangerous disease. The reasons for it are not fully understood. The formation of a new formation in a woman’s body does not always occur with the manifestation of clear symptoms, so it is necessary to undergo regular examinations by a gynecologist using ultrasound methods. It is always better to detect a cyst early and either remove it or treat it than to use various methods to treat its rupture. However, situations with its rupture occur quite often, and in this case the main thing is to consult a doctor in time, who will provide the necessary assistance and prescribe effective treatment.

A follicular cyst is a formation that arises from a follicle that has not undergone ovulation. The pathology is detected mainly in teenage girls with an unsteady menstrual cycle and young women, less often in the late reproductive period. Does not occur during menopause. It has a benign course. Does not malignize, is prone to spontaneous regression. In rare cases, it requires surgical treatment - removal of the formation or the entire ovary.

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

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

Causes of pathology development: basic theories and risk factors

In the century before last, follicular ovarian cysts were known as water disease. No one knew the exact cause of the pathology, but doctors assumed the influence of lifestyle on the occurrence of such formations. It was 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 serving God and renounced worldly affairs. The disease was considered incurable and put an end to the woman’s future fate.

At the beginning of the 20th century, a different theory of the occurrence of the disease appeared. Doctors of that time considered the main cause of ovarian cysts to be inflammatory diseases of the pelvic organs - the uterus and appendages. 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 connection between hormonal disorders and ovarian pathology. In those years, it was not only about a failure in the production of hormones, but also about genetic damage. It was believed that the tendency to develop the disease is inherited.

Today, the main cause of the formation of a follicular cyst is considered to be hormonal imbalance followed by anovulation. This theory does not explain all aspects of the development of the disease. Even healthy women do not ovulate every month, but not everyone develops cystic cavities.

Ovulation process.

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

Sexually transmitted infections. Inflammatory processes in the appendages disrupt their functioning and contribute to anovulation. The follicle does not burst, and a cyst appears - a cavity filled with fluid;
Natural hormonal changes. It has been 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 have not been studied, 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 (during stimulation of ovulation);
Previous 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 (there are no favorable conditions for bearing and giving birth to a child). The work of the ovaries is inhibited, ovulation does not occur, and a cyst grows in place of the follicle.

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

On a note

The influence of two more factors is considered: irregular sex life and dissatisfaction with sexual relationships. Confirmation of this theory has not yet been found.

Psychosomatics explains the formation of cystic cavities by fixating on one thought, and in particular on issues of relationships with men. According to experts, the development of the disease is caused by the suppression of certain emotions, including those associated with sex and the birth of children. To prevent the appearance of cysts, it is recommended to close certain stages of your life in a timely manner, competently live your own feelings and enjoy every day without looking back at the past.

How does a follicular cyst form?

Normally, in a healthy woman who does not take hormonal medications, follicles in the ovaries mature monthly throughout the reproductive period. Among all follicles, one dominant one stands out (rarely 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 time, the egg remains inside. The formation continues to grow and fill with fluid. A cyst appears - a cavity surrounded by a thin capsule. The growth of the formation is associated with the gradual leakage of blood serum, as well as with the continuous secretion of fluid by granulosa epithelial cells.

Distinctive features of a 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 is most often formed on the right ovary - where ovulation occurs in 60-70% of cases.

The photo schematically shows 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 bother the woman, do not change the menstrual cycle and are not accompanied by pain in the lower abdomen. Severe symptoms of the disease occur when the cyst grows (up to 5-6 cm or more).

There are three main signs of pathology:

Menstrual irregularities

Characteristics:

Long delay of menstruation. According to reviews of women who have encountered this 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 ovarian formation, menstruation comes late, and their character always changes;
The appearance of nagging 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. Minor spotting occurs between menstruation on days 12-18 of the cycle. Bleeding can persist for up to two weeks and progress to full menstruation.

Menstrual irregularities can be a symptom of the presence of a cystic formation.

During 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 normal from pathology during this period. At the age of 45-50 years, the main role in 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 profuse, with clots. There is a deterioration in the general condition, and severe weakness appears. Possible nausea and vomiting, chills. If uterine bleeding develops, immediate hospitalization in a gynecological hospital is indicated.

It is important to know

Follicular cyst is one of the leading causes of bleeding in adolescence. Hormonally active formation 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 a 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 pinched and tissue ischemia develops. The pain is localized on the right or left in the lower abdomen, depending on the side of the lesion. Irradiation is noted 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 is important to know

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

Complications that arise during a long course of the disease

Conditions requiring emergency medical care:

Leg torsion

A dangerous complication occurs under the influence of certain factors:

Physical activity, including heavy lifting;
Sports activities involving jumping and turning;
Sudden change in body position;
Intimacy.

Torsion of the cyst pedicle often occurs during pregnancy. The complication develops in the second and third trimester and is associated with displacement of the ovary by the growing uterus.

The symptoms of the complication depend on the degree of torsion of the leg. With partial twisting, the symptoms increase gradually over several hours. There is pain in the lower abdomen, which intensifies over time. 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, less often diarrhea;
Urinary retention;
Tension of the muscles of the anterior abdominal wall;
Increased heart rate and breathing;
Increased body temperature;
Paleness of the skin and mucous membranes;
Loss of consciousness.

Torsion of the legs threatens the development of ovarian necrosis. With timely assistance, it is possible to save the organ by untwisting the cyst and restoring blood flow. Without treatment, necrosis spreads to neighboring tissues, leading to the development of peritonitis and sepsis.

Capsule rupture

The main cause of cyst rupture is said to be violent sexual intercourse, as well as physical activity. If the cyst bursts, its contents exit into the abdominal cavity. Symptoms of acute abdomen occur:

Cramping pain on the affected side - right or left. The pain can be acute, unbearable, leading to loss of consciousness;
Abdominal muscle tension;
Nausea, vomiting;
Paleness or cyanosis (blue discoloration) of the skin;
A sharp drop in blood pressure;
Bloody vaginal discharge.

This is what a ruptured capsule of an ovarian cyst looks like.

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

Infection

A rare complication that occurs in women after an abortion and against the background of pelvic inflammatory processes. Accompanied by the appearance of the following symptoms:

Drawing or cramping pain in the lower abdomen;
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 spread to neighboring organs. The spread of pathogenic microorganisms through the bloodstream (sepsis) is possible. The only treatment is 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. While 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 special features. Under the influence of hormonal changes, the cyst should disappear within 2-3 months. If this does not happen, complications may develop (torsion, capsule rupture).

A small follicular cyst does not interfere with 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 at 16-20 weeks, when the likelihood of miscarriage and other complications is minimal.

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

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

Diagnostic search

The following methods are used to identify pathology:

Gynecological examination. On palpation, a cyst is defined as a unilateral, mobile, painless, elastic formation measuring 4-10 cm. A cavity of smaller diameter is not always felt during bimanual examination;
Laboratory research. CA-125, a marker of ovarian malignancy, remains within normal limits;
Ultrasound. With ultrasound examination, the follicular formation is visible as a round cavity with a thin capsule. The formation is homogeneous, the contents are echo-negative;
Doppler. Color mapping does not reveal pathological blood flow around the formation.

The above methods are sufficient to carry out 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 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 connection?

It is important to distinguish between three concepts:

A follicular cyst is a cavity filled with fluid. This is a single ovarian mass. It can be multi-chambered, but more often does not have a cellular structure;
Multifollicular ovaries are a physiological condition of the appendages, detected by ultrasound in the first phase of the cycle. 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. An ultrasound shows the appearance of a large number of follicles ranging in size from 8-10 cm and an enlargement of the ovary.

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

Distinctive features are presented in the table:

Characteristic	Follicular cyst	Multifollicular ovaries	Polycystic ovary syndrome
Hormonal background	Estrogen is increased, progesterone and prolactin are decreased	Not changed	Luteinizing hormone is elevated, the ratio of LH and FSH is disrupted
Ovulation	Absent. Possible in rare cases in a healthy ovary	Saved	Chronic anovulation
Pregnancy	Impossible. In rare cases - during ovulation in a healthy ovary	Possible	Almost impossible
Health Risk	Possible if complications develop (cyst rupture, pedicle torsion, infection)	No	PCOS is combined with other diseases: endometrial hyperplasia, breast pathology, high risk of thrombosis, diabetes mellitus, cardiovascular pathology
Spontaneous cure	Maybe	Maybe	No

On a note

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

Difference between normal and polycystic ovary.

Tactics for identifying pathology and treatment methods

Follicular ovarian cyst is a retention formation. It has a benign course and tends to regress spontaneously. Education occurs 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 for 3 months after detection of the disease. No medications are prescribed in this case. A woman is advised to monitor her feelings and, if her condition worsens, immediately consult a doctor. To prevent the cyst from rupturing or twisting, it is important to follow simple rules:

Do not have sex (or at least exclude violent intimacy, be careful during sexual intercourse);
Avoid thermal procedures. You cannot visit the bathhouse, sauna, go to the solarium, take a hot bath or shower;
It is contraindicated to lift weights of more than 3 kg and engage in sports with serious stress on the body;
It is recommended to avoid sudden body turns and jumps.

Not all gynecologists adhere to wait-and-see tactics for follicular ovarian cysts. There are recommendations according to which hormonal treatment is recommended for all women with this pathology. Combined oral contraceptives are prescribed for a period of 3 months. Progesterone medications can be used to induce menstruation.

Hormonal therapy is justified if there are complaints of lower abdominal pain, bleeding or significant menstrual irregularities. If the disease is asymptomatic, there is no point in taking hormones.

Regulating hormonal levels with the help of COCs allows for rapid regression of the follicular cyst.

To speed up the resorption of the cyst, non-drug methods of influence are used:

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

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

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

Methods of surgical treatment:

Cyst excision. The best option for education on a thin stem. Healthy ovarian tissue is practically not affected, the function of the organ is not impaired;
Ovarian resection - removal of the cyst along with part of the organ. Possible if a formation is detected on a broad base and intact tissues;
Ovariectomy – removal of the ovary. It is carried out if there are no healthy tissues left.

Schematic representation of the stages of removal of an ovarian cyst using a laparoscopic method.

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

In modern gynecological hospitals, priority is given to laparoscopic methods. After the operation, the patient recovers quickly. With a intact ovary, reproductive function is not impaired. If one ovary has been removed, then the other takes over its task, and in the future there will also be 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 maintain sexual and physical rest, avoid stress and overexertion. You can plan a pregnancy 3-6 months after treatment.

The prognosis for follicular cysts 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 imbalances.

Prevention of ovarian cysts has not been developed. Gynecologists advise promptly treating all emerging reproductive diseases, avoiding abortions and taking hormonal medications only when indicated. For timely detection of pathology, it is recommended to undergo an annual examination with a doctor. Often a cyst becomes an accidental finding during a medical examination.

Interesting video about follicular ovarian cyst

Causes of development of functional cysts and their treatment

Follicular ovarian cyst- symptoms and treatment

What is an ovarian follicular cyst? We will discuss the causes, diagnosis and treatment methods in the article by Dr. E. V. Popenko, a gynecologist-endocrinologist with 32 years of experience.

Definition of disease. Causes of the disease

Follicular ovarian cyst(non-bursted follicle) is a retention functional tumor-like formation of the ovary, represented by a cavity filled with fluid.

Benign ovarian tumors account for 12-25% of tumors of the female reproductive system, reduce a woman’s ability to become pregnant and are often an indication for surgical intervention. Ovarian cysts account for an average of 17% of all ovarian formations, a significant part of which are retentional - 70.9% of cases. Follicular ovarian cysts are the most common pathology in women of reproductive age. Among benign ovarian tumors, their share, according to domestic and foreign authors, accounts for up to 80% of cases. These formations occur in women at any age.

A follicular cyst develops from mature preovulatory follicles or antral follicles and is a single-chamber thin-walled formation filled with transparent and light contents. Most often it is one-sided. Sizes vary from 2 to 20 cm.

This pathology occurs with high frequency in women with infertility. It is known that in women with follicular cysts the content of estradiol in the blood increases, which, according to the literature, is one of the factors involved in the formation of follicular cysts.

Tumor-like processes most often develop against the background of long-term inflammatory diseases, inadequate use of antibiotics and hormonal drugs. All this leads to persistent destabilization of immune homeostasis, which is the background against which ovarian cystic formations arise.

For the first time, a follicular ovarian cyst was described in 1827 as a “watery disease” in a childless forty-year-old woman. At that time, this disease was considered incurable. Since then, scientists around the world have tried to understand the etiology and pathogenesis of these ovarian tumors. In 1972, the concept of apoptosis (programmed cell death) was introduced. Researchers have begun to study the relationship between apoptosis, steroidogenesis and ovarian function. As a result of the study, one of the theories of the occurrence of follicular ovarian cysts arose - a hormonal-genetic factor.

At the beginning of the twentieth century. Two more theories of the occurrence of ovarian cysts have been put forward, based on disturbances in the functioning of the hormonal system and inflammatory processes of an infectious nature in the appendages.

To date, the exact etiology of follicular cyst formation is not known for certain. The main reason is considered to be lack of ovulation. In turn, the lack of ovulation is most often associated with hormonal disorders. Hormone imbalance manifests itself in the form of hyperestrogenism, increased levels of follicle-stimulating hormone and lack of luteinizing hormone.

The most significant risk factors for the development of follicular ovarian cysts today they are considered:

When developing therapeutic and preventive directions, doctors today try to take into account all three theories of the occurrence of follicular ovarian cysts.

Most studied Causes of follicular ovarian cysts:

If you notice similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!

Symptoms of follicular ovarian cyst

When a hormonally inactive ovarian cyst forms, there are usually no symptoms. Such cysts are determined only by ultrasound examination and disappear on their own in subsequent menstrual cycles.

When hormonally active follicular cysts form, a woman may be bothered by:

menstrual irregularities with delayed menstruation or bleeding during the intermenstrual period;
heaviness in the lower abdomen;
pain from the location of the ovarian cyst.

Pathogenesis of follicular ovarian cyst

Every woman has a genetically determined ovarian reserve. At birth, each girl has about 1 million eggs. At the time of puberty, there are about 300 thousand of them. With the onset of menstruation, several follicles with eggs begin to grow each month, and only one reaches the ovulatory state. This is ensured by atresia of the remaining follicles that began to grow in a given menstrual cycle. If the follicle does not rupture during ovulation and it does not become atretic, then when filled with fluid as a result of effusion from the bloodstream and secretion of follicular cells, a cyst is formed.

Complications of follicular ovarian cyst

A follicular ovarian cyst is dangerous because there is a risk of torsion of its stem and rupture of the cyst (ovarian apoplexy). Signs of torsion of the cyst leg are sharp pain in the lower abdomen from the side where the cyst is located, rapid heartbeat, weakness, nausea, vomiting, drop in blood pressure up to loss of consciousness, cyanosis of the skin.

The rupture of the cyst is manifested by dagger pain from the localization, fainting, nausea and vomiting, while the body temperature remains normal. If bleeding into the abdominal cavity occurs, a rapid heartbeat (tachycardia), a drop in blood pressure develops, the skin becomes pale bluish, weakness, drowsiness appears, and a state of shock develops.

Torsion of the cyst stalk and ovarian rupture are acute conditions requiring emergency surgical care. The adhesive process after the operation can lead to obstruction of the fallopian tubes and, accordingly, to tubal infertility. In addition, the very presence of a follicular cyst will prevent the maturation of a new follicle to the ovulatory stage, and infertility in this case will be associated with a lack of ovulation.

Diagnosis of follicular ovarian cyst

Diagnosis of follicular ovarian cysts primarily involves taking an anamnesis, bimanual examination (bimanual), and ultrasound examination of the pelvic organs. In addition to ultrasound, methods of computed tomography and magnetic resonance imaging of the pelvic organs and laparoscopy are used, in which both diagnosis and treatment are possible.

When an ovarian cyst is detected, the level of CA 125 in the blood serum is necessarily examined. The examination plan includes:

blood hormone studies: FSH, LH, AMG, estradiol, progesterone;
general blood and urine analysis;
blood biochemistry;
smear for flora and oncocytology;
Ultrasound of the mammary glands;
colposcopy.

This list of examinations is determined by the need to use hormonal therapy during the presence of a cyst, rehabilitation and prevention of relapses after treatment.

Treatment of follicular ovarian cyst

Treatment tactics for follicular ovarian cysts are chosen depending on the size and growth dynamics of this formation, the age of the patient and the need for reproductive function.

Questions about the need for active medical intervention for newly diagnosed asymptomatic cysts, surgical treatment in the absence of complications, the choice of the extent of surgery and the method of hemostasis are debatable. Laparoscopic cystectomy in compliance with the principle of functional surgery is the “gold” standard for surgical treatment of cysts. Despite the fact that this operation allows you to save the organ, it has not yet been fully established how surgical treatment of cysts affects reproductive function.

If the cyst is less than 5 cm, has asymptomatic development and does not cause functional impairment, a wait-and-see approach is practiced. Ultrasound monitoring of the cyst is carried out over three menstrual cycles without the use of drugs. When using medications to treat follicular ovarian cysts, oral contraceptives may be used. For these purposes, single-phase low-dose oral contraceptives are prescribed. Their action blocks the functioning of the ovaries, thereby preventing the formation of new follicular cysts. The action of oral contraceptives can reduce the growth of a follicular cyst, up to complete resorption. The menstrual cycle as a whole is normalized, and the risk of ovarian cancer is reduced.

The question of surgical treatment arises in emergency situations that threaten the patient’s life: torsion of the pedicle of an ovarian cyst, ovarian apoplexy. Also, removal of a follicular ovarian cyst is indicated for the persistent form of the cyst, rapid growth of the formation, and large size.

Most often, removal of a follicular ovarian cyst is performed laparoscopically with enucleation of the cyst, sometimes with resection of the ovary. At the same time, surgical treatment using resection of part of the ovaries sharply reduces the follicular reserve, which leads to the need to use donor oocytes in the IVF program even in young patients. Considering the fact that follicular retention cysts are the most common (according to histological examination), it is most important to avoid ovarian resection to preserve the follicular reserve. Currently, the method of fine-needle aspiration followed by cytological examination of the aspirate is widely used for the treatment of ovarian cysts. This method allows you to completely preserve the existing follicular reserve, remove the ovarian cyst, and examine its contents without surgery, without anesthesia, without loss of ability to work.

Removal of an ovarian cyst using fine-needle aspiration under ultrasound guidance is performed in an operating room.

Under local anesthesia with a 10% lidocaine solution (6 dose spray), an ultrasound machine with a vaginal sensor and a sterile puncture adapter is used. Using an ultrasound sensor, the ovary with the cyst is brought into the lateral fornix of the vagina onto the puncture line, and the cyst is punctured through the vagina with a 16G needle.

After inserting a needle into the cavity of the ovarian cyst, aspiration of its contents is carried out with a syringe. A visual inspection of the resulting aspirate is carried out, the quantity is measured and its nature (color, presence of impurities) is assessed. The aspirate must be sent for cytological examination to an oncology clinic.

Forecast. Prevention

The prognosis for ovarian follicular cysts is favorable. This pathology is highly treatable. But you need to remember that cyst recurrence is possible. For this reason, dynamic monitoring of the patient using ultrasound is necessary.

Prevention of ovarian follicular cyst formation includes:

prevention of abortion and promiscuity;
timely treatment of inflammatory diseases of the female genital organs and menstrual dysfunction;
exclusion of stressful situations;
maintaining a healthy lifestyle;
regular visits to the gynecologist.

Reading time: 13 minutes.

Follicular ovarian cyst is one of the most common gynecological pathologies; it is a benign formation, which is classified as a group of functional cysts. These cysts occur when there is a failure in the ovulation process. Since the pathology does not manifest itself in any way, it can remain undetected for a long time and is diagnosed during the next gynecological examination.

The neoplasm itself is not dangerous for a woman, but if there are other hormonal disorders in the body, the cyst can cause infertility. That's why women should know more about this problem.

About the disease

If during the growth and maturation of the follicle the ovulation process is disrupted for some reason, a neoplasm develops in the ovary - the absence of an egg from the dominant follicle.

Reference! It is the most common cystic neoplasm of the ovary, accounting for 80% of all ovarian cysts. The disease code according to ICD-10 is N83.0 “Follicular ovarian cyst”.

Dimensions

In most cases, the size of the pathology does not exceed 10 cm, but sometimes large cysts are diagnosed - 20 cm. The size of the cyst increases due to the accumulation of exudate in it - blood or lymphatic; in addition, the neoplasm grows with continued cellular synthesis of secretions.

Healthy ovary and cyst

If the tumor exceeds 6 cm in size, it should be treated with medication. If the cyst continues to grow and develop abnormally, surgery is prescribed. Small cysts, as a rule, resolve without the help of medications within 1 to 3 menstrual cycles.

In the right and left ovary

It should be noted that the blood supply and nutrition of the left and right ovaries are different. The right ovary is supplied with blood and nutrients better than the left, so more often the follicle matures on the right side. Thus, the reasons for the appearance of a cyst on the right or left side lie in the blood circulation, and its size is larger. But the mechanism of cyst development in both ovaries occurs in exactly the same way.

Sometimes a right-sided follicular cyst can be mistaken for manifestations of appendicitis, so careful diagnosis is necessary.

Cysts are distinguished as follows:

single;
multiple;
single-chamber;
multi-chamber;
one-sided;
double sided;
recurrent;
persistent, which are observed for 2 or more months;
cysts during pregnancy;
complicated;
uncomplicated.

Causes

As already mentioned, the reason for the formation of pathology is a violation of the ovulation process. In this case, we can identify the following most common factors that can give impetus to the launch of the pathological process:

failure in the process of follicle formation;
the beginning of the menstrual cycle in girls under 11 years of age;
frequent abortions;
pathologies of the endocrine system;
obesity;
irregular menstruation and hormonal fluctuations;
long-term use of hormonal drugs.

Separately, it should be said about stress, which also plays an important role in the dysfunction of the endocrine glands. For the ovaries to work correctly, the brain must send them the right impulses. During prolonged emotional overload, brain impulses can become disrupted, which often causes the development of not only benign, but also malignant tumors in the ovary.

Complication in the form of torsion of the cyst stalk

As for the mechanism of cystic formation, it is as follows. Follicle maturation occurs in the first half of the menstrual cycle. When it reaches 3 cm, which is observed in the middle of the cycle, the follicle bursts and releases the egg. It enters the fallopian tube, where it can be fertilized. This is ovulation. If the follicle does not rupture, it grows further and transforms into a cyst. This process can also be reversed if the size of the cystic cavity is small and there are no other hormonal disorders in the body.

Doctors know cases of congenital pathology - the development of follicular cysts occurs during intrauterine development. In some cases, a follicular cyst is diagnosed during puberty or during menopause, since with its onset the number of anovulatory cycles increases.

Important! The presence of a congenital follicular cyst usually stimulates early puberty.

Cyst symptoms

Identifying the symptoms and causes of the pathology will help to begin treatment in a timely manner. Clinical manifestations of an ovarian cyst are associated with its size, hormonal levels and the presence of other pathologies of the reproductive system. Small cysts in the left and right appendages do not give symptoms, but large cystic formations may be accompanied by:

Separately, it is necessary to say about the signs that are observed when a cyst ruptures:

sharp pain in the lower abdomen;
loss of consciousness;
nausea and vomiting;
cold sweat;
dizziness and severe weakness;
temperature increase.

When the cyst stalk is torsed, the following clinical picture appears:

pain;
nausea;
dizziness;
feeling of fear;
decreased blood pressure;
the woman lies on her side and presses her legs to her stomach.

Important! These symptoms in a woman are very dangerous; to treat them, the patient must be immediately hospitalized.

Diagnostics

Tumor on ultrasound

The doctor can make a preliminary diagnosis based on the patient’s complaints and during a gynecological examination, during which a mobile and slightly painful formation located on the side and in front of the uterus is revealed.

To confirm the diagnosis, the woman is sent for the following studies:

pregnancy test to exclude the presence of an ectopic pregnancy;
echography;
CT and MRI;
Dopplerometry;
diagnostic laparoscopy.

The criteria for diagnosing a follicular cyst are:

spherical shape;
homogeneous structure;
thin walls - up to 2 mm;
flat and smooth surface.

If the doctor remains in doubt about the accuracy of the diagnosis, a differential diagnosis is prescribed.

Reference! In the fetus, a follicular cyst can be diagnosed using ultrasound after 34 weeks of pregnancy.

Treatment methods

Since a follicular type cyst can resolve on its own, the doctor may choose observational tactics for a period of no more than 3 months. At this time, a woman should carefully monitor her feelings and, in case of minor health problems, immediately consult a doctor. In addition, you should regularly undergo ultrasound and monitor the growth of the tumor. Before treating it, you must undergo a thorough examination.

Medication

Most often, follicular cysts are treated without surgery. Basically, for the treatment of the right or left ovary, medications are prescribed in the form of tablets. To quickly cure an illness, the doctor prescribes several medications in combination, which in combination give a positive result.

For functional cysts, hormonal agents are recommended, which are divided into several groups: gestagens (Duphaston, Progestogel, etc.), oral contraceptives (Yarina, Diane 35, Rigevidon, etc.) and antiandrogens (Dienogest, Spironolactone, etc.). With their help, the hormonal levels in the female body are balanced. However, it is strictly forbidden to take them on your own, only as prescribed by a specialist.

Duphaston is an effective drug for the treatment of follicular cysts

Treatment with Duphaston is very often prescribed.

Expert opinion

Gynecologist-obstetrician

30 years of experience

For inflammation, enzymes are prescribed to prevent purulent formations. If the cyst is very painful, it is recommended to take painkillers such as Ibuklin, Pentalgin. Nosh-pa and Duspatalin are effective for relieving spasms. For cysts caused by stress and strain, sedatives are additionally prescribed.

In addition to tablets, your doctor may prescribe injections, ointments, suppositories and vitamins as auxiliary therapy.

Physiotherapy procedures are also indicated:

ultraphonophoresis;
electromagnetophoresis;
magnetic therapy;
SMT-phoresis and others.

Restoring the harmony of brain activity is very important, so oxygen therapy is often prescribed.

Removal

Sometimes a follicular neoplasm can only be cured with surgery. If conservative treatment does not bring the desired effect and the cyst continues to grow, surgical treatment is prescribed, which can be performed in the following ways:

cyst excision- applied to tumors with a thin stalk. In this case, healthy tissues are not damaged, and the function of the organ is preserved.
Ovarian resection- the cyst is removed along with part of the ovary. This intervention is performed for cysts with a wide base.
Ovariectomy- complete removal of the ovary. This operation is performed if there are no healthy tissues left in the organ.

The operation is carried out mainly because after it the patient recovers as quickly as possible, and complications are minimized.

Important! When one ovary is removed, the other takes over its task, therefore, there will be no problems with conception.

Folk remedies

If the cyst does not resolve on its own, but does not exceed 6 cm, homeopathic or traditional treatment is prescribed, which takes a long time, and must be regular and methodical.

Depending on the degree of development of the disease, the following procedures may be used:

herbal treatment, which is aimed at stabilizing hormonal levels, as well as increasing immunity;
treatment aimed at restoring the functioning of the nervous system;
douching, tamponation, baths with medicinal herbs.

Thus, if necessary, increase the production of progesterone, the following herbs are recommended:

meadow lumbago;
goose cinquefoil;
cuff;
vitex;
raspberry leaves.

If you need to increase your androgen concentration, you can try:

celery;
hogweed;
rapeseed;
black currant;

If antihormonal therapy is needed, the following will come to the rescue:

field grass;
elecampane;
calendula;
comfrey;
black root;
sparrow;
wild carrot seeds.

Mahogany is a very effective herb that affects a woman’s reproductive system, but it can increase blood circulation, which is undesirable for cystic endometriosis. Therefore, careful diagnosis and physician approval are necessary before starting therapy.

Baths can be prepared using decoctions of the following herbs:

tansy;
cuff;
hog uterus.

The bath time is 20 minutes.

Local compresses, for example, with a 10% salt solution, also help. Gauze soaked in the solution is applied to the stomach several times a day for half an hour.

Therapeutic tampons are inserted into the vagina overnight, and it is necessary to lie down on the side on which the cyst was found. To prepare tampons you can use:

aloe juice and honey;
onion juice;
gruel from nettle leaves and so on.

Is it possible to get pregnant?

Are you planning a pregnancy?

YesNo

Most ovarian tumor diseases, even benign ones, prevent getting pregnant, but, as practice shows, with a follicular cyst in the left or right ovary this can still happen.

Pregnancy has a beneficial effect on the pathology, since the cyst usually resolves on its own during this period. If this does not happen, the doctor may recommend proper nutrition, vitamins, an active lifestyle, and strengthening the immune system. In some cases, it is necessary to take hormonal drugs that help the cyst disappear.

As a rule, ovarian pathology does not threaten the health and life of the mother and child, but there is a risk of cyst complications, which can become a serious threat to pregnancy.

Delay of menstruation

The menstrual cycle and follicular cyst are closely related. An egg that is not released from the shell activates the release of hormones that prevent the onset of menstruation. Therefore, a delay in menstruation with a follicular cyst is a common occurrence. The duration of the delay can be from 5 days to several months.

If the cyst is larger than 6 cm, changes in the menstrual cycle may be as follows:

heavy menstruation;
prolonged menstruation – more than 7 days;
painful course.

Scanty discharge of menstrual blood is also possible, they are caused by a low concentration of progesterone, and premenstrual spotting is also possible.

As for small follicular cysts that resolve on their own, they do not affect the menstrual cycle, and a woman may not even be aware of their existence.

Relapse

In some cases, after medical or surgical treatment of the cyst, the tumor appears again. This can happen as a result of a lack of normalization of a woman’s hormonal levels, or if the cyst was not completely removed during surgery.

To reduce the risk of relapse, it is recommended:

prevent obesity;
avoid sudden movements;
do not lift heavy objects;
reduce the impact of stress;
do not take hot baths;
plan contraception correctly;
Keep a diary of your menstrual cycle and seek the help of a doctor if there are any changes.

Complications

If the tumor does not disappear within 3 menstrual cycles, the following complications are possible:

Cyst rupture

Therefore, despite the relative harmlessness of a follicular cyst, it must be monitored and promptly treated.

Follicular cyst is a tumor-like formation of the uterine appendages originating from the follicle. This is one of the most common ovarian diseases. A follicular cyst is not a tumor and belongs to the so-called. Its liquid contents only stretch the walls of the formation, sometimes causing growth to gigantic sizes (more than 10 cm in diameter). There is no pathological proliferation of cells in the walls. The liquid that fills the formation is non-inflammatory in nature, and its properties are close to blood plasma.

This form accounts for about 75% of all ovarian cysts and occurs at any age, even in newborns. In adolescence, follicular cysts account for up to one fifth of all gynecological diseases. The disease is most common in women of reproductive age (20-45 years). After menopause, the incidence of the disease decreases. The course of the disease is benign; it never degenerates into cancer.

Causes and mechanisms of development

Two main causes of follicular ovarian cyst are discussed – increased blood supply to the uterine appendages and hormonal disorders.

About half of follicular cysts are caused by inflammation of the ovaries and fallopian tubes. These processes are accompanied by increased blood circulation in the pelvic organs and stagnation of blood in them. At the same time, damage to surrounding tissues develops - perioophoritis.

Blood flow in the pelvic organs increases during ovulation, pregnancy, childbirth, the postpartum period, and breastfeeding. Interrupted sexual intercourse, lack of orgasm with strong arousal, also increase the likelihood of developing a follicular cyst.

Another mechanism for the development of education is an imbalance of hormones, in particular, hyperestrogenism, an increase in the level of follicle-stimulating hormone, and a lack of luteinizing hormone. Hormonal imbalance may be a consequence of diseases of the nervous system or its functional disorders under stress. It appears after abortion, as well as due to other diseases of the internal genital organs. Against the background of hyperestrogenism, a so-called single-phase menstrual cycle occurs, accompanied by constant anovulation. Bilateral follicular cysts may appear during ovarian hyperstimulation for infertility treatment.

Provoking factors:

smoking;
chronic stress;
infectious diseases, especially neuroinfections.

Normally, during each menstrual cycle, a dominant follicle is formed in the ovary, in which the egg develops. In the middle of the cycle, the follicle bursts, ovulation occurs, and the egg is released into the abdominal cavity. It then enters the fallopian tubes, where it meets the sperm.

A follicular cyst occurs when the follicle does not complete its development and no egg is released from it, that is, there is no ovulation. In a confined space, fluid accumulates, which is secreted by granulosa cells. In addition, the liquid part of the blood sweats into the cavity of the atretic follicle. Liquid formation begins to grow. The boundary between a normally growing follicle and a cystic formation is its diameter of 30 mm.

The follicular cyst usually has thin smooth walls, a diameter of 30 to 60 mm, and light yellow contents.

A special form is the follicular cyst in fetuses and newborns. It is determined in one out of 2,500 girls born. Its development is associated with stimulation of the embryo by the mother’s sex hormones, as well as human chorionic gonadotropic hormone. It is impossible to diagnose this condition in utero. After birth, the baby is monitored monthly. In half of the cases, the disease goes away on its own after 2-3 months. If complications arise (hemorrhage, ovarian torsion, tissue necrosis), surgical removal of the formation is performed.

Clinical manifestations

In most cases, follicular cysts do not manifest themselves in any way. Girls may experience a later onset of menstruation.

Some patients have moderate pain in the lower abdomen or groin areas. This pain can intensify with body movements, sexual intercourse, and heavy exercise. It is often expressed in the second phase of the menstrual cycle, when the follicle reaches a large size. At the same time, the basal temperature drops below 36.8˚C. Such symptoms may be accompanied by slight spotting, which then progresses into normal menstruation.

Some patients experience delays in menstrual bleeding for a period from several weeks to 3-4 months. After this, profuse, painful menstruation is observed, sometimes turning into metrorrhagia (intermenstrual bleeding). The longer the delay in menstruation, the higher the risk of complications (cyst rupture, hemorrhage, leg torsion).

Long-term cysts can cause pain, which is accompanied by constant dull pain in the lower abdomen or in the groin areas.

Is it possible to get pregnant with this pathology?

The presence of a follicular cyst is a sign. This disease reduces the chance of pregnancy because ovulation can only occur in the unaffected ovary, but this is rare. Complications of the disease (hemorrhage, rupture, etc.) increase the risk of spontaneous abortion. After treatment, reproductive function is completely restored.

If the cyst was first discovered during pregnancy, it is often removed laparoscopically in the second trimester of pregnancy. This allows you to avoid serious complications that pose a danger to the life of the woman and child.

How dangerous is a follicular cyst?

It can cause serious complications:

leg torsion;
wall rupture;
hemorrhage in the ovary or abdominal cavity.

Torsion of the leg causes venous stagnation, compression of nerves and blood vessels, organ enlargement, and tissue swelling. It is accompanied by intense pain in the lower abdomen that occurs suddenly during physical activity or during sexual intercourse. Symptoms of peritoneal irritation, nausea, vomiting, cold sweat, fear, fainting, and increased body temperature are typical. Quite often, intestinal motility is absent and constipation develops. The pain is not relieved in any particular position. During clarifying questioning, the fact of the appearance of acute pain several days or weeks before this episode is sometimes revealed, for which the woman usually does not see a doctor.

Symptoms of a ruptured ovarian follicular cyst include severe abdominal pain, nausea, vomiting, dizziness, and symptoms of peritoneal irritation. Body temperature does not increase. This condition is provoked by injury, sexual intercourse, lifting a heavy object, or playing sports.

Hemorrhage into the ovary (apoplexy) or intra-abdominal bleeding is accompanied by signs of blood loss - pallor, rapid pulse, decreased blood pressure, cold sweat, drowsiness, and impaired consciousness.

Diagnostics

An external examination cannot reveal any deviations from the norm. During a gynecological examination, a pathological formation can be felt on the side or in front of the uterus. It has an elastic consistency, round shape and smooth surface, quite mobile, painless, size is about 5-6 cm. There are cases of rupture of this formation during a two-handed gynecological examination.

Diagnostics uses ultrasound with color Doppler mapping. It helps to visualize the walls of the formation, clarify its size, determine the presence of blood flow, and see specific acoustic effects (amplification effect).

In doubtful cases, laparoscopy, computed tomography, and magnetic resonance imaging are performed.

Treatment

Treatment of follicular ovarian cysts is usually carried out with medication. Non-steroidal anti-inflammatory drugs are prescribed, and hormonal agents are prescribed if indicated. In most cases, the follicular cyst resolves spontaneously within 1-3 menstrual cycles. After this, the woman should be observed by a gynecologist for at least three months.

If conservative treatment does not bring any effect, a planned laparoscopy and enucleation of the cyst is performed. At the same time, they try to preserve as much healthy ovarian tissue as possible.

If complications arise, emergency surgery is required. Before this, he is prescribed bed rest and cold applied to the lower abdomen. A laparoscopic approach is used, in which instruments and a video camera are inserted into the patient’s abdominal cavity through a small puncture of the anterior abdominal wall. If the ovarian tissue is preserved, the cyst is removed. In case of large multiple formations, intra-abdominal bleeding, torsion of the cyst stalk, or during perimenopause, removal of the ovary may be necessary.

Treatment after surgery is aimed at restoring normal ovarian function. Combined oral contraceptives and vitamins are used.

The prognosis of the disease is favorable. In most cases, the pathology responds well to treatment. However, cases of relapse cannot be excluded when a follicular cyst appears again after some time, in the same or opposite ovary. Repeated cases require careful monitoring and identification of the cause that caused them. A follicular cyst must always be differentiated from an ovarian cyst.

Relapse Prevention

After treatment, the woman can live a normal life. This disease is not a limitation for sexual activity or the use of intrauterine contraception. It does not require a special diet, but obesity should be avoided. It is recommended to avoid sudden movements, heavy lifting, abdominal muscle training, and jumping. The complex of therapy often includes sanatorium-resort treatment and psychoprophylaxis.

It is advisable to eliminate traumatic factors and get rid of stress. If necessary, it is recommended to take vitamins, phytoestrogens or hormonal drugs. Adequate sleep and rest are important. You need to avoid hot baths. Sunbathing on the beach or in a solarium is not recommended for such patients.

It is necessary to plan a pregnancy, use proper contraception (preferably hormonal), and refuse abortion. A woman should keep a diary of her menstrual cycle, and if she suspects hormonal imbalances (delayed menstruation, unusual pattern, intermenstrual bleeding), consult a doctor immediately.