What are the top reasons for abnormal uterine bleeding. How do ovarian cysts, endometriosis, and uterine fibroids affect menstrual cycles. When should you seek medical attention for irregular bleeding patterns.

Understanding Abnormal Uterine Bleeding: When to Be Concerned

Abnormal uterine bleeding is a common concern among women of all ages. It encompasses a range of irregular bleeding patterns that deviate from the typical menstrual cycle. But how can you distinguish between normal variations and potentially problematic symptoms?

Normal menstrual cycles typically last between 24 to 38 days, with periods lasting up to eight days. Abnormal bleeding may include spotting between periods, post-coital bleeding, postmenopausal bleeding, or bleeding during pregnancy. Additionally, exceptionally heavy menstrual flow, unusually short or long periods, or highly irregular cycles can all be considered abnormal.

Signs of Abnormal Uterine Bleeding

• Bleeding or spotting between periods
• Bleeding after sexual intercourse
• Postmenopausal bleeding
• Bleeding during pregnancy
• Exceptionally heavy menstrual flow
• Unusually short or long periods
• Highly irregular menstrual cycles

Is any deviation from the average menstrual cycle a cause for concern? Not necessarily. However, persistent irregularities or sudden changes in your bleeding patterns warrant a consultation with a healthcare provider to rule out underlying conditions.

Ovarian Cysts: Silent Culprits Behind Irregular Bleeding

Ovarian cysts are fluid-filled sacs that develop in or on the ovaries. While most cysts are harmless and resolve on their own, some can cause abnormal bleeding and other symptoms. But how exactly do ovarian cysts lead to irregular bleeding patterns?

Ovarian cysts can disrupt the normal hormonal balance in the body, leading to changes in the menstrual cycle. In some cases, cysts can cause the ovary to produce excess estrogen, which can result in irregular bleeding or spotting between periods. Large cysts may also cause physical pressure on surrounding tissues, potentially leading to breakthrough bleeding.

Common Symptoms of Ovarian Cysts

• Abnormal bleeding or spotting
• Pelvic pain or discomfort
• Bloating
• Fever
• Nausea

Can ovarian cysts resolve without medical intervention? Many ovarian cysts do disappear on their own without treatment. However, persistent or symptomatic cysts may require surgical removal. Regular gynecological check-ups can help monitor cysts and determine the best course of action.

Endometriosis: A Hidden Cause of Abnormal Bleeding

Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus. This misplaced tissue can cause a range of symptoms, including abnormal bleeding. But why does endometriosis lead to irregular bleeding patterns?

The endometrial-like tissue outside the uterus responds to hormonal changes during the menstrual cycle, just like the tissue inside the uterus. This can lead to bleeding in areas where the tissue has implanted, such as the fallopian tubes, ovaries, or even the intestines. The result can be heavy or prolonged periods, as well as spotting between periods.

Key Symptoms of Endometriosis

1. Abnormal bleeding during and between periods
2. Severe menstrual cramps
3. Chronic pelvic pain
4. Pain during or after sexual intercourse
5. Difficulty conceiving

How is endometriosis treated? Treatment options for endometriosis vary depending on the severity of symptoms and the patient’s desire for future fertility. They may include hormonal therapies, pain management medications, or surgical interventions. In some cases, a combination of treatments may be recommended for optimal symptom relief.

Uterine Fibroids: Benign Tumors with Significant Impact

Uterine fibroids are non-cancerous growths that develop in the uterus. These tumors can range in size from as small as a pea to as large as a grapefruit. But how do fibroids contribute to abnormal uterine bleeding?

Fibroids can cause heavy menstrual bleeding and spotting between periods in several ways. They may increase the surface area of the uterine lining, leading to heavier periods. Large fibroids can also put pressure on the uterine lining, causing irregular bleeding. Additionally, fibroids can interfere with the normal contractions of the uterus, affecting its ability to stop menstrual bleeding effectively.

Treatment Options for Uterine Fibroids

• Medications to manage symptoms
• Hormonal therapy to shrink fibroids
• Surgical removal of fibroids (myomectomy)
• Radiofrequency ablation
• Hysterectomy (in severe cases)

Are all uterine fibroids symptomatic? Not necessarily. Many women with uterine fibroids experience no symptoms at all. However, when fibroids do cause symptoms, abnormal bleeding is often one of the most noticeable signs, along with pelvic pain and pressure.

Uterine Polyps: Small Growths with Potentially Big Effects

Uterine polyps are growths that occur in the inner lining of the uterus (endometrium). While usually benign, these small tissue masses can significantly impact menstrual patterns. But what makes uterine polyps a common cause of abnormal bleeding?

Polyps can cause irregular bleeding by disrupting the normal shedding of the uterine lining during menstruation. They may also have their own blood vessels, which can bleed irregularly. This can result in spotting between periods, heavy menstrual bleeding, or prolonged periods. In some cases, polyps can even cause postmenopausal bleeding.

Symptoms Associated with Uterine Polyps

1. Irregular menstrual bleeding
2. Heavy menstrual flow
3. Bleeding between periods
4. Postmenopausal bleeding
5. Infertility (in some cases)

How are uterine polyps diagnosed and treated? Diagnosis often involves a combination of ultrasound and hysteroscopy. Treatment options may include watchful waiting for small polyps, hormonal medications to shrink polyps, or surgical removal for larger or symptomatic polyps. The choice of treatment depends on factors such as the size and number of polyps, as well as the patient’s age and fertility desires.

Pregnancy Complications: When Bleeding Demands Immediate Attention

While some light spotting can be normal during pregnancy, any bleeding during this time should be taken seriously. Pregnancy-related bleeding can indicate various complications, some of which require immediate medical attention. But what are the potential causes of bleeding during pregnancy?

Bleeding in early pregnancy may signal a miscarriage or an ectopic pregnancy, where the fertilized egg implants outside the uterus. In later stages, bleeding could indicate placental problems, preterm labor, or other serious complications. Regardless of the stage of pregnancy, any bleeding should be promptly evaluated by a healthcare provider.

Possible Causes of Pregnancy-Related Bleeding

• Implantation bleeding (early in pregnancy)
• Miscarriage
• Ectopic pregnancy
• Placenta previa
• Placental abruption
• Preterm labor

How urgent is it to seek medical care for pregnancy-related bleeding? Any bleeding during pregnancy should be considered a medical emergency until proven otherwise. Immediate medical evaluation can help identify the cause and provide appropriate treatment, potentially saving the life of both mother and baby.

Less Common Causes of Abnormal Uterine Bleeding

While conditions like ovarian cysts, endometriosis, and uterine fibroids are common culprits behind abnormal bleeding, there are other, less frequent causes that shouldn’t be overlooked. What are some of these less common reasons for irregular bleeding patterns?

Infections, such as pelvic inflammatory disease or sexually transmitted infections, can cause abnormal bleeding. Bleeding disorders that affect blood clotting can also lead to heavy or prolonged menstrual bleeding. In rare cases, certain types of cancer, including uterine, cervical, or ovarian cancer, may present with abnormal bleeding as an early symptom.

Less Common Causes to Consider

1. Pelvic inflammatory disease
2. Sexually transmitted infections
3. Bleeding disorders (e.g., von Willebrand disease)
4. Hormonal imbalances
5. Certain medications
6. Uterine, cervical, or ovarian cancer

Why is it important to consider these less common causes? While they may not be as frequent, these conditions can have serious health implications if left undiagnosed and untreated. A thorough evaluation by a healthcare provider can help rule out these possibilities and ensure appropriate management.

Abnormal uterine bleeding can be a sign of various underlying conditions, ranging from benign growths to more serious health issues. Understanding the potential causes and recognizing when to seek medical attention is crucial for maintaining reproductive health. If you’re experiencing persistent irregular bleeding patterns, consulting with a gynecologist can help identify the cause and determine the most appropriate treatment plan for your individual situation.

Remember, while some variations in menstrual patterns are normal, significant changes or persistent abnormalities warrant medical evaluation. By staying attuned to your body and seeking timely care, you can address potential issues early and maintain optimal reproductive health.

Top Reasons for Abnormal Bleeding: Virtuosa GYN: OB-GYNs

Top Reasons for Abnormal Bleeding: Virtuosa GYN: OB-GYNs

Premenopausal women bleed each month as part of their menstrual cycle. On average, periods last up to about eight days and occur every 24-38 days, according to the American College of Obstetricians and Gynecologists.

Some women experience abnormal bleeding. This can occur when you have bleeding or spotting between periods, after sex, after you’ve gone through menopause, or when you are pregnant. 

Bleeding is also considered abnormal when you have exceptionally heavy menstrual bleeding, when your periods are unusually short or unusually long, or if your periods occur very irregularly.

Abnormal bleeding can have various causes. Here at Virtuosa GYN in San Antonio, Texas, our women’s health care providers have extensive expertise identifying the causes of abnormal bleeding. We’d like to tell you about some of the more common causes of abnormal bleeding.

Ovarian cysts

Ovarian cysts are fluid-filled sacs that can develop in your ovaries. Although most cysts don’t cause symptoms, they can occasionally cause abnormal bleeding, as well as pain, bloating, fever, nausea, and other symptoms.

Cysts may go away on their own. When they don’t, we can remove them surgically.

Endometriosis

Endometriosis is a condition that occurs when tissue from within your uterus grows where it doesn’t belong, such as in or on your fallopian tubes, ovaries, bladder, rectum, or intestines. In addition to pain, nausea, trouble getting pregnant, and some other symptoms, endometriosis can cause abnormal bleeding during and between menstrual periods.   

Treatment options for endometriosis include medication, hormonal therapy, and surgery.

Uterine fibroids

Fibroids are tumors that develop in the uterus. They are very common and are rarely cancerous. Ranging in size from tiny (the size of a pea) to large (the size of a grapefruit), uterine fibroids can cause heavy menstrual bleeding as well as spotting between periods.

Treatment for uterine fibroids includes medication, hormonal therapy, surgery, and a procedure known as radiofrequency ablation, which uses radio waves to shrink fibroids.

Uterine polyps

Uterine polyps are growths in the inner lining of the uterus. Although they are usually not cancerous, they may cause irregular periods, heavy menstrual bleeding during periods, unusually long periods, or spotting between periods.

Treatment options for uterine polyps include medication, hormonal therapy, and surgery.

Pregnancy complications

If you are pregnant, abnormal bleeding may be a sign of miscarriage, ectopic pregnancy, or other pregnancy complications. Seek medical care immediately if you experience bleeding while you’re pregnant.

Other disorders

Less commonly, abnormal bleeding can result from infections, bleeding disorders, or several types of cancer.

If you’re coping with abnormal uterine bleeding, heavy periods, or any other women’s health concern, we can help. Here at Virtuosa GYN, our highly professional and thoughtfully compassionate providers work with you to diagnose gynecological conditions and create a personalized treatment plan for you. Call us to schedule a consultation with one of our care providers.

4 Telltale Signs of Ovarian Cysts

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Understanding Ovarian Cysts | Cedars-Sinai

CS-Blog

Cedars-Sinai Blog

Apr 04, 2022
Victoria Pelham

Women might be scared or surprised to learn that they have an ovarian cyst.

But these fluid-filled sacs that develop on or inside a woman’s ovaries are much more common than you might think—and they are usually not a cause for concern. An estimated 10% of women experience ovarian cysts. Many women don’t even realize they’re there because benign ovarian cysts can be asymptomatic and frequently resolve on their own.

Sometimes, though, they can grow too large or rupture and cause severe pain. In rare cases, they could become cancerous.

Gynecologists say paying attention to what’s going on with your body can help you determine what’s typical—and safe—for your reproductive system and assist you in staying ahead of any complications.

“Cysts are a normal part of a fertile body’s process,” says Dr. Elizabeth Kim, a Cedars-Sinai OB-GYN. “What’s not normal is significant pain or ongoing duress.”

Obstetrics & Gynecology

Guerin Children’s

“If you’re unable to drink or keep any fluids down, you need more help.”

Reproductive cycle ties

Women and transgender men (men who were assigned female at birth) of childbearing age who are not on hormonal birth control and don’t have any health conditions restricting their periods often form at least one usually small cyst on an ovary every month, explains Dr. Kim.

A natural feature of the ovulation process, the cysts tend to pop up shortly before the menstrual cycle.

Most commonly, these are functional cysts that either continue to grow inside an ovary when an egg isn’t released (known as follicular cysts) or form when the sac surrounding an egg stays intact after the body releases the egg (a corpus luteum cyst).

Although these cysts are not always detectable, one common sign of them is pain that occurs on just one side of the abdomen. This can either be sharp or dull and may come and go.

Functional cysts typically clear up on their own within six to eight weeks, according to the American College of Obstetricians and Gynecologists (ACOG).

Read: Polycystic Ovary Syndrome Q&A with Dr. Jessica Chan

Gastrointestinal discomfort

Mild gastrointestinal symptoms like constipation, diarrhea, bloating and stomachaches are also common.

“If you think about your belly as a closed compartment, a cyst that’s getting a little bit larger can press on and affect other things in that space,” Dr. Kim says.

Most cysts hover around 2-3 centimeters. In rare cases, they can grow all the way up to 30 centimeters. When they reach a substantial size, they may start to impact a woman’s bowel and bladder, causing swelling and pressure.

Reproductive health risk factors

Certain conditions can raise the risk of chronic, uncomfortable cysts.

Polycystic ovary syndrome (PCOS) can cause multiple cysts to cluster on ovaries. Not everyone with PCOS will develop cysts, although it does increase your chances. The masses on their own don’t mean you have the hormonal illness, either: A diagnosis requires 12 or more follicular ovarian cysts, among other symptoms, specialists note.

Women with endometriosis—when endometrial tissue grows outside the uterus—can grow endometriomas, also known as chocolate cysts. They consist of old menstrual blood and endometrial tissue.

Fertility medicines, such as clomiphene, and pregnancy itself are also linked to ovarian cysts.

Read: Endometriosis Q&A with Dr. Kelly Wright

Rupture and complications

If you are experiencing persistent, throbbing pain that is tolerable but getting worse, Dr. Kim says it’s time to visit your OB-GYN or primary care provider. It usually stems from unchecked growth of ovarian cysts.

Your doctor will perform a pelvic ultrasound and exam to identify a cyst, as well as blood work to detect any underlying conditions, including hormone problems, pregnancy or ovarian cancer.

Seek help at your nearest emergency room if your symptoms are unmanageable and potentially life-threatening, she adds. Significant, worsening pain—especially on your right side—could indicate a serious medical emergency, such as appendicitis, and needs to be evaluated. Uncontrolled nausea, vomiting and pain that isn’t improving after 12 hours also need to be examined.

“If you’re unable to drink or keep any fluids down, you need more help,” she stresses.

Extreme pain in either side of your lower abdomen or back might mean a cyst has opened. While the average rupture typically won’t cause further complications, some can cause a small amount of bleeding at the site of the cyst, potentially dropping your blood pressure.

Another rare but serious consequence of ovarian cysts is fallopian tube twisting, which can cut off ovarian blood supply.

These complications require immediate treatment.

Read: Not Just a Stomach Ache: Symptoms of Appendicitis

Treatment options for ovarian cysts

If you have a potentially worrisome cyst that hasn’t burst, your gynecologist might monitor its progress through repeated ultrasounds, ACOG notes. Significant growths could require conservative pain management and fluids for hydration.

Due to heavy blood loss—which can cut off blood flow to essential organs—patients with severe symptoms of rupture may need to stay at the hospital until bleeding stops. Your provider can replace fluids or blood, if necessary.

Doctors may suggest surgery for patients who have:

• An abnormally large cyst
• Continued growth
• Complex cysts (like endometrioma) that contain solid areas, bumps or tissue
• Endometriosis, for fertility-preserving reasons
• Ongoing bleeding or complications
• Health conditions that make it difficult to stop blood flow
• Cancer warning signs

Surgeons use either minimally invasive laparoscopy or open surgery to remove the mass, as well as any blood clots, excess blood or fluid—and sometimes the surrounding ovary. Your fertility goals and family history of breast and ovarian cancer often factor into your care plan.

Estimates cited by the Office on Women’s Health at the U.S. Department of Health and Human Services show that around 5%-10% of women undergo ovarian cyst removal. Just 13%-21% of those cysts are cancerous.

Women’s health experts agree that the risk of ovarian cysts leading to ovarian cancer is very low, but ovarian cyst growth does slightly increase the risk of ovarian cancer for older, postmenopausal women.

Read: OB-GYN Surgery: The Minimalist Revolution

Take charge

Stay vigilant, especially if your doctor has already informed you of an existing cyst.

And if you experience chronic cysts that cause pain or rupture, work with your doctor to create a preventative plan, Dr. Kim says. Your doctor can prescribe various types of hormonal birth control, which stop the cycle that allows these cysts to form.

Learn more about the Obstetrics/Maternity program and Gynecologic Services at Cedars-Sinai.

frequently asked questions of patients with ovarian cyst

Patients diagnosed with ovarian cyst often ask doctors on medical portals a lot of questions, for example, what can or cannot be done with an ovarian cyst, can pregnancy affect the course of the disease with an ovarian cyst, etc. This article contains the most frequently asked questions of women diagnosed with an ovarian cyst.

Can the stomach hurt with an ovarian cyst?

Pain in the lower abdomen is the most important symptom of a growing ovarian cyst. True, by themselves they do not say anything, since they can be a symptom of any diseases of the genitourinary system and inflammatory processes.

However, it is worth checking with a gynecologist if abdominal pain is accompanied by:

• Radiating (reflected) pain in the lower back, rectum, lateral or upper abdomen
• Menstrual irregularities, delayed or absent menses
• Bloody discharge between periods
• Bloating
• Bowel or bladder disorders
• Pain during intercourse

If such symptoms appear, a woman should immediately make an appointment with a gynecologist and have an ultrasound of the pelvic organs.

Can menstruation be delayed with an ovarian cyst?

Delayed menstruation is also one of the main symptoms of an ovarian cyst. Associated symptoms for the diagnosis of ovarian cysts can be viewed in the previous section of the article.

In general, irregular menstrual cycles are common in women, which can be due to many reasons. Usually the cycle duration is from 21 to 35 days. It is believed that a delay of up to 5 days is not a cause for concern, beyond this time it is already a recommendation to consult with your gynecologist.

Very often, menstrual irregularities and delays in menstruation cause functional ovarian cysts (follicular and corpus luteum cysts). The fact is that the cells that make up these cysts produce the hormone progesterone. If it is produced in too large quantities, then its effect on the body in the second phase of the cycle is extended until the delay of menstruation (the hormonal background cannot ensure timely rejection of the endometrium) or vice versa – bleeding (due to uneven rejection of the uterine endometrium).

Often, delays in menstruation begin to occur a few months before the appearance of a cyst, when the pathological process of formation has already started. Therefore, gynecologists often predict the early detection of an ovarian cyst if menstruation began to be delayed for no apparent reason and health problems. And the delays do not have to be long – 7 days is already considered a dangerous signal.

That is why, at the slightest suspicion, it will not be superfluous to undergo a gynecological examination. Do not be afraid if the doctor recommends surgical removal of the ovarian cyst. It is better to do this in a timely manner with a sparing laparoscopy method and preserve the ovary and reproductive function than to ignore the problem and earn health problems, the least of which will be infertility.

Can there be a false positive pregnancy test with an ovarian cyst?

Gynecologists answer this question in the affirmative – an ovarian cyst can indeed be the cause of a positive test in the absence of pregnancy. But usually the second strip in the test appears weakly, not bright enough.

However, if you understand the problem, it usually turns out that such a result is not caused by a cyst, but by a cystoma – a hormonally active tumor on the ovary. Ultrasound cannot distinguish a cyst from a cystoma that produces hormones that may well distort the test result, so the doctor who performed the ultrasound examination calls any volumetric cavity formation a cystic formation in conclusion. And it is colloquially referred to simply as a cyst.

However, if an ultrasound scan reveals a neoplasm, and against this background, a pregnancy test after a missed period shows a positive result, this is a serious indicator that a woman should undergo additional examinations to rule out a suspicion of a malignant tumor.

In addition to cystoma, other factors can affect the incorrect test result:

• Incorrect application of the test
• Use of an expired, damaged, or improperly stored test
• Ectopic pregnancy
• Irregular menstrual cycle (if there is no set period between periods, then you should not seriously consider using the test as a method of determining pregnancy)
• Contraceptive use
• Ovarian disorders

Can I have sex with an ovarian cyst?

There is no definite answer to the question whether it is possible to have sex with an ovarian cyst or not. Everything depends on the individual case.

In general, the cyst is not an obstacle to a full sexual life. But with such a diagnosis, it is necessary to exclude physical stress on the press, so a woman should avoid sexual positions in which she will strain her abdominal muscles. The load on the abdominal muscles is fraught with rupture or torsion of the cyst. Also, intense intimate marathons with a significant overall physical load on the woman’s body are highly undesirable.

However, there are cases when sex with an ovarian cyst is contraindicated:

• If the cyst is large (about 10 cm)
• If intercourse causes pain (do not ignore this pain to avoid rupture of the cyst)

If a patient is going to have an operation to remove an ovarian cyst, the woman may also wonder: is it possible to return to an active sexual life soon after the removal of the ovarian cyst? Subject to a successful operation and favorable test results after it, the patient can start an intimate life again in a month.

By the way, an interesting fact: scientists have proven that regular sex, which brings pleasure to a woman, has a positive effect on the hormonal balance in her body, and as a result, helps prevent the formation of ovarian cysts.

Can I do sports with an ovarian cyst?

For girls who carefully monitor their physical form, the question is especially relevant whether it is possible to continue to exercise with an ovarian cyst. The diagnosis of an ovarian cyst causes certain restrictions on intense exercise, as well as certain exercises and sports. Much also depends on the complexity of the course of the disease.

Doctors advise to completely exclude physical education if the cyst was accompanied by inflammatory processes. In this case, classes can be started only after the course of treatment, gradually increasing the load.

Some types of exercise can lead to rupture of even a small cyst, therefore, with any type of ovarian cyst, stress on the abdominal muscles is prohibited. Also banned are athletics, intense running and strength training – everything that can cause sudden movements and cramps in the lower abdomen. Apoplexy (tissue rupture) can be provoked by any sudden movement or the slightest injury – a fall, jump, somersault, etc.

The following exercises can lead to rupture and torsion of the cyst:

• Jumping
• Leg swing
• Lunges
• Squats
• Oscillating Press
• Sprint
• Barbell or Heavy Dumbbell Lift
• Sharp twists or bends of the torso

Jogging and cardio training can be replaced by walking. This light version of running is completely safe.

In any case, before starting sports training with a diagnosis of an ovarian cyst, it is better to first consult with a doctor who will help you choose the optimal load and a sport that will not hurt.

Is it possible to lead a normal life with an ovarian cyst?

The diagnosis of an ovarian cyst does not impose strict restrictions on the habitual lifestyle of most patients. However, there are still a number of contraindications.

Contraindications for ovarian cyst:

• Sauna or bath
• Taking a hot bath
• Massages, body wraps and other spa treatments
• Various physical therapy procedures (unless prescribed by a gynecologist)
• Tanning in direct sunlight
• Intense sports activities
• Self-treatment

Is it possible to get pregnant with an ovarian cyst?

The best option is to plan the conception of a child in advance, having previously passed all the gynecological examinations that will reveal a cyst.

In the case of an acute pathology (rupture or torsion of an ovarian cyst) requiring radical surgical intervention, after surgery, there may be difficulty in conceiving if adhesions occur in the fallopian tubes (as a complication after surgery) or if one damaged ovary has to be removed. However, if the operation is planned and carried out in a timely manner, then problems with conception usually do not arise.

If the patient has a functional cyst, then it is not an obstacle to conception and pregnancy. Moreover, often such cysts, without medical treatment, resolve on their own during pregnancy, when the body rearranges its hormonal levels. But still it is better to constantly be observed by a gynecologist.

There are cases when an ovarian cyst is found already in a pregnant girl. If it is small in size and does not bother the woman, then the patient is simply observed.

It is believed that pregnancy can proceed normally with an ovarian cyst if the following factors coincide:

• Cyst no more than 8 cm in size
• The size of the cyst does not increase
• The level of tumor markers is within the normal range

In the case of acute pathologies, the medical council may prescribe an operation to remove the cyst during pregnancy, although radical intervention is not welcome in the later stages. In such cases, doctors evaluate the ratio of harm and risk from the cyst to the health of the mother and child.

In order for the pregnancy to proceed safely, without any unpleasant diagnoses, every woman must visit a gynecologist regularly with an ultrasound of the pelvic organs.

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Ultrasound diagnosis of ovarian cysts | Floris

• TODAY we want to talk about the diagnosis of another terrible disease in women – ovarian cysts. Our interlocutor is a doctor of the highest category, head of the department of ultrasound diagnostics at the Floris Medical Center, GENNADY YAROVOY.

  – A cyst is a fluid-filled cavity in the ovary. By its nature, it refers mainly to benign tumor neoplasms. Up to 96% of these formations are cysts such as follicular cyst, cyst of the corpus luteum, endometrioid, serous cyst and paraovarian. Up to 90% of this list is occupied by the first two most common, so-called functional cysts, that is, formed during the functioning of the ovary. After the death of the egg or corpus luteum, such cysts are resorbed and altered periods occur. Such cysts generally do not require surgical intervention, but only dynamic observation during 1-3 monthly cycles and hormonal correction. These medical measures make it possible to avoid both severe psychological trauma for the patient and surgery.

  – What are the causes of ovarian cysts?

  – The causes are still unknown, but one of the main hypotheses is a violation of the ratio of pituitary hormones that regulate the functioning of the ovaries. Their release, in turn, is regulated by the central nervous system. Constant stress, strict weight loss diets, genital infections – all these factors change the functioning of the ovaries. A large number of ovarian tumors are detected in women over 40 years old: it is at this age that a significant restructuring occurs in the system that regulates the functioning of the ovaries.

  – How do ovarian cysts manifest themselves clinically?

  – In most cases, they do not show themselves. Many patients have a violation of the menstrual cycle in the form of delays in menstruation. Menses coming after a delay are more profuse than usual, or more scanty. Or there are more long-term spotting bleeding. The most common complaint of patients with ovarian cysts is dull, aching pain in the lower abdomen, sometimes in the groin. In the future, after stabilization of the size of the cyst, these pains gradually disappear. Pain may also appear during menstruation, caused by trauma at the time of rupture and emptying of the cyst or its pressure on neighboring organs. Relatively rare complications include torsion of the cyst leg or its rupture with violation of the integrity of the vessel and hemorrhage into the small pelvis. Clinically, these complications, as a rule, begin with severe pain in the lower abdomen, accompanied by nausea and vomiting. Moreover, the pain often increases with pressure on the cyst during the study. Most cysts are discovered incidentally during a gynecological or ultrasound examination.

  – How does ultrasound diagnostics help in diagnosing cysts and what do doctors see on monitor screens?

  – Ultrasound of the pelvic organs in the recognition of cysts and tumors of the ovaries is of particular importance, since the clinical picture of many diseases is identical, and the data of a gynecological examination are nonspecific. Under these conditions, it is ultrasound that is the basis of the diagnostic process, the results of which determine the fate of the patient. This area of ​​ultrasound diagnostics presents significant difficulties in terms of differentiation, when during one study in a short time, the ultrasound doctor must exclude the presence of normal variants, inflammatory diseases, tumors of the uterus and ovaries, and, most importantly, to conduct a differential diagnosis between different types of cysts and ovarian tumors. This imposes a huge responsibility on the specialist.

  Well, now let’s look at what an ultrasound doctor sees when examining the pelvic organs. As is known, the main ultrasound sign of a cyst is the detection of a liquid formation in the projection of the ovary, limited by the capsule. It arises as a result of the accumulation of a secret. Different types of cysts differ from each other in size, capsule thickness, blood supply, various internal contents, growths inside the cyst cavity, etc. To draw the right conclusions as a result of an ultrasound study, you need to consider all this with the help of a vaginal probe. During ultrasound, this sensor is brought close to the organ under study and its condition is studied. The accuracy of such diagnostics approaches 100%. For example, follicular cysts on ultrasound look like spherical liquid formations with a thin, even wall. They change their shape and size during a hydrodynamic test (pressure with a sensor). Sometimes, at the same time, cysts can self-destruct right in front of the ultrasound doctor. But the cysts of the corpus luteum are distinguished by a diverse internal structure and may have dense inclusions due to blood clots. Endometrioid cysts have an internal content that looks like chocolate, which is why they are also called “chocolate”. Their content does not change during the research process. They are distinguished by a thick wall with a double contour. These cysts enlarge before menstruation. They arise from pieces of tissue, usually lining the uterine cavity, but sometimes “moving” to other organs and tissues due to a hormonal shift in the body, accompanied by a decrease in the woman’s immunity. Serous cysts – very similar in form to follicular cysts, but occur mainly in women in the premenopausal period. They are located high above the uterus, easily displaced when pressed by the sensor. The other two rare types of cysts are paraovarian, located near the ovaries and in its ligaments, and dermoid cysts. In essence, these are benign tumors that have grown from germinal tissue, so they can be found even in girls. Such cysts have a rounded shape with an even thin capsule, this can be seen with ultrasound. Paraovarian cyst with homogeneous contents, and next to it a healthy ovary. Dermoid cysts have a heterogeneous structure and dense inclusions. Their contents are mainly fat, hair, teeth, and so on. But when the formations in the small pelvis grow very quickly, jumpers and multiple different growths appear inside them, uneven thickening of the walls, increased blood flow, then this causes concern among ultrasound doctors, since such symptoms are already characteristic of malignant tumors, the diagnosis of which is very difficult. As part of our conversation, we will not consider it.

  – What should a woman do if any of these cysts are found?

  – First of all, she needs to visit a gynecologist, who will prescribe the necessary additional examination, and then treatment and control ultrasound monitoring. All this can be done in our medical center, which has expert-class ultrasound equipment, highly qualified doctors and a laboratory with the best equipment.