Follicular cyst - causes and symptoms. Treatment of follicular cysts with medications and folk remedies. Features of follicular ovarian cyst Follicular cyst 6

A follicular cyst is a benign ovarian formation, the symptoms of which at the initial stage of development are mild. Only regular gynecological examination and ultrasound diagnostics can reveal the presence of pathology and the main causes of its occurrence. An untreated cyst can lead to dire consequences, including infertility.

Every month, every woman’s body produces follicles, the most active of which becomes a temporary carrier of the egg. At the moment of ovulation, the follicle should burst and release the egg, providing it with an exit for further movement to the uterus. If the rupture does not occur, the follicle begins to accumulate fluid, blood, and a new formation appears in the ovary, which is called a follicular cyst. Why doesn't the follicle burst? This disorder most often occurs as a result of hormonal imbalance.

Remember! In a healthy female body, the follicle must burst and release an egg.

It can appear on one ovary or on both at once. However, the simultaneous formation of a tumor on two ovaries is extremely rare. It is worth noting that the follicular cyst of the left ovary, as well as the right one, can resolve on its own. If the diameter of the formation does not exceed 5 cm, then the period of disappearance of the cyst varies from one to three months. If the growth of the cavity progresses, the woman is prescribed medication, specialist supervision and regular examinations in the ultrasound room.

Structure of a follicular cyst on the ovary

Causes of cyst formation

As mentioned earlier, a benign follicular cyst of the left or right ovary can appear due to a number of factors, the main one of which is considered to be a violation of hormone levels. However, there are other reasons for the occurrence. First of all, the development of a neoplasm is associated with an incorrect lifestyle and a negligent attitude towards one’s own health.

The following are the reasons for the formation of follicular ovarian cysts:

1. and infections. STD.
2. Prolonged stress, anxiety, disturbances in the psycho-emotional sphere of a woman (depressed state, depression, fixation on problems or non-existent shortcomings).
3. Excess weight or, conversely, exhaustion.
4. Poor nutrition.
5. Disturbances in sleep and general rest patterns.
6. Too vigorous sex life or, conversely, its complete absence.
7. Hard physical labor.
8. Abortion, difficult childbirth, unprofessionalism of the doctor during examination.

Also, the occurrence of a follicular ovarian cyst may be due to changes in the activity of the kidneys, endocrine system, and liver.

Symptoms of pathology

The peculiarity of a follicular cyst is that it is not always possible to independently determine its presence in the body. Especially in the first stages of development. Initially, the cavity is quite small in size and does not manifest itself in any way. It is for this reason that many women are not even aware of the formation of pathology in the reproductive organs.

Increasing in size, the formation begins to manifest itself with painful symptoms. The appearance of specific pain in the lower abdomen helps to distinguish a cyst from other diseases. In this case, the symptoms of a cyst on the left and right ovaries are completely identical.

Signs of a follicular cyst:

1. Changes in the menstrual cycle, in particular long delays.
2. Heavy bleeding during menstruation.
3. The presence of uncharacteristic bleeding between periods.
4. Nagging pain in the groin on the left or right side. It depends on whether the follicular cyst is formed on the right ovary or on the left.
5. Painful periods.
6. Pain in the lower abdomen, which intensifies with physical activity, sudden movements, and sexual contact.
7. Urge to urinate frequently.

It is important to note that the severity of symptoms directly depends on the existing diseases of the female sphere. The most important influence is the presence of uterine fibroids, adnexitis (inflammation of the appendages), as well as overgrown endometriotic tissue formed due to endometriosis.

In general, the list of symptoms of follicular ovarian cysts is quite wide and a considerable part of them can indicate other diseases, for example, the appendix. That is why The final diagnosis can only be made by the attending physician after an ultrasound scan..

Follicular cyst on ultrasound:

Possible complications

Treatment of a follicular cyst is carried out if the size of the neoplasm exceeds 5 cm in diameter. Ignoring doctor's advice, careless and sudden movements, active sexual intercourse can lead to dangerous consequences for health.

The most common complication of follicular ovarian cysts is neoplasms. In this case, the woman develops characteristic symptoms of apoplexy:

• sharp, stabbing pain in the lower abdomen;
• decreased blood pressure;
• cold sweat;
• fainting;
• nausea, vomiting;
• general weakened state;
• dizziness.

If the cyst bursts near a vessel, bleeding may open in the abdominal cavity. In addition to apoplexy, torsion of the pedicle of the cystic formation may occur. Here the symptoms may be slightly different. In addition to the above symptoms, increased heart rate, fever, pale skin, constipation or diarrhea are added.

The appearance of any of the above symptoms poses a huge health hazard. This condition requires promptly calling a medical team and transporting the patient to the hospital, where, with an accompanying examination and ultrasound, a correct diagnosis will be made and further medical measures will be carried out.

Treatment of follicular cyst

As already mentioned, a small cystic formation has the ability to resolve on its own within two to three months. It is likely that the woman will not even notice any violations. The only thing that can indicate the presence and further resorption of a cavity is a change in the consistency of menstruation. This may be a small clot in the discharge or slight changes in its color.

Sometimes experts recommend postponing treatment and waiting until the cyst disappears on its own. A woman is advised to pay attention to her lifestyle. You need to eliminate possible stressful situations, physical activity, gain a positive attitude and love yourself. In addition, walk often, eat right and take time to rest. Of course, during this period the woman should be under constant supervision of a specialist and regularly visit the ultrasound room.

Regarding how to treat a follicular ovarian cyst, the size of which exceeds 5 cm in diameter, it is important to note that specialists carry out a whole range of measures. Physiotherapy methods are prescribed here: electrophoresis, acupuncture, magnetic therapy, ultraphonophoresis. Vitamin complexes are prescribed. Numerous options for traditional therapy are allowed: herbal decoctions, infusions. When treating follicular ovarian cysts, hormonal medications are also prescribed to restore the imbalance of hormones. In addition, in some cases a course of antibiotics is recommended.

If the follicular cyst does not go away on its own and it cannot be cured, surgical intervention by a surgeon will be required. Surgery is prescribed if the tumor grows more than 7 cm in diameter. The most optimal method for removing a cyst is. This method is suitable for women who have not crossed the age threshold of 50 years, as well as in cases where doctors are absolutely confident that the education is of good quality. The main advantages of laparoscopy are the absence of noticeable traces of surgical intervention and the speed of the operation. The recovery period is also quite short.

If any complications or malignancy of the cyst are detected, more serious treatment will be required. This can be either the removal of nearby tissues damaged by an overgrown cyst or the removal of the entire ovary. The postoperative period in this case will be longer and more painful. That is why you should closely monitor any changes in your health and undergo regular medical examinations.

Although a follicular ovarian cyst is a benign neoplasm, it requires special monitoring, and in some cases, urgent treatment. A negligent attitude can lead not only to problems in the female sphere and infertility, but also to a completely sad outcome. Therefore, every woman should pay attention to any deviations in her own health and visit the doctor’s office in a timely manner.

The ovaries perform many essential functions in the female reproductive system. The duration of the menstrual cycle, the ability to conceive and bear a child depend on these small paired glands. In addition, even the most attractive and slender woman will lose her beauty if her ovaries suddenly stop producing the necessary hormones. That is why it is extremely important to monitor your health and visit the gynecologist’s office at least once a year. The most common problem. And the most common cyst encountered during examination (83% of all cases) is follicular.

A follicular ovarian cyst is a benign formation, usually unilateral, that forms from an unovulated follicle in the middle of the menstrual cycle. Such a cyst is a single-chamber, less often two-chamber or multi-chamber, cavity with thin walls. It can reach 10 cm in diameter (which is extremely rare; the “usual” size of a pathological formation is 2.5-6 cm). To understand why follicular cysts occur, you need to know how healthy ovaries work.

The first phase of the menstrual cycle is called follicular. One begins simultaneously with the arrival of menstruation and lasts on average about 2 weeks, that is, a good half of the entire cycle (normally its duration is from 21 to 35 days, on average - 28). During this time, a new follicle is formed in the ovary, in which the egg matures. Then comes the ovulatory phase, when the follicle ruptures, releasing a mature egg ready for fertilization. Thus, the follicle disappears, and in its place a temporary gland appears - the corpus luteum, which produces the hormone progesterone, which is well known to all of us.

Sometimes a malfunction occurs in the body, and the follicle does not complete its development, does not burst, and, accordingly, the egg does not come out. Gradually it fills with fluid, which is secreted by granulosa cells. A cycle with an unruptured follicle is called anovulatory, and, alas, it is impossible to get pregnant during this period.

Causes of follicular ovarian cysts

For a long time, doctors did not know why cysts formed, seemingly against the background of complete health. However, today there are two main reasons for their occurrence: increased inflammatory process and hormonal disorders.

50-60% of all cysts owe their appearance to the inflammatory process of the ovaries and fallopian tubes. During this condition, blood rushes to the affected areas, causing stagnation. Changes occurring in the ovaries due to inflammation are caused by:

• STD;
• oophoritis, salpingo-oophoritis, adnexitis;
• acute infections;
• congestive hyperemia of the pelvic organs;
• gynecological interventions.

Hormonal imbalance is the culprit in the appearance of cysts in 30-40% of cases. It may appear due to:

• diseases of the nervous system;
• chronic physical fatigue;
• constant stress;
• childbirth;
• menopause period;
• exhaustion or excess body weight;
• uncontrolled use of hormonal drugs;
• dysfunction of the thyroid gland;
• hyperstimulation of ovulation (for example, in the treatment of infertility).

Of course, all of the above reasons apply to adults, mature representatives of the fairer sex. However, follicular cysts are a problem not only for women of reproductive age. A fluid cavity is sometimes formed during the process of intrauterine development when:

• a strong surge of hormones in a woman in labor during childbirth;
• stimulation of the fetal ovaries by maternal estrogens.

Fortunately, most cysts reported in female infants disappear on their own during the first months of their life.

Hello. I have a small follicular cyst (3 cm) on my left ovary. The doctor said that she would most likely go away after her next period. I don't understand how it will disappear? Help me figure it out, please. (Maria, 19 years old)

Hello Maria. Your cyst contains an egg that has not been released like during a normal menstrual cycle. Some time must pass, and after the death of this egg, the cyst will resolve and disappear due to a special layer of cells contained in its capsule. This month, you may have a slightly changed nature of menstruation - they will be more scanty or, on the contrary, more abundant. Don't worry, get an ultrasound scan every month and see a doctor.

Features of right-sided and left-sided ovarian cysts

Basically, a cyst of the left ovary appears in women of reproductive age during hormonal fluctuations: endocrine disorders, in menopause that occurs too early (before 45 years), as well as in girls with early puberty.

Although the reasons for the appearance of the tumor have not yet been fully studied, scientists believe that the cyst of the right ovary is formed due to the fact that this gland is connected to the main aorta by its artery, and therefore dominant follicles are more often formed on the right. Inflammatory processes of the uterine appendages can also be the cause.

Good evening. I have been involved in sports all my life, I can no longer live without it. Yesterday I was diagnosed with a follicular cyst of the right ovary, 40 mm. I have a race planned in a couple of days. The cyst did not appear yesterday, I played sports quite actively, and nothing happened. I will take the medications prescribed by the doctor. Can I continue my studies? (Olga, 34 years old)

Good evening, Olga. The fact that nothing happened during your active activities while having a cyst only speaks of your luck. With this size, the risk of rupture or torsion of the formation is not as great as with sizes of 8-10 cm, but it is still there, and quite significant given your lifestyle. Think about what is more important to you – sports or your health? Moreover, you will have to give up your favorite activity for a very short time. Take care of yourself, postpone active sports for a couple of months.

Symptoms of follicular ovarian cyst

In the vast majority of cases, follicular cysts do not manifest themselves in any way. Most often they are discovered accidentally during an ultrasound examination. However, this rule only applies to small cysts (up to 5-6 cm in size), and not even in all cases. After all, one should take into account not only the diameter of the tumor, but also the woman’s health status, her age, and individual characteristics. Follicular cysts can cause the following symptoms:

1. Delayed menstruation. Most often, this is the main reason for the patient to see a doctor.
2. Discomfortable sensations in the second phase of the menstrual cycle, nagging pain in the lower abdomen.
3. Scanty spotting in the middle of the cycle. Sometimes they go away after a few days, less often - the bleeding continues until the onset of real menstruation;
4. Malaise, general weakness.

Cysts that have grown in diameter greater than 6 cm manifest themselves clinically much more often, and their symptoms are as follows:

1. Feeling of heaviness in the lower abdomen, fullness. As a rule, such unpleasant sensations appear only on one side – the one where the cyst is located, and manifest themselves after emptying the bladder and/or rectum.
2. Increase in abdominal volume.
3. Aching or sharp pain in the lower abdomen. Soreness appears in the second phase of the cycle, and intensifies during physical activity, sexual intercourse, sudden movements, running, etc.
4. Increased body temperature. The thermometer can easily cross the 38°C mark. This is an ominous sign that indicates possible complications.

Possible complications

In 80% of cases, follicular cysts do not pose a serious danger and resolve on their own with the next menstrual cycle.

However, in 20% of cases this does not happen, and without proper treatment the following serious complications can arise:

1. (from 360° to 720°). This is an extremely serious complication, which can be triggered by any sudden movement or blow to the stomach. Due to compression of tissues and blood vessels, the ovarian tissue ceases to be supplied with blood, and without emergency surgical help, everything can end very badly. Symptoms of torsion: sharp unbearable pain in the groin area or lower abdomen, which does not subside in any body position, cold sweat, drop in blood pressure, nausea, vomiting, weakness, tachycardia, feeling of fear, intestinal cessation.
2. Cyst rupture always occurs suddenly, most often in the middle of the menstrual cycle. Causes of rupture: sudden movements, heavy lifting and similar activities associated with physical activity. The contents of a cyst that has burst immediately flow into the abdominal cavity. Treatment for this complication is surgical only. Symptoms of rupture: cold sweat, fainting, dizziness, sharp pain in the groin area.
3. Internal bleeding is possible if a follicular cyst located in close proximity to the vessel ruptures. In this case, emergency surgical intervention is required, otherwise due to massive bleeding, even death is possible. Symptoms: tachycardia, shock, pale skin, drowsiness, lethargy, hypotension.

If you feel discomfort, pain in the lower abdomen or a disruption in the menstrual cycle, it is better to immediately consult a doctor for an examination, otherwise the consequences of even such a “harmless” pathology as a follicular cyst can be quite serious.

Hello. My husband and I are planning a pregnancy, but an ultrasound revealed a 5 cm ovarian cyst. Can I get pregnant? (Elena, 30 years old)

Hello, Elena. Of course you can get pregnant. It all depends on the location of the cyst. If the egg matures on the side opposite to formation, there is a chance. However, I would not recommend that you try to conceive a child until you cope with the disease. It would be great if you first visit a doctor and draw up a treatment plan. The best solution is to first get rid of the cyst and then get pregnant.

How to treat a follicular ovarian cyst

If the cyst is small, gynecologists usually adhere to a wait-and-see approach, prescribing a treatment regimen designed to stimulate regression of the cystic formation: vitamins, homeopathic remedies, anti-inflammatory therapy, oral contraceptives (Duphaston treatment is most often used due to its high effectiveness). In parallel, you can use physiotherapeutic procedures: magnetic therapy, ultraphonophoresis, electrophoresis.

Usually within 2-3 months the cyst disappears without a trace. The patient only needs to follow the doctor’s simple recommendations and undergo a monthly ultrasound examination on days 5-7 of the menstrual cycle.

However, if after 3 months the follicular cyst has not gone away, treatment without surgery cannot be avoided. Removal of formation can occur in two ways:

1. By laparotomy. The classic method, in which the surgeon makes an incision on the anterior abdominal wall to access the internal organs. Its disadvantages are a greater number of possible complications and the appearance of an unaesthetic scar. However, this approach is convenient for the surgeon and is preferable for large cysts. With the help of laparotomy, the doctor will have a better view and will be able to carefully remove the tumor, while the risk of cyst rupture due to careless movement during laparoscopy is higher.
2. By laparoscopy. Access to the ovary is made using 3 small incisions (less than 1 cm). Through them, special surgical instruments equipped with an optical-light system are inserted, thanks to which the surgeon sees all his actions on the screen. After such an operation, there is a lower risk of developing an adhesive process, the rehabilitation risk is very short, and not a trace remains on the stomach. However, with large cysts there is a possibility of spontaneous rupture. A specialist performing such a manipulation must act with great care and precision.

Treatment of follicular cysts using folk remedies

Treatment with folk remedies is primarily aimed at stabilizing a woman’s hormonal levels. For therapy at home, a plant group containing phytohormones is selected. Microelements of some plants have a structure similar to estrogen, androgen and progesterone. Their use can correct hormonal levels and gently stimulate the ovaries.

Phytoestrogen, beneficial for the reproductive system, is found in clover, sage, licorice, sunflower seeds, oats, hops, and St. John's wort.

Androgen is a male hormone, but it is also produced in small quantities in the female body; it is no less important and helps to cure many diseases, including follicular cysts. The source of androgens are plants such as: black currant, celery, Irish moss, fennel, hogweed.

And finally, the following herbs are used to stimulate the production of progesterone: raspberry leaves, vitex, wild yam, mantle, meadow arrow.

All of the above plants stimulate the production of luteinizing hormone, which promotes the production of your own progesterone. When treating with herbs, it’s time to change your diet a little - eat more eggs, fish, foods containing starch, fatty meat. These products will slightly enhance the effect of the herbs.

Before starting herbal treatment, make sure that there is a follicular cyst and its size does not exceed 6 cm. To do this, be sure to visit a doctor. In other cases, plants will be of little help, and time will be lost. Moreover, you should approach treatment with even the most harmless herb very carefully. For example, boron uterus, which can increase blood circulation, can be very dangerous if the dosage is incorrect.

So, you have firmly decided to trust traditional medicine. First, make sure that there is no pain in your lower abdomen, no pressure, no vaginal discharge or other manifestations of discomfort. When treating at home, visit your doctor every month and undergo an ultrasound examination. This is the only way to protect yourself and control the process of cyst growth or regression.

Hello. A month ago, I was diagnosed with a follicular cyst measuring 3.5 cm. I had a routine ultrasound, but have not yet visited a doctor. This month my period is 7 days late. I'm worried, what should I do? (Yulia, 23 years old)

Hello Julia. Your cyst is small, as is the delay period, so there is no reason to panic. With a follicular cyst, a delay in menstruation is a common occurrence. However, you should not delay visiting a gynecologist. Only a doctor can prescribe the right treatment regimen that will help you get rid of the cyst and normalize your menstrual cycle. To avoid complications, contact a specialist as quickly as possible.

Ask a free question to a doctor

A follicular ovarian cyst is called functional, probably because it occurs as a result of hormonal imbalances and is associated with the work of the endocrine system, which controls the reproductive sphere, where the ovary occupies an important position.

The follicular cyst has several names, it is also called functional or retention, but the essence of it always remains the same - a smooth, thin-walled, connective tissue cavity in the ovarian tissue, having a diameter of 1 to 4 cm on average, sometimes reaching 7 or more cm with long-term existence , and depending on the menstrual cycle.

Taking into account the mechanism of cyst formation, it can be explained why reproductive age is most susceptible to such a pathology, although there are also exceptions to this rule. In world medical practice, cases of intrauterine cyst formation have been described, which is associated with the anatomical structure, which provides for the presence in the ovary of a follicle that can be stimulated by maternal estrogens in a female fetus.

Formation of a functional ovarian cyst

The formation of a retention cyst is preceded by a hormonal imbalance, which prevents the normal maturation of the follicle and the release of a full-fledged egg from it. As a result of this, ovulation does not occur, and instead of the corpus luteum expected in the second phase, a formation appears, which itself is capable of exhibiting hormonal activity, which is associated with the morphological structure of the lining of the cyst.

The cystic formation is lined with multirow follicular epithelium (granulosis), producing estrogens. Under the granulosa there are theca cells, which normally form the basis for the formation of the corpus luteum, and in pathological processes they can hyperplasia (grow) under the influence of the second phase hormone - progesterone, producing it themselves.

The hormonal activity of a functional cyst is expressed in the effect on the endometrium, which also undergoes hyperplasia, which leads to uterine bleeding. In girls, this pathological process causes premature puberty.

A follicular cyst usually finds its place in one ovary, but there are known cases of cystic formations in both the right and left ovary at the same time. This suggests that they arose independently of each other, at different times and in different menstrual cycles.

It is important to monitor hormone levels in women with menstrual irregularities. Thus, it is possible to prevent the formation of cystic atresia of the follicle, which “gives life” to the cyst itself.

Disputes about the differences in the development of right- or left-sided cystic formations continue to this day, but there is no data on the prevailing frequency of the pathological process on any specific side.

The probability of a cyst occurring in the left ovary is the same as in the right, except that the symptoms of a follicular cyst of the right ovary may be similar to those of acute appendicitis. But right-sided rupture (ovarian apoplexy) occurs more often, since the right ovary is more intensively supplied with blood.

Symptoms of a follicular cyst

If the tumor is small in size, it may not make itself felt at all and leave the woman in the dark for a long time until it is accidentally discovered during an ultrasound examination. If a cystic formation reaches a certain size, it can “give itself away” with the following signs:

• nagging pain or unpleasant feeling of heaviness in the lower abdomen, aggravated by sudden movements and stress;
• scanty brown discharge from the genital tract after expected ovulation, that is, starting from the middle and towards the end of the cycle;
• regular unpredictable delays in menstruation;
• uterine bleeding if the cyst begins to produce hormones;
• infertility due to retention of a mature egg in the follicle (lack of ovulation), sclerosis of ovarian tissue or obstruction of the fallopian tubes (a large cyst can compress the tube and narrow its lumen);
• premature puberty due to hormonal activity of the cyst.

If the listed signs of an ovarian retention cyst occur, a visit to the antenatal clinic with ultrasound diagnostics is mandatory.

Main aspects of treatment of follicular ovarian cyst

When all the research has been carried out, the worst fears have been realized and the diagnosis has been made, the woman rushes to ask the doctor, her friends, and Google how to treat a follicular ovarian cyst. Considering that hormonal levels play a major role in the process of cyst formation, one should not joke with it and should not self-medicate. Hormonal drugs prescribed for such pathologies require special caution, due to the delicate organization of the endocrine system of the female body, and are calculated only by a doctor after a hormonal study has been carried out.

The asymptomatic course of a functional ovarian cyst, if it does not increase in size (ultrasonic diagnosis of the ovaries), often does not require treatment at all. The doctor’s tactics boil down to monitoring changes in size using ultrasound and monitoring hormone levels for two to three months. Often such cysts resolve on their own before the next period.

If there is an increase in the size of the cyst, constant discomfort in the lower abdomen and the formation of new cysts, then the doctor will first prescribe hormonal treatment, usually combined oral contraceptives, which normalize the menstrual cycle.

Leveling of hormonal imbalance in the case of follicular ovarian cyst is achieved by treatment with duphaston with the active ingredient dydrogesterone - an analogue of progesterone, which, without suppressing ovulation, allows you to achieve the secretory phase and keep hormones at normal levels. The main indications for the use of duphaston are hormonal imbalance with menstrual cycle disorders, but at the same time, the drug is not considered a panacea and if there is no effect from treatment, other options are sought.

Surgery is indicated for large and increasing tumors. Typically, retention cysts are removed by laparoscopic access, and in cases of ruptured complicated cysts, laparotomy is used. An ovary is removed extremely rarely during reproductive age and there must be special indications for this. For women over 45, the organ is removed to prevent ovarian cancer.

It is important to remember that the cyst either eliminates itself, or the doctor can handle it, but not the owner of the cystic formation, so self-medication in the case of a functional ovarian cyst is unacceptable.

Possible complications of follicular cysts

The behavior of a functional ovarian cyst is unpredictable. It can “live” for years and not bother you, it can become inflamed and fester, or it can suddenly rupture. Rupture of the cystic capsule is considered the most serious, life-threatening complication for a woman, which entails other complications:

• cystic contents pour into the abdominal cavity, which, if emergency medical care is not provided, will inevitably lead to peritonitis;
• The ovary itself ruptures due to hemorrhage in its tissue. In this case, emergency surgery must save the situation, otherwise the rupture may result in massive blood loss and death.

The following signs are typical for cyst rupture:

1. dagger pain, quickly turning into diffuse pain;
2. cold sweat, nausea, fainting;
3. abdominal wall tension;
4. hypotension, tachycardia;
5. pallor of the skin.

With the development of peritonitis, acute pain begins to subside, pressure continues to drop, drowsiness appears, and the skin becomes bluish.

Another complication that requires urgent surgical intervention is ovarian torsion, which can occur when the cyst reaches gigantic proportions. Torsion has the same symptoms as rupture of the cystic capsule and is caused by the same provoking factors:

• ovulation;
• sudden movements;
• thermal procedures;
• hot bath.

Typical complications of the listed acute surgical conditions are:

1. development of acute anemia due to loss of large amounts of blood;
2. adhesions as a consequence of peritonitis and abdominal surgery;
3. infertility.

When a cyst or ovary ruptures, subsiding pain may indicate the development of peritonitis, rather than an improvement in the condition. In such cases they say: “Delay is like death.”

The statement about the impossibility of malignancy of a functional ovarian cyst is hardly justified, because almost all tissues of the human body are susceptible to malignant degeneration and a follicular cyst is no exception, the only difference is the extent to which the danger may arise. In the case of a retention cyst, the likelihood of malignant degeneration is not significant, but possible.

Follicular cyst and pregnancy

Pregnancy with a cystic formation in the ovary is doubtful for a number of reasons:

• hormonal influence;
• secondary sclerotic changes in ovarian tissue;
• associated inflammation;
• lack of a normal ovulatory phase.

However, like all rules, this also has an exception, the result of which is an unexpected pregnancy and in some cases it can cure a follicular ovarian cyst. Often, after a successfully completed pregnancy, gynecologists do not find a cyst. However, everything again depends on its size and behavior.

It should be borne in mind that during pregnancy the hormonal background undergoes significant changes, creating favorable conditions for the growth of the uterus and acceptable for cyst enlargement, that is, they can grow simultaneously and ultimately begin to interfere with each other. This fact is the basis for removing the follicular cyst during pregnancy. This tactic is chosen in order to prevent possible consequences (rupture of the capsule or ovary will jeopardize not only the pregnancy, but also the woman’s life).

When planning a pregnancy, it is important to “deal with” the cyst, restore normal hormonal levels and the menstrual cycle in order to prepare the ground favorable for conception and fetal development.

Prevention of follicular cysts

Preventing the occurrence of ovarian retention cysts comes down to nonspecific prevention. Based on the reasons for the formation of a cystic cavity in the ovary, where the key role is played by endocrine and psycho-emotional conditions, the prevention of relapse of the disease includes the following program:

1. elimination of stressful situations that cause psycho-emotional disorders (visiting a psychologist and psychotherapist);
2. achieving hormonal balance (use of medications according to the schedule);
3. regulation of metabolic processes by prescribing vitamin, antioxidant and homeopathic complexes;
4. the use of physiotherapeutic procedures indicated for follicular cysts (oxygen therapy, magnetophoresis, ultraphoresis);
5. sanatorium-resort treatment, where prevention will be carried out comprehensively and purposefully.

Women who have or have a history of cystic formations must always and everywhere remember precautions. In such cases:

• mud therapy and thermal procedures that increase blood circulation in the pelvic organs are excluded;
• the hot bath is replaced by a shower;
• The time spent in the sun and in the solarium is limited (5-7 minutes once a week).

Those who love and engage in sports should know that exercises that provoke the appearance of negative pressure in the abdominal cavity can cause cyst rupture, so it is advisable to avoid excessive physical activity, sudden turns of the body, jerking and bending.

Video: "Ovarian follicular cyst: causes, indications for removal"

In clinical practice, follicular cysts are quite common. According to its histological type, it does not belong to malignant and oncogenic tumors, which pose a serious danger to the body. In the medical literature, a follicular cyst is considered a functional neoplasm, which resolves on its own in most cases. However, not all patients have positive dynamics, so doctors carry out diagnostic monitoring of the structure.

It is a pathology of a non-inflammatory nature, as evidenced by ICD-10 code No. 83.0. It means that the etymology of its appearance is not directly related to infections, bacteria, although organic pelvic diseases influence its progression.

From a biological point of view, it blocks the attack, as it continues to progress in size or remain unchanged in diameter. It degenerates into a cyst if its size exceeds 25 mm.

According to its structure, the cyst filled with liquid contents and is adjacent to the right or left ovary. The ultrasound picture usually shows it as a hypoechoic formation with smooth edges and a homogeneous structure.

The presence of such a neoplasm implies that the luteal phase of the menstrual cycle has not occurred, but the corpus luteum has not formed, although not everything is so simple, since the follicle may burst in the neighboring ovary.

REFERENCE! The diameter of a follicular cyst usually ranges from 25 mm to 100 mm. The larger the size of the “temporary tumor”, the greater the risk of complications and the appearance of negative symptoms.

Causes

It is not known exactly what can trigger the growth of a cyst, but scientists believe that it's all due to hormonal imbalances and organic diseases that cannot always be tracked and noticed.

There are several probable reasons that contribute to the development of pathology:

1. Lack of ovulation in the previous menstrual cycle.
2. Diseases of the pelvic organs (adnexitis, oophoritis, cervicitis, endometriosis).
3. Ovarian dysfunction after abortion and surgery.
4. Uterine fibroids.
5. Hormonal disorders.
6. Pathologies of the thyroid gland.
7. Stress.
8. Uncontrolled use of hormonal drugs.
9. The onset of menarche.
10. Perimenopause.
11. STI.

These are only possible causes of the disease, since a direct connection between the occurrence of a cyst and the above conditions has not been proven. It is likely that they can become common catalysts for growth follicular tumor.

Symptoms

According to a survey of patients, this is a functional neoplasm in most cases it is asymptomatic. On ultrasound, it is very often discovered by chance during a routine preventive examination.

If the size of the cyst is large enough or it continues to grow, then the woman already feels alarming symptoms, which includes the following clinical signs:

1. Delayed menstruation.
2. Intermenstrual bleeding.
3. Pain on the right or left side, a feeling of heaviness and discomfort.
4. Heavy, painful or prolonged periods.
5. The occurrence of pain after sex, sudden movements, heavy lifting and physical activity.
6. Asthenic syndrome.

Symptoms appear all patients individually depending on the size of the cystic formation. In any case, you should immediately consult a doctor, as there is a high risk of complications such as tumor rupture or torsion.

If this does happen, then the woman experiences acute and unbearable pain. in the stomach, nausea, vomiting, dizziness and a sharp rise in temperature. In such a situation, you should immediately call an ambulance, as urgent surgical intervention is necessary.

IMPORTANT! Pain that occurs as a result of the progression of a follicular cyst usually manifests itself in the luteal phase of the cycle, when hormonal changes inevitably occur. This is a reason to be wary and do a control ultrasound of the pelvis

How does a cystic formation occur?

In a general sense, a cystic formation grows as a result of the influence of two factors:

1. Increased blood supply to the ovaries.
2. Hormonal imbalance.

In the first case, intense blood flow occurs due to chronic inflammation of the appendages and fallopian tubes. In turn, excessive blood supply to the pelvic organs provokes the appearance of stagnant processes. This clinical picture is very “favorable” for the growth of a cystic formation.

However, in addition to organic diseases, increased blood supply to the ovaries causes:

1. Pregnancy.
2. Childbirth and postpartum complications.
3. Lactation period.
4. Uterine fibroids.

All these conditions contribute to improper maturation of follicles.

The follicle has grown due to hormones

Hormonal imbalances are the second cause of tumor growth. The fact is that some hormones are produced in insufficient or excessive quantities. This causes different clinical consequences.

Serious endocrine changes are observed during menstruation and ovulation. If follicle-stimulating hormone (FSH) is greatly increased in phase 1 of the cycle, and lutein is simultaneously decreased, then the growth of a follicular cyst begins.

Normally, on days 11-16 of the menstrual cycle, the dominant follicle ruptures. From there the mature one comes out and goes to the fallopian tubes. At the site of the burst capsule, a capsule is formed that secretes the hormone progesterone.

Thus, the woman’s body and subsequent pregnancy. In the case of a follicular cyst, such a clinical picture is practically impossible.

The growth of neoplasms is accompanied by certain factors. do not mature fully, and the egg in the capsule does not develop. Upon reaching maximum size. Liquid contents begin to accumulate in the capsule cavity, which intensively produces estrogen.

It increases due to the secretion of granulosa cells. In addition, blood penetrates the follicle, which inevitably causes the growth of the tumor. In this case, ovulation does not occur, but in rare cases it is possible if the follicle ovulated on a neighboring ovary.

In the left

Most often the dominant follicle, but it is possible that the process of folliculogenesis affected the left pair of the organ. In any case, cystic formations are no different from each other. Their localization does not play such a significant role.

The size of the cyst can be of different diameters, which is usually recorded on ultrasound. If the tumor has grown on the left ovary, then there is some probability that the follicle will ovulate on the right one. This means that ovulation will occur, but the cystic formation on the left organ will not immediately disappear.

On an ultrasound image, a follicular cyst is defined as a hypoechoic formation with anechoic contents. The shape of the tumor is always clear and round with defined boundaries that are in contact with the ovarian stroma. The neoplasm is single-chamber in structure with a smooth surface.

IMPORTANT! A hypoechoic formation of an irregular, asymmetrical shape with uneven contours speaks in favor of the presence of a corpus luteum or the occurrence of a more dangerous pathology (organic cyst, cancer). In addition, the doctor must examine the condition of the uterus, as well as the inguinal lymph nodes.

On the right

A neoplasm on the right ovary is most common in clinical practice. In such a situation, the probability of ovulation of the left dominant follicle is very low.

According to histological characteristics, follicular cyst of the right ovary no different from the same neoplasm on the left pair organ. On an ultrasound picture, the tumor is defined as a darkened spot with smooth contours and liquid contents.

The shape of the cyst is always symmetrical and round. The blood supply in this area produces enhanced echo signals. In this case, the doctor suspects the presence of a cystic formation. The size of the tumor can vary greatly depending on the cause that caused this pathology.

Diagnostics

Diagnosis of pathology is not difficult. During a routine gynecological examination, it is almost impossible to detect a cystic formation, with the exception of very large neoplasms that can be easily felt with the fingers. The standard diagnostic measures are the following procedures:

1. Ultrasound of the pelvic organs.
2. CT, MRI of the pelvic organs.
3. Hormonal screening.

Most often, a cyst is detected using ultrasound, as this is the safest and most accessible research method. Using ultrasound diagnostics, you can easily see the size, shape, location and structure of the tumor. Laboratory tests are carried out as a secondary research method after the final conclusion of ultrasound, CT or MRI.

Only after passing All diagnostic procedures can talk about treatment tactics.

Treatment

In most cases, it resolves on its own within 1-4 months.. No special treatment is required for this diagnosis. Doctors use a “wait and see” approach, that is, they carry out dynamic monitoring of the tumor.

For these purposes, the woman undergoes a control ultrasound 3 months after diagnosis. If the tumor regresses, then it continues to be monitored.

As a preventative measure a woman should not lift weights or engage in intense physical activity. In case of large cysts, it is necessary to adhere to sexual rest.

If the tumor progresses and remains unchanged, treatment is prescribed, which may consist of the following measures:

1. Taking hormonal drugs (COCs), anti-inflammatory drugs, vitamins.
2. Carrying out physiotherapeutic procedures.
3. Carrying out laparoscopy.

Hormonal drugs are prescribed only after receiving the results of laboratory tests, and other therapeutic measures are prescribed depending on the patient’s clinical picture.

IMPORTANT! The size of the cyst is important when carrying out treatment tactics. If the diameter of the neoplasm does not exceed 60 mm, then a “wait and see” position or hormonal therapeutic correction is used. For larger tumors, surgery is necessary.

Laparoscopy is a last resort which involves surgical removal of the cyst. It is carried out in case of ineffectiveness of hormonal correction or increased growth of cystic formation.

When the tumor diameter is from 60 to 100 mm, there is all the risk of torsion or rupture A. In this case, surgical intervention with further histological examination of the biomaterial is the optimal treatment option.

During such an operation, the doctor can perform a resection:

1. Only neoplasms, without touching the ovarian tissue (cystectomy).
2. Neoplasms and affected ovarian stroma (organ-preserving surgery).
3. Cysts together with the ovary (advanced cases).

Complications

Follicular cysts, despite the fact that they are not classified as oncogenic tumors, are prone to serious complications. Negative consequences are possible if the diameter of the cystic formation exceeds 60 mm.

In gynecological practice, these are primarily the following conditions:

1. Cyst rupture.
2. Apoplexy (torsion).

If such consequences do occur, the patient must be hospitalized immediately.

The symptoms of rupture and apoplexy are hard to miss, since such pathologies are characterized by:

1. Acute “dagger-like” pain in the lower abdomen.
2. Vomit.
3. Nausea.
4. Fainting.
5. Weakness.
6. Dizziness.
7. Hypotension.
8. Temperature increase.

The contents of the neoplasm burst, and the leaked liquid ends up in the abdominal cavity. If this process is not stopped in time, peritonitis will begin, and then ovarian rupture. The likelihood of death is very high. An ambulance must be called immediately.

IMPORTANT! Rupture and apoplexy of the cyst are provoked by physical activity, hot bath, sauna, sexual intercourse, as well as ovulation.

Is pregnancy possible?

Conceiving a child with a follicular cyst almost impossible. Ovulation simply does not occur, and the egg does not mature. It remains undeveloped inside the capsule, which is subsequently filled with liquid.

In rare cases it happens that in the neighboring ovary a dominant follicle begins to mature, which then ovulates.

Conception with such a clinical picture is possible, but in the presence of a cystic formation, the fetus cannot be carried to term, since there is a high probability of cyst rupture, miscarriage, ectopic pregnancy, etc.

In any case, before it is necessary to resolve the issue of tumor formation, and also undergo a course of hormonal therapy if there are serious violations in this area.

As a result, it turns out that a follicular cyst is a harmless ovarian tumor, which often goes unnoticed because it resolves on its own. However, with serious endocrine pathologies it increases in sizes.

This is an alarming sign indicating a complication of the disease. In this case, diagnostic observation is an insufficient measure, since serious correction is required, including therapeutic and, in extreme cases, surgical measures. If the doctor and the patient pay due attention to the treatment of a follicular cyst, then the prognosis of the disease will be very favorable.

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:

1. 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;
2. Laboratory research. CA-125, a marker of ovarian malignancy, remains within normal limits;
3. 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;
4. 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

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