An ovarian cyst

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Definition

An ovarian cyst is a fluid-filled sac within the ovary. Often they cause no symptoms. Occasionally they may produce bloating, lower abdominal pain, or lower back pain. If the cyst either breaks open or causes twisting of the ovary severe pain may occur. This may result in vomiting or feeling faint. The majority of cysts are, however, harmless.

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Most ovarian cysts are related to ovulation being either follicular cysts or corpus luteum cysts. Other types include cysts due to endometriosis, dermoid cysts, and cystadenomas. Many small cysts occur in both ovaries in polycystic ovarian syndrome. Pelvic inflammatory disease may also result in cysts. Rarely cysts may be a form of ovarian cancer. Diagnosis is undertaken by pelvic examination with an ultrasound or other testing used to gather further details.

Often cysts are simply observed over time. If they cause pain, medications such as paracetamol (acetaminophen) or ibuprofen may be used. Hormonal birth control may be used to prevent further cysts in those who are frequently affected. However, evidence does not support birth control as a treatment of current cysts. If they do not go away after several months, get larger, look unusual, or cause pain they may be removed by surgery.

Most women of reproductive age develop small cysts each month. Large cysts that cause problems occur in about 8% of women before menopause. Ovarian cysts are present in about 16% of women after menopause and if present are more likely to be cancer.

Causes

Ovarian cysts often develop naturally in women who have monthly periods.

They can also affect women who have been through the menopause.

Types of ovarian cyst

There are many different types of ovarian cyst, which can be categorised as either:

  • functional cysts
  • pathological cysts

Functional cysts

Functional ovarian cysts are linked to the menstrual cycle. They affect girls and women who haven’t been through the menopause, and are very common.

Each month, a woman’s ovaries release an egg, which travels down the fallopian tubes into the womb (uterus), where it can be fertilised by a man’s sperm.

Each egg forms inside the ovary in a structure known as a follicle. The follicle contains fluid that protects the egg as it grows and it bursts when the egg is released.

However, sometimes a follicle doesn’t release an egg, or it doesn’t discharge its fluid and shrink after the egg is released. If this happens, the follicle can swell and become a cyst.

Functional cysts are non-cancerous (benign) and are usually harmless, although they can sometimes cause symptoms such as pelvic pain. Most will disappear in a few months without needing any treatment.

Pathological cysts

Pathological cysts are cysts caused by abnormal cell growth and aren’t related to the menstrual cycle. They can develop before and after the menopause.

Pathological cysts develop from either the cells used to create eggs or the cells that cover the outer part of the ovary.

They can sometimes burst or grow very large and block the blood supply to the ovaries.

Pathological cysts are usually non-cancerous, but a small number are cancerous (malignant) and often surgically removed.

Conditions that cause ovarian cysts

In some cases, ovarian cysts are caused by an underlying condition such as endometriosis.

Endometriosis occurs when pieces of the tissue that line the womb (endometrium) are found outside the womb in the fallopian tubes, ovaries, bladder, bowel, vagina or rectum. Blood-filled cysts can sometimes form in this tissue.

Polycystic ovary syndrome (PCOS) is a condition that causes lots of small, harmless cysts to develop on your ovaries. The cysts are small egg follicles that don’t grow to ovulation and are the result of altered hormone levels.

http://www.nhs.uk/Conditions/Ovarian-cyst/Pages/Causes.aspx

Risk factors

A woman can develop cysts on the ovary at any time during her life, including while still in the womb. Three types of ovarian cysts can occur, with physiologic cysts — those that develop as a result of normal female hormonal fluctuations — the most common. Physiologic cysts generally need no treatment because they resolve spontaneously and have no risk factors. Benign neoplasms and cancerous cysts occur far less frequently.

Non-Cancerous Ovarian Cysts

High hormone levels in a pregnant woman can cause her growing baby daughter to have ovarian cysts before she’s even born. Most fetal ovarian cysts disappear before birth; of those that remain at the time of birth, 90 percent resolve spontaneously by the time the baby is 3 months old.

Each month, the normal menstrual cycle causes changes in hormone levels. In the follicular phase of the menstrual cycle, simple benign cysts can form. After ovulation, the corpus luteum — the shell of the follicle that contained the ovulated egg — forms a simple cyst. Complex but benign cysts alsocan form from these normal processes. Because normal hormone changes cause these cysts, the only risk factor for developing them is being female. Simple cysts contain only fluid; complex cysts can contain solid material.

The most important thing to remember about most ovarian cysts is that they don’t require surgical removal. Time — and, in some case, medication — are the best treatment for benign ovarian cysts. See your doctor if you have concerns about ovarian cysts.

Ovarian Cancer

Ovarian cancer is the leading cause of cancer death in women with almost 15,000 deaths per year. The best tool for diagnosis or suspicion is a pelvic ultrasound with color flow evaluation. This is better than a CAT scan or MRI.

The problem is that most of these cancers are picked up late, usually stage three or four. There are no real risk factors, but there are some interesting statistics to be aware of. The Oral Contraceptive Pill actually has a protective affect on the incidence of ovarian cancer. Ten years of continuous OCP usage can lower the risk for developing ovarian cancer by 60%. Also, the more children one has, the lower risk for ovarian cancer as well. Alcohol consumption does not affect the rate, as opposed to breast cancer, which increases your risk of ovarian cancer. There is a strong family association for developing this cancer. If one carries the cancer gene, BRCA1 or BRCA2 then they would have a 15% and 40% chance respectively for getting ovarian cancer.

http://www.livestrong.com/article/556323-risk-factors-of-ovarian-cysts/

Symptoms

Often times, ovarian cysts do not cause any symptoms. However, symptoms can appear as the cyst grows. Symptoms may include:

  • abdominal bloating or swelling
  • painful bowel movements
  • pelvic pain before or during the menstrual cycle
  • painful intercourse
  • pain in the lower back or thighs
  • breast tenderness
  • nausea and vomiting

Severe symptoms of an ovarian cyst that require immediate medical attention include:

  • severe or sharp pelvic pain
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  • fever
  • faintness or dizziness
  • rapid breathing

These symptoms can indicate a ruptured cyst or an ovarian torsion. Both complications can have serious consequences if not treated early.

http://www.healthline.com/health/ovarian-cysts?m=0#symptoms3

Diagnostics

Your doctor can detect an ovarian cyst during a routine pelvic examination. They may notice swelling on one of your ovaries and order an ultrasound test to confirm the presence of a cyst. An ultrasound test (ultrasonography) is an imaging test that uses high-frequency sound waves to produce an image of your internal organs. Ultrasound tests help determine the size, location, shape, and composition (solid or fluid filled) of a cyst.

Imaging tools used to diagnose ovarian cysts include:

  • CT scan: a body imaging device used to create cross-sectional images of internal organs
  • MRI: a test that uses magnetic fields to produce in-depth images of internal organs
  • Ultrasound device: an imaging device used to visualize the ovary
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Because the majority of cysts disappear after a few weeks or months, your doctor may not immediately recommend a treatment plan. Instead, they may repeat the ultrasound test in a few weeks or months to check your condition.

If there aren’t any changes in your condition or if the cyst increases in size, your doctor will request additional tests to determine other causes of your symptoms.

These include:

  • pregnancy test: to make sure you’re not pregnant
  • hormone level test: to check for hormone-related issues, such as too much estrogen or progesterone
  • CA-125 blood test: to screen for ovarian cancer

Treatment 

Your doctor may recommend treatment to shrink or remove the cyst if it doesn’t go away on its own or if it grows larger.

Birth control pills

If you have recurrent ovarian cysts, your doctor can prescribe oral contraceptives to stop ovulation and prevent the development of new cysts. Oral contraceptives can also reduce your risk of ovarian cancer. The risk of ovarian cancer is higher in postmenopausal women.

Laparoscopy

If your cyst is small and results from an imaging test rule out cancer, your doctor can perform a laparoscopy to surgically remove the cyst. The procedure involves your doctor making a tiny incision near your navel and then inserting a small instrument into your abdomen to remove the cyst.

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Laparotomy

If you have a large cyst, your doctor can surgically remove the cyst through a large incision in your abdomen. They’ll conduct an immediate biopsy, and if they determine that the cyst is cancerous, they may perform a hysterectomy to remove your ovaries and uterus.

Prophylaxis

Ovarian cysts can’t be prevented. However, routine gynecologic examinations can detect ovarian cysts early. Benign ovarian cysts don’t become cancerous. However, symptoms of ovarian cancer can mimic symptoms of an ovarian cyst. Thus, it’s important to visit your doctor and receive a correct diagnosis. Alert your doctor to symptoms that may indicate a problem, such as:

  • changes in your menstrual cycle
  • ongoing pelvic pain
  • loss of appetite
  • unexplained weight loss
  • abdominal fullness

http://www.healthline.com/health/ovarian-cysts?m=0#prevention7

Useful advice

There are natural options that are very effective for managing functional ovarian cysts. We like to approach it at two different levels – clearing out and prevention. In this guide you will learn how to clear out excess estrogens and cysts while working to prevent future ones from being created. This therapy usually has results in 3 months, but should only be done prior to trying to conceive.

The Benefits of Natural Therapies for Ovarian Cysts:

  • Reduces excess estrogens
  • Promotes hormonal balance
  • Reduces cyst size and growth
  • Least invasive
  • Very effective
  • No side effects

How to Help Ovarian Cysts Naturally…

Step One: Reduce Estrogen

Excess estrogen is one of the most common types of hormonal imbalance which can cause the disruption of ovulation. One of the best ways to rid the body of excess estrogens is to stop exposing yourself to xenohormones and to start taking a supplement called DIM (diindolylmethane).

Avoid exposure to estrogens and xenoestrogens

  • Stop eating soy foods
  • Eat only organic meats and dairy
  • Do not microwave foods in plastic
  • Stop drinking water from plastic bottles
  • Avoid mineral oil and parabens in skin care products
  • Use natural detergents

Supplement with DIM
DIM helps to clear the body of these excess estrogens, aiding in hormonal balance and reducing the promotion of ovarian cyst growth. DIM should be taken daily for at least three months along with lifestyle changes which include avoiding xenoestrogens found in products, foods and the environment.

Step Two: Increase Progesterone and Balance Hormones

Natural Progesterone
When there is excess estrogen in the body, there is usually also a progesterone deficiency. Balancing your estrogen and progesterone levels by using natural progesterone cream will help reduce the ovarian cysts and the chance of them occurring in the future. Use of natural progesterone cream helps to increase progesterone levels.

Dr. John Lee believed natural progesterone to be one of the best treatments for ovarian cysts. One of the ways he used natural progesterone to eliminate ovarian cysts was by having his patients apply natural progesterone from days 10-26 of the cycle. This “tricks” the body into thinking it is pregnant which suppresses ovulation. If ovulation doesn’t occur, functional ovarian cysts cannot form.

Note: This is a short term treatment that is best done in conjunction with the other supportive supplements. The above natural progesterone protocol is intended to help the body eliminate the ovarian cysts and prevent the formation of new ones, so that in a few months you can begin trying to conceive. Remember, should you choose to follow Dr. Lee’s natural progesterone protocol for ovarian cysts you may not ovulate during that time, which means you may not be able to get pregnant. If you would like to learn more about how Dr. John Lee treats ovarian cysts with natural progesterone cream, please consider purchasing his book on natural progesterone at his website.

Supportive Herbs for Ovarian Cysts

Now that “clearing out” is covered let’s look at balancing the body so we can help prevent future cysts. Consider an herbal program for preventing ovarian cysts from forming in the first place.

We like to use herbs to help to nourish the endocrine system, promote hormonal balance, regular ovulation, and proper circulation to the reproductive organs. We also like to use herbs that are detoxifying to the liver for improved hormonal balance and estrogen metabolism. Ovarian cysts are considered a state of stagnation in the body, both in regard to the liver and circulation to the reproductive organs.

Maca root (Lepidium meyenii): Maca is a great fertility herb that helps the body produce progesterone and balance the hormones without containing any hormones itself. We find that maca helps natural progesterone to work better by nourishing the endocrine system. Maca is best taken daily at 1,000-3,000 mg.

Black Cohosh root (Actaea racemosa): This herb promotes regulation of the entire menstrual cycle. Black cohosh is one of the best herbs for relieving ovarian pain.

Dong Quai root (Angelica sinensis): This traditional Chinese herb aids hormonal balance and is specific for congestive fertility issues. Dong Quai also supports healthy circulation to the reproductive organs and reduction in pain associated with a variety of fertility issues.

Milk Thistle seed (Silybum marianum): This herb supports hormonal balance through liver support. Milk thistle helps the liver to cleanse and regenerate itself. As we all know, the liver helps to filter toxins from the body, including excess hormones.

Tribulus, aerial parts and fruit (Tribulus terrestris)Tribulus has been found to normalize ovulation when used prior to ovulation. One study performed on 36 women who were not ovulating, showed that that 67% realized normal ovulation after only 2-3 months of consistent use. Tribulus has also been found to be a nourishing tonic for the female reproductive system as a whole, especially concerning the ovaries.

Vitex, Chaste tree berry (Vitex agnus-castus)Vitex aids in regulating hormonal balance, promotes ovulation, and improves timing of the entire menstrual cycle.

Wild Yam root (Dioscorea villosa)Wild Yam promotes a healthy menstrual cycle and hormonal balance. Wild Yam is also an excellent remedy for reducing ovarian pain.

Yarrow aerial parts (Achillea millefolium)Yarrow relieves pelvic congestion through improved circulation to the reproductive organs.

Learn about other herbs supportive for fertility here…

Step Three: Dissolve and Reduce Cysts

There are two natural therapies that have been used time and time again to help the body break down the cysts, reduce their size and may help them to disappear all together.

Systemic Enzyme Therapy: The body contains a variety of enzymes. Enzymes are catalysts for chemical reactions necessary to the innumerable actions that maintain the function of the body. A subclass of enzymes known as Systemic Enzymes work to help the body breakdown excess foreign tissues and reduce inflammation. Supplementation with a high quality systemic enzyme blend such as Wobenzym N may help the body to reduce the size of the cysts or eliminate them over time.

Castor Oil Pack: Castor Oil Packs are an ancient therapy that help to cleanse and heal the area of the body where they are placed. The castor oil has a drawing power that helps the body to clear itself of excess tissues and toxins. Castor oil packs stimulate the lymphatic and circulatory systems. The lymphatic system removes toxins and waste from the area where the pack is applied. A castor oil pack also increases circulation which helps to bring in fresh oxygenated, nutrient rich blood to the reproductive organs, including the ovaries. This is a vital step to helping the body reduce and dissolve ovarian cysts. Do not apply during menstruation.

http://natural-fertility-info.com/ovarian-cyst-remedy

Outcome 

The outlook for premenopausal women with ovarian cysts is good. Most cysts disappear within a few months. However, recurrent ovarian cysts can occur in premenopausal women and women with hormone imbalances.

If left untreated, some cysts can decrease fertility. This is common with endometriomas and polycystic ovary syndrome. To improve fertility, your doctor can remove or shrink the cyst. Functional cysts, cystadenomas, and dermoid cysts do not affect fertility.

Although some doctors take a “wait and see” approach with ovarian cysts, your doctor may recommend surgery to remove and examine any cyst or growth that develops on the ovaries after menopause. This is because the risk of developing a cancerous cyst or ovarian cancer increases after menopause. However, ovarian cysts don’t increase the risk of ovarian cancer. Some doctors will remove a cyst if it’s larger than 5 centimeters in diameter.

Complications

Most ovarian cysts are benign and naturally go away on their own without treatment. These cysts cause little, if any, symptoms. But in a rare case, your doctor may detect a cancerous cystic ovarian mass during a routine examination.

Ovarian torsion is another rare complication of ovarian cysts. This is when a large cyst causes an ovary to twist or move from its original position. Blood supply to the ovary is cut off, and if not treated, it can cause damage or death to the ovarian tissue. Although uncommon, ovarian torsion accounts for nearly 3 percent of emergency gynecologic surgeries.

Ruptured cysts, which are also rare, can cause intense pain and internal bleeding. This complication increases your risk of an infection and can be life-threatening if left untreated.

http://www.healthline.com/health/ovarian-cysts?m=0#complications4

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