WOMEN’S BODIES: PROBLEMS OF THE OVARIES. OVARIAN CYSTS
Ovarian cysts
A cyst is a fluid-filled cavity surrounded by
a well-defined wall. There are many normal cystic structures in the body, for example the ovarian follicles. The urinary and gall bladders become cystic when they не full (inflammation of these is called respectively ‘cystitis’ and cholecystitis’). An abnormal cyst develops when anything interferes with the drainage or absorption of fluid from a cystic structure.
Ovarian follicular cysts
Sometimes an ovarian follicle that doesn’t release its ovum continues to fill with clear fluid and becomes larger than the usual 1.5 cm of the normal mature follicle, so that the follicle becomes an ovarian cyst. Follicular cysts rarely become bigger than the size of a tennis ball. Small cysts usually cause no problems. They are often found by chance during a routine pelvic examination.
Follicular cysts of less than 7-cm diameter usually disappear spontaneously within a couple of months. If they cause no symptoms they need no treatment, though they’re usually checked after six to eight weeks to make sure that they’re subsiding.
Occasionally follicular cysts can become the size of grapefruit or larger, when they cause dull pelvic aching and symptoms from pressure on other organs. Urinary frequency can be a problem because the bladder has less space to expand. Surgical removal is recommended for cysts larger than 7 cm because they usually don’t go away by themselves (or take ages to do so).
Sometimes, following ovulation, the ruptured follicle may fill up with fluid (often bloodstained) after it has sealed to form the corpus luteum. Corpus luteum cysts are
more likely to cause menstrual irregularities (early or late periods, or intermittent spotting or bleeding) as a result of disturbed progesterone production but, like follicular cysts, they usually disappear without treatment.
Follicular and corpus luteum cysts are often called physiological or functional cysts because they form during normal processes in the ovary. However, sometimes these simple cysts can become complicated.
A cyst that is attached to the ovary by a narrow stalk may twist or rupture, causing severe sudden abdominal pain. Rupture associated with bleeding into the abdominal cavity can cause severe shock. These are abdominal emergencies that need immediate surgery.
Occasionally a cyst can leak slowly, resulting in less acute symptoms that are often hard to distinguish (without special tests) from the symptoms of sub-acute appendicitis, pelvic infection or ectopic pregnancy. Laparotomy usually solves the puzzle.
One of the good side-effects of the contraceptive Pill is that because it prevents follicle development and ovulation, it also prevents follicular and corpus luteum cysts and the complications that may develop from them.
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