Oral Contraceptives Are Not an Effective Treatment for Ovarian Cysts – Cochrane for Clinicians

Cochrane for Clinicians

Putting Evidence into Practice

DEAN A. SEEHUSEN, MD, MPH, and J. SCOTT EARWOOD, MD, Eisenhower Army Medical Center, Fort Gordon, Georgia

Am Fam Physician. 2014 Nov 1;90(9):623.

Clinical Question

Are oral contraceptives an effective therapy for ovarian cysts?

Evidence-Based Answer

Oral contraceptives are not an effective treatment for ovarian cysts, whether the cysts are spontaneous or associated with medically induced ovulation. Most cysts resolve without intervention within two to three months. Those that do not resolve in this time frame are more likely to be pathologic in nature and should prompt referral for a surgical evaluation. (Strength of Recommendation: B, based on inconsistent or limited-quality patient-oriented evidence.)

Practice Pointers

Oral contraceptives have long been known to be highly effective at suppressing the development of ovarian cysts. In one study, the relative risk of developing ovarian cysts was 0.22 (95% confidence interval, 0.13 to 0.39) for women taking an oral contraceptive compared with those not taking an oral contraceptive.1 Although oral contraceptives are commonly used to treat ovarian cysts, the authors sought to clarify whether this is appropriate. Eight randomized controlled trials were included in this review. Although the studies were too heterogeneous to conduct meta-analyses for most questions, results from these studies were consistent enough to draw several conclusions.

Five trials looked at spontaneously occurring ovarian cysts, representing a combined total of 398 women. The largest study included 141 women, and four of the studies were conducted in Turkey. The oral contraceptives used in these studies contained ethinyl estradiol combined with desogestrel or levonorgestrel. Individually, none of the five trials found a statistically significant benefit of oral contraceptive use vs. expectant management in expediting resolution of cysts.

Three trials with a total of 288 participants evaluated the effectiveness of oral contraceptives for treating ovarian cysts in women whose ovulation was medically induced. In these studies, ovulation was induced with clomiphene (Clomid), human menopausal gonadotropin, human chorionic gonadotropin, or a combination of these medications. Eligibility criteria for these studies included the presence of an adnexal cyst that was at least 1.5 to 2 cm in diameter. Participants were randomized to monophasic oral contraceptives or expectant management. Problems with randomization, blinding, and sample size estimation were common to all three studies. No benefit of oral contraceptives over expectant management was observed in any trial.

A common finding in the studies included in this review was that ovarian cysts that were not resolving within two to three cycles were often pathologic in nature. For example, in a 2003 study of 62 women randomized to oral contraceptives or expectant management, 19 women had persistent cysts and subsequently underwent laparoscopy. 2 Six of the cysts were serous cystadenomas, four were endometriomas, two were mucinous cystadenomas, and one was a mucinous cystadenofibroma. The remaining six were follicular cysts. This reflects the general consensus that functional cysts typically resolve in eight to 12 weeks.3 These findings are also consistent with current guideline recommendations that ovarian cysts smaller than 50 mm be managed expectantly for up to three cycles and that oral contraceptives not be used for treatment.4

SOURCE:

Grimes DA,
Jones LB,
Lopez LM,
Schulz KF.
Oral contraceptives for functional ovarian cysts. Cochrane Database Syst Rev.
2014;(4):CD006134.

Oral contraceptives for functional ovarian cysts

Background:

Functional ovarian cysts are a common gynecological problem among women of reproductive age worldwide. When large, persistent, or painful, these cysts may require operations, sometimes resulting in removal of the ovary. Since early oral contraceptives were associated with a reduced incidence of functional ovarian cysts, many clinicians inferred that birth control pills could be used to treat cysts as well. This became a common clinical practice in the early 1970s.

Objectives:

This review examined all randomized controlled trials that studied oral contraceptives as therapy for functional ovarian cysts.

Search strategy:

We searched the databases of CENTRAL, MEDLINE, POPLINE, and EMBASE, as well as clinical trials databases (ClinicalTrials.gov and ICTRP). We also examined the reference lists of articles and wrote to authors of identified trials to seek articles we had missed.

Selection criteria:

We included randomized controlled trials in any language that included oral contraceptives used for treatment and not prevention of functional ovarian cysts. Criteria for diagnosis of cysts were those used by authors of trials.

Data collection and analysis:

Two authors independently abstracted data from the articles. One entered the data into RevMan and a second verified accuracy of data entry. For dichotomous outcomes, we computed the Mantel-Haenszel odds ratio with 95% confidence interval (CI). For continuous outcomes, we calculated the mean difference with 95% CI.

Main results:

We identified eight randomized controlled trials from four countries; the studies included a total of 686 women. Treatment with combined oral contraceptives did not hasten resolution of functional ovarian cysts in any trial. This held true for cysts that occurred spontaneously as well as those that developed after ovulation induction. Most cysts resolved without treatment within a few cycles; persistent cysts tended to be pathological (e.g., endometrioma or para-ovarian cyst) and not physiological.

Authors’ conclusions:

Although widely used for treating functional ovarian cysts, combined oral contraceptives appear to be of no benefit. Watchful waiting for two or three cycles is appropriate. Should cysts persist, surgical management is often indicated.

Ovarian cysts – Diagnosis and treatment

Diagnosis

A cyst on your ovary can be found during a pelvic exam. Depending on its size and whether it’s fluid filled, solid or mixed, your doctor likely will recommend tests to determine its type and whether you need treatment. Possible tests include:

• Pregnancy test. A positive test might suggest that you have a corpus luteum cyst.
• Pelvic ultrasound. A wandlike device (transducer) sends and receives high-frequency sound waves (ultrasound) to create an image of your uterus and ovaries on a video screen. Your doctor analyzes the image to confirm the presence of a cyst, help identify its location and determine whether it’s solid, filled with fluid or mixed.
• Laparoscopy. Using a laparoscope — a slim, lighted instrument inserted into your abdomen through a small incision — your doctor can see your ovaries and remove the ovarian cyst. This is a surgical procedure that requires anesthesia.

• CA 125 blood test. Blood levels of a protein called cancer antigen 125 (CA 125) often are elevated in women with ovarian cancer. If your cyst is partially solid and you’re at high risk of ovarian cancer, your doctor might order this test.

  Elevated CA 125 levels can also occur in noncancerous conditions, such as endometriosis, uterine fibroids and pelvic inflammatory disease.

Treatment

Treatment depends on your age, the type and size of your cyst, and your symptoms. Your doctor might suggest:

• Watchful waiting. In many cases you can wait and be re-examined to see if the cyst goes away within a few months. This is typically an option — regardless of your age — if you have no symptoms and an ultrasound shows you have a simple, small, fluid-filled cyst.

  Your doctor will likely recommend that you get follow-up pelvic ultrasounds at intervals to see if your cyst changes in size.

• Medication. Your doctor might recommend hormonal contraceptives, such as birth control pills, to keep ovarian cysts from recurring. However, birth control pills won’t shrink an existing cyst.

• Surgery. Your doctor might suggest removing a cyst that is large, doesn’t look like a functional cyst, is growing, continues through two or three menstrual cycles, or causes pain.

  Some cysts can be removed without removing the ovary (ovarian cystectomy). In some cases, your doctor might suggest removing the affected ovary and leaving the other intact (oophorectomy).

  If a cystic mass is cancerous, your doctor will likely refer you to a gynecologic cancer specialist. You might need to have your uterus, ovaries and fallopian tubes removed (total hysterectomy) and possibly chemotherapy or radiation. Your doctor is also likely to recommend surgery when an ovarian cyst develops after menopause.

Preparing for your appointment

You’re likely to start by seeing your primary care provider or a doctor who specializes in conditions that affect women (gynecologist).

What you can do

Make a list of:

• Your symptoms, including those that seem unrelated to the reason for the appointment, and when they began
• All medications, vitamins and other supplements you take and the doses
• Your medical history, including menstrual irregularities
• Questions to ask your doctor

Take a family member or friend with you, if possible, to help you remember the information you’re given.

Questions to ask your doctor include:

• What’s likely causing my symptoms?
• What tests might I need?
• Are my cysts likely to resolve on their own or will I need treatment?
• Do you have printed materials or brochures I can have? What websites do you recommend?

Don’t hesitate to ask other questions.

What to expect from your doctor

Questions your doctor might ask include:

• How often do you have symptoms?
• How severe are your symptoms?
• Do your symptoms seem related to your menstrual cycle?
• Does anything improve your symptoms?
• Does anything make your symptoms worse?

Aug. 26, 2020

Show references

1. Frequently asked questions. Gynecologic problems FAQ075. Ovarian cysts. American College of Obstetricians and Gynecologists. http://www.acog.org/Patients/FAQs/Ovarian-Cysts. Accessed May 2, 2017.
2. Muto MG. Approach to the patient with an adnexal mass. https://www.uptodate.com/contents/search. Accessed May 2, 2017.
3. Ovarian cysts fact sheet. Office on Women’s Health, U.S. Department of Health and Human Services. http://www.womenshealth.gov/publications/our-publications/fact-sheet/ovarian-cysts.html. Accessed May 2, 2017.
4. Sharp HT. Evaluation and management of ruptured ovarian cyst. https://www.uptodate.com/contents/search. Accessed May 2, 2017.
5. Muto MG. Management of the adnexal mass. https://www.uptodate.com/contents/search. Accessed August 20, 2020.

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Ovarian cysts: No biggie, but birth control can help

Patients almost always have the same look on their face when we talk about ovarian cysts. It’s that look of, “OMG, I have a ticking time-bomb in my pelvis!” I worry that they imagine a giant green blob growing larger and larger inside them, like a Chia pet, that might one day suddenly explode.

The good news is that this imaginative view of an ovarian cyst is far worse than the reality. If you have ovaries, there’s a good chance you’ll have a cyst at some point or another, and a good chance you won’t even know it if you do.

But what do ovarian cysts have to do with birth control? Many hormonal contraceptive methods—like the pill, the patch, the ring, and the shot—affect the ovaries. These methods lead to fewer cysts, while other methods can cause more. Let’s start with a quick review of what’s going on “in there, down there.”

Ovulation 101

If you have a typical menstrual cycle, an egg is released from one ovary each month. The fancy name for the process is ovulation. To get the egg ready for release, a sac filled with fluid develops around it (fancy name = follicle). When a follicle grows larger than expected, it is called a functional cyst*. A cyst is basically a bubble—a collection of fluid with a thin wall around it.

Cysts 101

So what does “larger than expected” mean? Cysts are usually half an inch to one inch in size—pretty small. But since an ovary is usually about the size of an almond, a cyst may double the size of the ovary to which it’s attached. Most of the time, the body reabsorbs this fluid within a few months and we are none the wiser. Sometimes a cyst can cause symptoms, such as:

• Abdominal discomfort or bloating

• Pelvic pain that comes and goes, or is different from your usual menstrual cramps

• Pain during bowel movements

• Pain during sex

If your health care provider finds a cyst on your ovary during a pelvic exam or ultrasound, most of the time you can be reassured that it will disappear on its own. You may want to have a follow-up visit to make sure.

Less often, a cyst keeps growing and becomes a problem. It’s important to know the warning symptoms of a more serious cyst:

• Sudden and severe pain in your pelvis or lower abdomen

• Pain that comes with fever or vomiting

• Pain that causes dizziness or fainting

These are reasons to see your provider right away. Complications of ovarian cysts are rare, but if you have one with one of these symptoms, you could be experiencing ovarian torsion (when a large cyst causes the ovary to twist) or rupture (when the cyst opens and may cause bleeding).

Where does birth control come in?

One of the main ways hormonal birth control prevents pregnancy is by stopping ovulation—so the egg never leaves the carton, so to speak. The pill, the patch, the ring, and the shot are most reliable at blocking ovulation, so using these methods may mean fewer ovarian cysts. If you tend to get ovarian cysts, your provider may recommend one of these methods to prevent future cysts.

The progestin-only or mini-pill has an unpredictable effect on ovulation and may lead to more cysts. These almost always disappear on their own, but if you’ve had problems with cysts in the past, the mini-pill may not be the best contraception for you. (FYI, the mini-pill is not a common birth control choice: so few women in the U.S. use it, we can’t even get a reliable estimate.) Norplant, an old contraceptive implant that’s no longer available in the U.S., also had this side effect. Studies of the implant that’s currently on the market (Nexplanon) suggest that cysts are less of an issue.

Birth control has other benefits.

There are other ways birth control can contribute to ovarian health too. The pill reduces your risk of ovarian cancer by at least 40%—and the longer you use it, the more it helps! This is true even if you have a family history of ovarian cancer. And since the patch and the ring have the same combination of hormones as the combination pill, we expect they also protect against ovarian cancer. All hormonal methods, including the shot, the implant, and the hormonal IUD, also protect against endometrial cancer (cancer of the uterine lining). So for all those years you don’t want to be pregnant, choosing a highly effective method of contraception can also be a smart move toward a healthier future.

* What if it’s not just a functional cyst? There are other types of cysts that can grow on the ovary. These often need additional medical attention, including surgical removal, but are far less common than functional cysts. Most of these are benign, meaning not cancerous, but some extremely rare ones are cancerous. If someone in your family had ovarian cancer, it is important to tell your provider.

It’s Not Just for Birth Control

Birth control pills (BCPs) have been around since the 1960s. Mainly known for their use in preventing pregnancy, these and other hormonal contraceptives have beneficial effects in many other health conditions. Let’s look into some of those clinical entities in some typical patients who might present to primary care.

Ovarian Cyst

A 17-year-old patient of yours was seen in the emergency department for acute stabbing pain in the right lower quadrant. A urine pregnancy test was negative. Imaging showed a normal appendix and a 7-cm cyst torsed over her right ovary. She was taken to the operating room and underwent laparoscopic right ovarian detorsion and cystectomy. When you next see her after her surgery, she asks whether the cyst could grow back and what can be done to prevent future cyst formation.

The answer is that she can begin taking BCPs. The same mechanism that “quiets down ovarian function” and suppresses the hypothalamic-pituitary-ovarian axis for contraception helps prevent cyst formation within the ovary. Combined contraceptives are recommended (unless estrogen is contraindicated) for women with recurrent symptomatic cysts, such as ruptured cysts or torsed cysts, and for patients with polycystic ovary syndrome (PCOS).

Monophasic preparations have been shown in some studies to prevent benign ovarian cysts more effectively than low-dose triphasic pills. In addition, oral contraceptives (combined or progesterone only) can be used as a nonsurgical or conservative option for patients with cysts who are not surgical candidates or who do not desire to proceed with surgery.

Patients should be counseled that BCPs will not resolve an existing cyst completely but might prevent the cyst from growing larger and prevent the ovary from forming new cysts. When using this approach, short-term serial ultrasounds are recommended (usually every 6-8 weeks) for follow-up unless otherwise indicated or the cyst resolves.

By decreasing ovulation and the constant low follicle-stimulating hormone and luteinizing hormone stimulation of the ovarian surface epithelium, BCPs reduce the risk for ovarian cancers. They are also used as primary prevention for women at risk for hereditary ovarian cancer (for example, patients with the BRCA gene).

Menorrhagia

A 39-year-old woman presents with heavy and painful menstrual bleeding for the past 20 days. She reports that she has been having heavier periods than usual for about 5 months. Her laboratory tests were reassuring, but an ultrasound showed a 4-cm intramural fibroid.

Menorrhagia is a common menstrual complaint that can be caused by hormonal factors in pubertal girls, teenagers, and perimenopausal women; underlying bleeding disorders; or anatomical factors, such as fibroids or adenomyosis.

After an appropriate workup for abnormal uterine bleeding, it is very common and cost-effective to use hormonal contraceptives (combined or progestin only, or hormonal intrauterine device [IUD]) as an initial therapy or as an alternative to surgical therapy. Furthermore, hormonal contraceptives can improve iron deficiency anemia in women with menorrhagia. It takes longer (a couple of months) to achieve a more favorable bleeding pattern with a medical, compared with a surgical, approach.

The mechanism of action of hormonal treatments on bleeding patterns is not fully understood, but it is believed that a steady state of hormonal exposure thins out the endometrial lining, thereby decreasing blood flow.

The type and size of the fibroid is a factor in predicting the success of medical therapy: A submucosal (intracavitary) fibroid is less likely to respond to hormonal treatment, as is a large subserosal fibroid.

Premenstrual Dysphoric Disorder

A 22-year-old woman presents with complaints of irritability, marked anxiety, tension and emotional lability, which always begin about a week before her period. Her symptoms remit with the onset of her menstrual flow. This has been affecting her personal and work relationships, and she now seeks your help. After your assessment, you determine that she meets the criteria for premenstrual dysphoric disorder (PMDD).

One option is to offer this patient a combined oral contraceptives containing ethinylestradiol (30 µg) and drospirenone, a progestin with a strong antimineralocorticoid effect.

Another option for PMDD or premenstrual syndrome (PMS) is to suppress menstruation and “stabilize the hormones” with continuous combined or extended cycle contraceptives. The vaginal ring has also been shown to help with PMDD.

Hormonal stabilization also underlies the use of hormonal contraception in the treatment of patients with menstrual migraines (without auras) or recurrent ovulation pain, and to achieve cycle regularity. Continuous (skipping placebo pills) or cyclical regimens can be used for those conditions.

Chronic Pelvic Pain

A 27-year-old woman presents to your clinic with chronic pelvic pain, severe dysmenorrhea, and dyspareunia. You suspect clinical endometriosis and recommend that she start on BCPs. She asks whether there are other options to treat her symptoms because she doesn’t think she’ll be compliant with daily pill use.

Several non-pill hormonal options are effective for endometriosis pain. Combined contraceptives (pill, patch, or ring) reduce prostaglandin production and relieve dysmenorrhea regardless of whether the patient has primary dysmenorrhea or the source of her pain is endometriosis, chronic pelvic inflammatory disease, inflammatory bowel disease, or pelvic congestion. Oral contraceptives have also been shown to reduce the size of endometriosis lesions.

Non-pill options, such as progestin implants and depot injection, have also been used to improve dysmenorrhea by achieving menstrual suppression. The levonorgestrel (LNG) IUD, which has the same mechanism of action, is another option to help women with dysmenorrhea and dyspareunia if long-acting reversible contraceptive is preferred. However, the LNG IUD might not achieve the same pain relief effect as the systemic hormonal options in endometriosis because this condition may also have extrauterine manifestations.

Acne and Hirsutism of PCOS

A 32-year-old woman with PCOS wants help for her acne and hirsutism. She has already seen a dermatologist and tried several common acne treatments without success.

Combined oral contraceptives can improve acne and hirsutism in PCOS by increasing sex hormone–binding globulin, decreasing luteinizing hormone stimulation of ovarian androgen production, and reducing the level of circulating free androgens.

Formulations containing antiandrogenic progestins (drospirenone or cyproterone acetate) are usually preferred, and triphasic preparations have been shown in some studies to improve acne. BCPs help prevent ovarian cyst formation and improve insulin resistance in PCOS and, along with medroxyprogesterone acetate, LNG IUD, and cyclical progesterone, reduce risk for endometrial cancer by decreasing unopposed estrogen.

Premature Ovarian Insufficiency

A 37-year-old woman with a 14-month history of amenorrhea has undergone an extensive workup and has been diagnosed with spontaneous premature ovarian insufficiency (POI).

The many important health conditions to address when managing patients with POI include vasomotor symptoms, emotional and sexual health, fertility options, bone health, cardiovascular disease, and overall mortality.

Unless contraindicated, women with POI are started on hormonal therapy, such as BCPs, to help prevent cardiovascular disease, osteopenia and osteoporosis, atrophic vaginitis, and bothersome vasomotor symptoms.  The American College of Obstetricians and Gynecologists recommends systemic hormonal therapy in women with POI until age 50-51 years (with yearly assessment of risk factors and contraindications).

Systemic hormonal therapy (eg, oral or vaginal contraceptives) are also used in the perimenopausal hormonal transition to help with the many symptoms that women typically experience, such as hot flashes, night sweats, mood lability, low sexual drive, and menstrual cycle changes. The need for hormonal treatment is assessed yearly until age 51 and is managed on a case-by-case basis.

Summary: Health Indications for Noncontraceptive Use of Hormonal Contraceptives

• Treatment of menorrhagia and bleeding due to leiomyomas/adenomyosis

• Treatment of dysmenorrhea and pelvic pain from endometriosis

• Inducing amenorrhea and menstrual cycle regularity for lifestyle/medical considerations

• Treatment of PMS/PMDD

• Prevention of ovarian cysts

• Prevention of menstrual migraines (without aura)

• Chemoprevention of endometrial cancer, ovarian cancer, and colorectal cancer

• Treatment of acne and hirsutism (hyperandrogenism)

• Treatment of vasomotor symptoms of perimenopause and in POI

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New Birth Control Pills Don’t Curtail Ovarian Cysts – Consumer Health News

(HealthDay is the new name for HealthScoutNews. )

TUESDAY, Aug. 5, 2003 (HealthDayNews) — If you’re taking birth control pills to reduce your risk of ovarian cysts, you could be waiting forever for results.

According to a report in the August issue of Obstetrics and Gynecology, the new generation of low-dose oral contraceptives don’t have the same ability to cut the risk of functional ovarian cysts as did the older, high-dose pills of the past.

In a potentially more troubling finding, the study also suggests that tubal ligation, or having your “tubes tied,” may increase your risk of developing these cysts by as much as 70 percent.

“Our finding about the new low-dose pills echoes what has been found in some previous studies, but it’s amazing how many doctors continue to prescribe by the ‘old rules,'” says study author Victoria Holt, a professor in the department of epidemiology at the University of Washington.

The finding concerning cysts and tubal ligations — a surgical procedure that blocks the path from the ovary to the uterus so eggs can’t be fertilized by sperm — was totally unexpected, Holt says.

“This was shown in only one other study before,” she says. That study was a small Mexican research project published in 2000 that found tubal ligation doubled the risk of a woman developing ovarian cysts.

Functional cysts commonly occur around mid-cycle, when a follicle destined to become an egg fails to mature. Instead of leaving the ovary in a process known as ovulation, it remains inside, floating in a tiny sac of fluid. It is that sac that eventually forms into a cyst.

Although rarely malignant, ovarian cysts lead to 200,000 hospitalizations in the United States each year. For some women, the cysts develop cycle after cycle, previous studies have shown.

Because birth control pills block egg development and ovulation, Holt says they were used intuitively by doctors for many years as a treatment to stop the cysts from forming.

But the advent of the new, lose-dose oral contraceptives changed that presumption. While the new pills still contained enough hormones to block ovulation and prevent pregnancy, they were no longer potent enough to override the body’s own chemistry involved in cyst formation, Holt believes.

For gynecologist Dr. Rachel Masch of New York University, the new finding is no surprise because evidence has been mounting for some time that low-dose pills don’t affect cyst formation.

She adds, however, that because the study found a small number of women for whom the treatment worked, there remain some circumstances under which she might still prescribe birth control pills for this purpose.

“If a woman wanted to use a pill for contraception, or to help clear her skin, for example, and she also had recurring cysts, then it is still reasonable to give it a try as a treatment,” Masch says. In most cases, though, other hormonal treatments are more likely to help.

As for the finding about tubal ligation and cysts, Masch says she’s not convinced the association is strong enough to recommend against the procedure — one of the most popular forms of birth control in the United States.

“I certainly wouldn’t advise a woman not to have tubal ligation based on this finding. But I do think it’s worthy of a closer look,” Masch says.

Holt’s study, funded by the National Institutes of Child Health and Development, involved more than 1,000 women between the ages of 18 and 39. They included 392 women diagnosed with functional ovarian cysts, and 623 cyst-free women who formed the comparison group. None of the women in this group was using any hormonal or surgical contraception, and most were using no contraception.

To document low-dose pill use and cyst development, the researchers interviewed the women in person, something not done in previous studies on the subject. The interviews were corroborated by the women’s medical and pharmacy records.

Then, using a method of mathematical calculation, the researchers computed the odds that would link the use of oral contraceptives with either cyst reduction or formation. Factors that could influence the outcome, including a history of cysts or smoking, were included in the analysis.

The result: While the new low-dose pills didn’t increase the risk of cysts, they also didn’t help prevent them in the overwhelming majority of women. Only 28 percent of the women diagnosed with cysts found relief on a low-dose pill — a dramatic drop from the 90 percent plus effectiveness rates seen with the older oral contraceptives.

Additionally, the study found a 70 percent increased risk of cyst formation in women who had tubal ligation.

Holt says she has no immediate explanation for this finding, and is calling for more research in this area.

More information

To learn more about ovarian cysts, visit the National Library of Medicine. To find out more about low-dose oral contraception or tubal ligation, check with Planned Parenthood.

Ovarian Cyst — Womens’ Health Specialists

The ovaries are two small organs located on each side of the uterus. It is normal for a woman to develop small cysts (a fluid filled sac) and these cysts are harmless and typically resolve on their own without treatment.

Monthly Cycle

Each month your ovaries will produce an egg. This egg is in a sac called a follicle, which grows inside the ovary. On day 5 of your cycle the hormone estrogen signals the uterus to thicken it’s lining to prepare for possible pregnancy. On day 14, the egg is released from the ovary, which is called ovulation. After ovulation a women can get pregnant as the egg moves into the fallopian tube where it can be fertilized by sperm. After ovulation, the empty follicle becomes the corpus luteum, which remains until the next period. The corpus luteum makes hormones that cause the endometrium to grow.

Types of Ovarian Cysts

Ovarian cysts are quite common in women during their childbearing years. Most are caused by changes in hormone levels that occur during the menstrual cycle as well as from the production and release of eggs from the ovaries. Women can develop one cyst or many cysts and they can vary in size from a small pea to as big as a grapefruit. There are many different types of ovarian cysts and each type causes a variety of symptoms. All cysts can bleed, rupture and twist and cause pain. Most cysts are benign but a few may turn out to be malignant.

Functional cysts

The most common type of ovarian cyst is a functional cyst. It develops from tissue that changes in the normal process of ovulation. There are two types of functional cysts -follicle and corpus luteum. Both of these cysts have no symptoms and usually will disappear within a few months.

Dermoid Cysts

Dermoid cysts are made up of different kinds of tissue such as skin, hair, fat and teeth. They may be found on both ovaries and are often small and may not cause symptoms. They can however become large and cause symptoms.

Cystadenomas

Cystadenomas are cysts that develop from the outer surface of the ovary. They are usually benign but can create problems because they grow very large and interfere with abdominal organs and cause pain.

Endometriomas

Endometriomas are cysts that form when endometrial tissue grows in the ovaries. This tissue then responds to monthly changes in hormones. The tissue bleeds monthly, which may cause a gradually growing cyst on the ovary called an endometrioma. It is also known as a “chocolate cyst” because it is filled with dark, red-brown blood. An endometrioma is often found in women who have endometriosis. This is a condition that can be painful, especially during the menstrual period or during sexual intercourse.

Multiple cysts

Polycystic ovary syndrome is a condition that develops in women who do not ovulate regularly and can develop multiple cysts. This condition causes irregular menstrual periods, infertility, and increased body hair.

Symptoms caused by Ovarian Cysts

Most ovarian cyst are small and do not cause symptoms. Some go away on their own. Some may cause symptoms because of twisting, bleeding, and rupture. They may cause a dull ache and pain during sexual intercourse. Some cysts may be cancer. The risk of ovarian cancer increases as you get older.

Diagnosis

An ovarian cyst can often be detected on pelvic exam, by an ultrasound or if a laparoscopy, which is a procedure that allows a doctor to look directly inside the body cavity, is done. Blood tests to measure CA 125 may be used to detect possible risk of ovarian cancer.

Treatment

If your cyst is not causing any symptoms it may be monitored for 1-2 months. Most functional cysts go away on their own over one to two menstrual cycles.

If your cyst is large or causing symptoms, your doctor may suggest treatment with hormones or surgery.

The type of treatment depends on several factors including the size and type of cyst, your age, your symptoms and your desire to have children.

Hormonal therapy

Your doctor may prescribe oral contraceptives (birth control pills) to treat functional ovarian cysts. The hormones in birth control pills stop ovulation. This prevents follicles from developing and stops new cysts from forming. Birth control pills may not be right for every woman, especially if you smoke cigarettes and are over 35. Your doctor will help you decide if hormonal therapy is right for you.

Surgery

Your doctor may suggest surgery to remove the cyst. Sometimes a cyst can be removed while leaving the ovary called a cystectomy. In other cases, one or both of the ovaries may have to be removed. Your doctor may not know which procedure is needed until the surgery begins.

FIND OUT MORE ABOUT OVARIAN CYST AT WWW.ACOG.ORG

90,000 Removal, treatment of ovarian cysts. Prevention

Whether it is necessary to remove the ovarian cyst or treat it conservatively depends on the woman’s age, the type and size of the cyst, and the symptoms of the disease.

The gynecologist can offer the following treatment options for ovarian cysts:

Removal of ovarian cyst . The gynecologist may recommend removing the cyst if it is large, does not correspond to the signs of a functional cyst, grows in size and does not go away within two or three menstrual cycles. If the cyst is painful or other symptoms appear, it can also be removed.

It is possible to remove the cyst without removing the ovary – exfoliation of the capsule of the ovarian cyst, as well as resection of the ovary, when part of the ovary is removed together with the cyst. A gynecologist-surgeon may suggest completely removing the affected ovary (oophorectomy), and leaving the healthy one intact. In some cases, removal of the ovary along with the fallopian tube (adnexectomy) is indicated.None of these operations deprives a woman of the opportunity to have children if she is of reproductive age. If at least one ovary is left, the body can continue to produce estrogen.

However, if the cystic formation is cancerous, removal of the uterus with fallopian tubes and ovaries on both sides is indicated. After menopause, the risk of developing a malignant cystic neoplasm increases. Most often, doctors prescribe surgery when a cystic formation develops in the ovaries after menopause.

Expectant tactics for ovarian cyst . If a woman is of reproductive age, the symptoms of an ovarian cyst are not pronounced, and an ultrasound examination showed that the cyst is filled with fluid, you can wait a while, and then re-examine in 1-3 months. The gynecologist will most likely prescribe periodic ultrasound examinations in order to know if the size of the cyst changes.

With expectant treatment, a woman regularly undergoes an ultrasound of the pelvic organs.This type of treatment is often prescribed for postmenopausal women if the cyst is filled with fluid and is less than 2 cm in diameter.

Oral contraceptive therapy for ovarian cyst . Your gynecologist may prescribe birth control pills to reduce the likelihood of a new cyst forming in subsequent menstrual cycles. The advantage of taking oral contraceptives is that the risk of developing ovarian cancer is significantly reduced – the longer a woman takes the pill, the lower the risk.

Prevention of ovarian cyst . Despite the fact that there is no definite way to prevent the development of an ovarian cyst, if you regularly undergo a gynecological examination, it will be easier to diagnose changes in the ovaries in the early stages. In addition, it is important to keep an eye on changes during your menstrual cycle, including symptoms that accompany your period but are not typical for you or that recur over several cycles.You should inform your doctor about any menstrual problems.

For more information on the treatment and prevention of ovarian cysts, please contact your gynecologist at the Zdorovye 365 clinic in Yekaterinburg.

Related articles:

Pain in the lower abdomen

Menstrual pain

Signs of pregnancy

Hysteroscopy

Colposcopy

Hysterosalpingography

Ultrasound of the small pelvis

Ultrasound of mammary glands

Mammography

Mastopathy

Laparoscopy in gynecology

Uterine myoma

Endometriosis

Sexually transmitted diseases

Inflammatory diseases

Bacterial vaginosis

Human papillomavirus

Ovulatory syndrome, symptoms

Adenomyosis

Ectopic pregnancy

Miscarriage

Menopause. Menopause syndrome

Urinary incontinence

Descent of internal organs

Premature birth

Removal of the uterus

Intimate plastic surgery

Contraceptive pills for ovarian cyst

IMPORTANT TO KNOW! An effective remedy for cysts without surgeries and hormones, recommended by Irina Yakovleva! Read more …

Ovarian cyst – is a fairly common disease among female ailments that requires urgent treatment.Its size can reach twenty centimeters in diameter. Basically, cysts do not pose a particular threat to the normal functioning of the body of women, if they are not malignant pathological neoplasms. Such cavities cannot progress in their size.

Applied therapy

An ovarian cyst is treated conservatively, with medication, and not everyone expects surgery. In certain situations, ovarian cysts do not need any medication or surgical treatment, dissolving on their own after three months of regular menstruation. In isolated cases, a sacred benign tumor can begin to bother with bleeding, pressure on nearby organs, or be complicated by damage to the integrity of the membrane. Here it will already be necessary to remove the cyst using an operation. This technique is called laparoscopy. Holes are made in the patient’s abdomen through which the cyst is removed. The wounds heal quickly without leaving scars. The postoperative period requires additional medication and rehabilitation. Vitamin therapy is used, where the main emphasis is on vitamins of groups A, E, B, C.If you are overweight, a diet is prescribed. Perhaps the appointment of anti-inflammatory and antibacterial drugs, homeopathy.

The occurrence of the disease may be associated with:

• obese;
• diabetes mellitus;
• chronic inflammatory gynecological processes;

90 130 violation of the cycle of menstruation;

• hormonal imbalance;

90 130 early onset of menstruation;

• recurrence of ovarian cysts;
• consequences of frequent abortions;
• ovarian dysfunction;
• lack of ovulation.

To prescribe an effective treatment, doctors take into account all the factors identified during the examination.

1. The nature and risk of pathological neoplasms.
2. Intensity of clinical symptoms.
3. Patient’s age.
4. Importance of maintaining fertility for the patient.

The development of a cyst is diagnosed according to the following criteria:

• acute pain in the lower abdomen with sudden onset and disappearance;
• Irregularity of the menstrual cycle;

90 130 prolonged pain in the menstrual period;

90 130 a feeling of heaviness in the pelvic region or pressure in the abdomen;

• painful effects in the abdomen after intense sports activities or sexual intercourse;
• recurrent bouts of nausea and vomiting;
• inability of the organism to produce offspring;
• The appearance of hair on the face and body in the male pattern.

Treatment of cysts with birth control pills

Birth control pills are often the mainstay of treatment to restore hormonal balance. The synthetic hormones included in the composition of contraceptive drugs are quite similar to natural biologically active substances found in the female body. It is estrogen and progesterone that stop the generation of other hormones that activate the maturation of follicles, due to which ovulation occurs.Contraceptive medications help to reduce the size and subsequently – complete resorption of the cyst. They suppress ovulation and reduce the risk of recurrence of pathological formation.

The function of the reproductive system does not change when using oral contraceptives, the hormonal background returns to normal, and the woman gains the opportunity to become pregnant, carry and give birth to a child.

The effectiveness and disadvantages of hormone therapy

In some patients, the use of contraceptive drugs can provoke the opposite effect, when the cyst begins to increase in diameter and sudden spotting appears.An incorrectly selected pharmaceutical product can provoke blood clots and increase the risk of developing cardiovascular diseases.

Hormonal medications can affect the general condition of the patient in different ways. For the timely detection of the side effects of the prescribed funds, a woman should visit the attending physician at least twice a year. Contraceptives can negatively affect the vaginal micloflora, which manifests itself in various symptoms. Many women develop thrush, in other words, bacterial vaginitis.The level of gestagen contained in the preparation helps to reduce the level of lactobacilli in the reproductive tract. In this case, you should stop taking the pills for a while – until the level of estrogen is restored, and the signs of thrush will disappear.

Current contraceptives contain small doses of hormonal components that do not cause an increase in body weight. With the wrong selection of the drug, it is quite possible to correct the weight in the direction of its increase. In most patients, weight gain is observed for the first three months, while the body adapts.If the body continues to grow in size, you should consult your doctor and switch to another type of pill. The effect of contraceptive pills on fat metabolism has been thoroughly studied. In order not to exacerbate the above side effects, you need to competently and individually approach the selection of funds for each individual woman. Hormonal treatment is contraindicated in pregnancy and breastfeeding. Unauthorized and uncontrolled intake of synthetic hormones can, on the negative side, irreversibly affect fertility.

In some women, the development of a cyst is asymptomatic, without causing any painful sensations. In such cases, only when performing ultrasound of the pelvic organs can ovarian pathology be detected. Also, a cyst is diagnosed using computed tomography, blood tests, hormone tests, puncture of the posterior vaginal fornix. Treatment of other forms of ovarian cyst development – for example, such as the corpus luteum or follicular cyst, is carried out with the help of hormone therapy. If the bladder does not dissolve on its own within a period of up to three months, the attending physician selects the appropriate hormonal medication.

Treatment is given over several menstrual cycles. During this period, the patient is under observation and repeatedly undergoes an ultrasound scan to track the changes that are taking place.

Since the disease is associated with an unstable hormonal background, it is recommended to consult an endocrinologist. Learn how the thyroid gland works. In parallel, you need to protect yourself from unnecessary stress. The central nervous system has a direct effect on the regulation of hormone secretion.

Many hormonal drugs (often contraceptive pills) are prescribed when the cyst is filled with fluid and has only a functional character. If the mass is in a compacted or solid state, patients are advised to undergo surgery to remove such a tumor to study the tissues and prevent the development of ovarian cancer.

A clear advantage of using hormonal medications is their effectiveness. Contraceptive pills recommended by doctors significantly affect the cause of the onset of the disease, restoring the balance of biologically active substances.During treatment, the menstrual cycle or the amount of menstrual flow may decrease.

The undesirable consequences of the use of a contraceptive drug can be avoided only by following the course of treatment indicated by the doctor.

Effectiveness of contraceptive drugs

As mentioned earlier, the development of a functional cyst is directly related to hormonal stimulation of ovarian function. Women who have reached childbearing age, who have critical days every month, are the most vulnerable, and they are more likely to develop an ovarian cyst.For women who have reached menopause, the disease poses a low degree of danger. There is more risk of malignant tumors. In the postmenopausal period, it is recommended to remove any cyst larger than five centimeters. Mothers whose daughters have not reached the age of majority, but have problems with a cyst, may not worry that their children are prescribed drugs as for mature women. Conservative therapy for ovarian cysts will help heal a teenager without surgery and health risks.

Prescribed contraceptive therapy gives its results, namely:

• therapeutic and prophylactic action;
• decrease in the possibility of re-formation of new ovarian cavities;
• prevention of oncological disease.

Also, the action of such drugs has a positive effect on the menstrual cycle, shortening its duration. Basically, the treatment of the cyst continues for three weeks. A permanent course of treatment with hormonal birth control pills may be prescribed in cases of susceptibility to recurrent hollow tumors in the future.

Secret

• Incredible … You can cure a cyst without surgery!
• This is the time.
• Without taking hormonal drugs!
• These are two.

90 130 In a month!

• That’s three.

Follow the link and find out how Irina Yakovleva did it!

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90,000 Scientists: birth control pills prevent uterine cancer

August 5, 2015

Photo author, PA

Photo caption,

Scientists have concluded that for every five years a woman takes oral contraceptives, the risk of developing endometrial cancer decreases by 25%

Contraceptive use has helped prevent 200,000 cases of uterine cancer in the last ten years.This is evidenced by research data obtained by scientists at Oxford University.

In women under the age of 75 who took the pill for 10 years, the risk of uterine cancer decreased from 2.3 per 100 people to 1.3.

Scientists analyzed data from 36 different studies, which included anamnesis of 27,276 women from the USA, Europe, Asia, Australia and South Africa who had endometrial cancer.

They concluded that for every five years a woman takes oral contraceptives, the risk of developing endometrial cancer is reduced by 25%, and the longer a woman takes these contraceptives, the better she is protected from this type of cancer.

Not only prevention of pregnancy

Scientists have also calculated that from 1965 (when the contraceptive pill was first widely used in the West) to 2014, 400 thousand cases of endometrial cancer were prevented in developed countries, including 200 thousand for last decade.

According to experts, the protective function of such a pill, which includes a small dose of the female hormone estrogen, lasts for many years even after the woman stops taking contraceptives.According to the head of the new study, Professor Valeria Beral, 70-year-old women who took oral contraceptives in their youth are still protected.

“You have to start talking about how they [oral contraceptives] not only prevent pregnancy – although this is why women actually start taking them. But you also need to understand that you are much less likely to get cancer than those women who do not take such drugs, “- says Professor Beral in the pages of the Lancet Oncology.

The professor also points out that the new generation of oral contraceptives contains about a quarter of the original dose of estrogen, but even this amount of the hormone is enough to reduce the risk of endometrial cancer.

Earlier studies have shown that contraceptive pills also protect against ovarian cancer, recalls Professor Beral.

Benefits outweigh risks?

However, as the scientists of the American National Cancer Institute state in the comments to the published article, it is rather difficult to adequately assess the effect of the contraceptive pill on the body due to various long-term and short-term side effects.

“These drugs are now safer, but I am not sure if their benefits are so great that they warrant their use on a routine basis, especially when you consider that most cases of endometrial cancer are detected in the early stages, and most of they are cured, “says oncologist Ida Ackerman at Sunnybrook Research and Treatment Center in Toronto.

In the past, it has been said that oral contraceptives help with problem skin (acne), and also prevent the development of ovarian cysts and fibroids.

However, there are risks, including the development of blood clots, stroke in young women, heart attack, cervical cancer, breast cancer.

As noted by Professor Beral, once a woman stops taking contraception, the risk of thrombosis and stroke disappears.

However, women are still advised to weigh the pros and cons before starting birth control pills, especially those with a family history of breast cancer, as oral contraceptives slightly increase the risk of developing this type of cancer.

The new study was commissioned by the British Medical Research Council and Cancer Research UK and published in the Lancet Oncology.

Contraceptives – Health IQ

Oral contraceptives: pros and cons.

It should be noted that oral contraceptives have a very large bouquet of side effects, which prevail over the advantages. Probably the only plus of birth control pills is reliable protection against unwanted pregnancy.But in view of the fact that today there are contraceptives that are much less traumatic for the female body, preference should be given to alternatives to oral contraceptives, for example, a non-hormonal coil, condoms or suppositories.

Why are oral contraceptives dangerous?

To begin with, the shutdown of ovarian function in young girls, which occurs as a result of taking birth control pills, is not physiological in itself.Many pills were discontinued in Europe due to the large number of deaths: thrombosis and strokes occurred in those taking these drugs. However, these pills are still prescribed and sold in Russia, that is, Russia is a kind of market for goods that are recognized as unsuitable, low-quality, and moreover, deadly in more developed countries. Some have varicose veins, others have hemorrhoids, and still others, we see varicose veins in the pelvic area during ultrasound examination of the pelvic organs.Subsequently, these patients have a thin endometrium, there is no ovulation, because the blood flow is impaired. When passing through the liver, birth control pills negatively affect the production of liver enzymes (SHBG). By binding to sex hormones, SHBG ensures their free movement in the bloodstream and protection from the damaging effects of enzymes. In addition, the patients have a decrease in libido. It is well known that taking oral contraceptives has a negative effect on the psyche of patients, often provoking depressive disorders.

Does the patient’s body return to normal after discontinuation of oral contraceptives?

Yes, the woman’s body gradually stabilizes, but it depends on how long the patient has been taking them, how much her ovaries are suppressed. In many cases, patients have serious menstrual irregularities, some women do not have menstruation for up to a year. Nevertheless, the cells are regenerated, the psyche also returns to normal.

Sometimes contraceptives are prescribed as a treatment for certain diseases, but based on the doctors of our clinic, it is necessary to first find the cause of the disease and cure it, and oral contraceptives should be prescribed as a last resort and only after passing a genetic test for thrombophilia (the risk of blood clots).Otherwise, even lethal outcome is possible.

Once again, we will emphasize that a woman is protected by her estrogens, and taking oral contraceptives, a woman loses her natural protection.

Spirals.

Mirena hormonal coil.

Now the hormonal spiral Mirena is being installed for women everywhere. The manufacturing company claims that it can be put on absolutely everyone – even those who have not had a birth.But in fact, this is a very dangerous thing: initially this spiral was developed as a therapeutic one, it contains a hormonal substance that acts for 5 years. This substance is released into the uterine cavity, and in the presence of recurrent polyps, endometriosis, fibroids, this substance causes atrophy. The patient may lose her period, and a serious disruption of the menstrual cycle may occur. The pharmaceutical company claims that the hormonal agent acts only on the uterus, but practice shows that they have an effect on the entire body: on the chest, so that patients develop cysts, and on the liver, and on blood clots, and on weight – that is, hormonal the Mirena spiral is almost as dangerous as oral contraceptives.The physician must always consider these risks.

Non-hormonal coil.

For those patients who have already had childbirth, the gynecologist of our clinic unequivocally recommends a non-hormonal coil. What is a non-hormonal coil and how does it work? A simple spiral, similar to a tube, is installed in the uterine cavity, its antennae go into the tubes. It contains any metal: copper, gold or silver, and it is precisely these metals that cause the inferiority of the uterine lining.Thus, the ovum mechanically has nowhere to attach, since there is a foreign body, and the mucous membrane itself does not contribute to fertilization.

A non-hormonal coil is indicated for patients who have a proven regular sexual partner, since if the patient is infected with the coil installed, the infection will very quickly enter the uterus due to the antennae, which can cause inflammation of the uterus (endometritis) and other unpleasant consequences. The spiral is set for 5 years, but if desired, it can be removed earlier and without fear of becoming pregnant.Plus, it’s a pretty budget option.

Before installation, the doctor must look at the state of the cervix: the patient should not have any inflammatory processes. It is necessary to pass an analysis for cytology, an analysis for infections and a smear for flora.

Other methods of protection.

If we are talking about patients who have not yet given birth, then they are advised to use condoms, and to increase the degree of protection, you can additionally use contraceptive suppositories.If you take into account all the recommendations of the manufacturer of these contraceptives and follow all the instructions, the degree of protection is quite high, according to studies, the effectiveness of condoms is 98%. But since people often neglect the instructions, in real life the picture is slightly different, and the effectiveness of condoms as a means of protecting against unwanted pregnancies is 85%. In addition, it should be remembered that condoms are still the only way to protect against sexually transmitted infections, so they should be used by patients who do not have a regular sexual partner.

Of course, modern methods of contraception, as well as information about them, are publicly available today. But, despite the initial ease of use, the individual selection of methods and means of contraception should be carried out by an experienced qualified specialist with maximum regard for the general condition of the patient and the characteristics of his intimate life.

90,000 Contraceptive pills, contraceptives, contraception, pregnancy spiral

Question: It is widely believed that combined oral contraceptives (COCs, birth control pills) are used only for protection against unwanted pregnancies .What are the current views on the use of COCs? Can you take the birth control pill for medicinal purposes?
Answer: Over the past 5-6 years, a wealth of experience has been accumulated in the use of combined oral contraceptives (contraceptive pills) for therapeutic purposes. Currently, birth control pills (COCs) are widely used for the treatment of acne and seborrhea (increased fat content, peeling and blemishes on the skin). There is evidence that oral contraceptives:

• have antibacterial activity without causing side effects;
• reduce the relative risk of developing pelvic inflammatory disease, ectopic pregnancy, menstrual irregularities, functional ovarian cysts, uterine fibroids, benign breast diseases (mastopathy, fibroadenoma), osteoporosis, rheumatoid arthritis, iron deficiency anemia.

Estrogens (female sex hormones), which are part of hormonal contraceptives, dilate the arteries and thereby help prevent coronary heart disease and stroke.
It has been established that hormonal contraceptives improve memory and mood by increasing the level of serotonin in the structures of the brain.
After artificial termination of pregnancy, monophasic low-dose contraceptives (Regulon, Marvelon) help to regulate the menstrual cycle.

Question: Does taking oral contraceptives (COCs) harm the body? A.Z., Vladikavkaz.
Answer: The composition of combined oral contraceptives includes synthetic hormones (estrogens and progestogens), the biological activity of which is higher than natural. Low-dose oral contraceptives of the third generation (Novinet, Yarina, Lindinet, Logest, Zhanin) have minimal side effects, which allows them to be used more widely even in young women.

Question: How long can I take combined oral contraceptives? F.B., Mozdok.
Answer: If well tolerated, oral contraceptives (COCs) can be taken for years. Currently, there are no published observations and scientifically substantiated data indicating the need to interrupt COC intake every 6-12 months. Long-term use of oral contraceptives reduces the risk of developing ovarian and uterine cancer. However, oral contraceptives are not protective against sexually transmitted infections.

Question: Can long-term use of contraceptive pills (COCs) cause the cessation of the independent functioning of the ovaries? S.Sh., Nalchik.
Answer: The effects of contraceptive pills (COCs) are reversible, i.e. after stopping the use of COCs, the modulating (changing) hormonal background effect ceases within a few days, regardless of the duration of continuous use of contraceptive pills. However, in some cases, taking contraceptive pills (COCs) masks the initially existing hormonal disturbances caused by subclinical (latent) changes in the hormonal centers of the pituitary gland and hypothalamus, and after stopping the use of contraceptive pills, the regularity of menstruation is disrupted.

Question: Can long-term use of birth control pills increase the risk of infertility? G.E., Rostov-on-Don.
Answer: In women taking birth control pills, the incidence of infertility is statistically significantly lower than in women using other methods of contraception.

Question: What are the therapeutic indications for taking oral contraceptives ( COC ) in adolescent girls who are not sexually active? M.Zh., City of Cherskessk.
Answer: Therapeutic indications for the appointment of oral contraceptives in adolescents are:

Question: What are the negative effects of taking combined oral contraceptives and possible contraindications? L.N., Kislovodsk.
Answer: The vasodilating effect on the veins provokes the risk of venous congestion and thromboembolism (blockage of the veins).
Progestogens that are part of oral contraceptives, having a vasoconstrictor effect only at the site of violation of the integrity of the arterial wall, contribute to the development of arterial thrombosis.
Therefore, patients with varicose veins, diabetes mellitus, arterial hypertension, severe thyroid pathology, the use of oral contraceptives (COC) is contraindicated.
With the existing pathology of the cervix, oral contraceptives should be taken after a complete examination and recovery, according to the doctor’s recommendation.

Question: I drink Jess the first package. Menstruation has been going on for 12 days without stopping. Is it okay? V.M., g.Baksan.
Answer: Prolonged menstruation while taking any combined oral contraceptive (COC) is not the norm and indicates an incorrect selection of COCs.
We consider it correct to urgently contact your attending physician.

Question: What is the effectiveness (contraceptive reliability) of various methods of contraception in practice? ZV, Nalchik.
Answer: According to the World Health Organization (WHO), the percentage of of the effectiveness of contraceptives in practice when taking oral contraceptives (COCs) is 92%, IUD (intrauterine device) – 99.2%, with condom contraception – 85 %, when using spermicides (vaginal suppositories, creams, tablets) – 71%.

Question: Is it possible to prevent unwanted pregnancy with a single dose of emergency contraceptive pill ? Zh.L., Essentuki.
Answer: You can. For the purpose of emergency contraception, the pill Postinor (or Escapela ) is taken once within 72 hours after intercourse. The effectiveness of a single dose of Postinor (or Escapel) is 98%.
Postinor, Escapel change the hormonal background, as a result of which the process of egg implantation is disrupted.However, it is the effect of changing the hormonal background that can contribute to uterine bleeding, disruption of the rhythm of menstruation.

Question: Can you please tell me if such a drug as Postinor is very harmful for the purpose of emergency contraception, and does bleeding always occur after it? A.M., Karachaevsk.
Answer: Postinor is an immediate contraceptive drug, when the desire to prevent pregnancy prevails over the many “disadvantages” of a sharp change in hormonal levels.
In other words, Postinor is not a planned contraceptive drug. After taking Postinor, bleeding does not always occur.

Question: When after childbirth can enter the IUD (intrauterine device, anti-pregnancy spiral)? A.V., Pyatigorsk.
Answer: IUD (anti-pregnancy spiral) is inserted no earlier than 6 weeks after delivery. The presence of an IUD does not prevent adequate breastfeeding. Service cost

Question: How long is the anti-pregnancy spiral inserted? L.M., Grozny.
Answer: Depending on the type of IUD, the duration of the presence of the intrauterine device is 3-5 years. If necessary, the IUD (anti-pregnancy coil) can be easily removed during menstruation before the end of its useful life. Service cost

Question: Is the introduction of the anti-pregnancy spiral painful? R.Sh., Nalchik.
Answer: The introduction of the IUD (spirals against pregnancy) with the observance of the technology of insertion on the most abundant day of menstruation does not cause discomfort and pain.

Question: Does the man feel the presence of the anti-pregnancy spiral? Z.Zh., Grozny.
Answer: The IUD (anti-pregnancy spiral) is inserted deep into the uterine cavity and is not felt by the man.

Question: What are the possible side effects of the anti-pregnancy coil? O.V., Pyatigorsk.
Answer: Against the background of an intrauterine device (spirals against pregnancy, IUD), it is possible to increase the duration of menstruation by 1-3 days, less often – an increase in the volume (amount) of menstrual blood.But these unpleasant effects are easily corrected by nutrition and the use of herbal infusion with a hemostatic effect.
Some cases of changes in the hormonal status against the background of the IUD in the form of persistent acne are described.

Question: I was diagnosed with chlamydia and prescribed treatment. Before prescribing treatment, I drank birth control pills. Is it possible to continue to use contraceptive pills in parallel with treatment? Lydia, Kazakhstan.
Answer: Treatment of chlamydia and other sexually transmitted diseases (STDs) is compatible with taking birth control pills (COCs).But given the duration of treatment for chlamydia (almost a month), the need to control the cure of both partners 1 and 3 months after the end of the course of antibiotic therapy and the need for condom contraception during this period (1 + 3 months!), We consider it reasonable to take a break from COCs.

Question: Based on the ultrasound results, I was diagnosed with multifollicular ovaries, and I was prescribed to take Jess until I start planning a pregnancy. I read that it is a contraceptive.Does a virgin need to be given birth control pills? And is it really possible to accept them all my life? M.I., Cherkessk.
Answer: Jess and other combined oral contraceptives (COCs, birth control pills) have the property of modulating (changing) hormonal levels. Thanks to this action, the ovaries seem to “rest”, i.e. do not produce hormones “at full strength.” This, in turn, changes their structure. As a rule, COCs (birth control pills) are taken for 3-6 months with subsequent monitoring of hormonal levels and ovarian structure.

Question: A month ago, they found follicular cyst size 4 cm. The doctor said to take hormonal contraceptives to choose from. Advise good contraceptive . Thanks in advance. S.E., Volgograd.
Answer: Hormonal contraceptives (combined oral contraceptives) are selected individually according to a special questionnaire, which avoids side effects.
It is the possibility of individual selection that explains the wide range of combined oral contraceptives produced by the pharmaceutical industry.

Question: I have been taking Mercilon for the second month. I got to Wednesday of the second week, but instead of the pill that is under the inscription “Wednesday” I took the pill under the inscription “Monday.” Please tell me if I need to take the appropriate pill (under the designation “medium”) or the sequence does not matter and is indicated for ease of use? N.I., Rostov-on-Don.
Answer: Mercilon is a monophasic drug, i.e. the tablets have the same composition.Thus, you can continue with any tablet.

Question: I have a question of life and death! It so happened that I inadvertently broke my hymen. I don’t have a sex life. Recovery operation is excluded, because I live in a small town where everyone knows each other! Now it may turn out that they will marry me, and I am not a virgin!
This is a very big shame for me and my family! I would like to make sure that the first night falls on the period of menstruation, but the choice of the wedding date, unfortunately, does not depend on me!
Please, help, advise what you can take to cause your period by the expected date!
Answer: The selection of an oral contraceptive for the purpose of shifting the onset of menstruation depends on the date of the start of the last menstrual period and the date of the wedding.And you can’t go wrong with the dates.
It is necessary to take into account the indicators of the blood coagulation system and liver function, so that after taking the pills the condition of the veins does not worsen and you do not feel sick or vomit during and after the wedding.
It is risky to resolve these issues in absentia. Pre-appointment phone number 8 (800) 500-52-74 (call within Russia is free) or +7 (928) 022-05-32. Service cost

Question: Is it possible to take the Regulon birth control pill for the treatment of anovulatory menstrual cycle when diagnosed with genital herpes? In the instructions for this contraceptive, genital herpes is indicated as a contraindication… What can be the consequences of taking Regulon with genital herpes? K.M., Makhachkala.
Answer: Taking any combined oral contraceptive (hormonal contraceptive) reduces immunological reactivity (immunity) with the possibility of dissemination (spread) of the herpes virus throughout the body.

Question: I am interested in this question: how can you get pregnant with your period? After all, pregnancy occurs when the egg matures, bursts and meets with the sperm.Does everyone ovulate differently, but not during their period? Sperm do not live for 7-10 days! Personally, I don’t get pregnant without contraception in the first five days after my period. But already on the sixth day, if we allow ourselves to relax, – everything, “zalet”. L.Yu., Karachaevsk.
Answer: There is a Coolidge phenomenon, according to which, in 5% of women, ovulation can occur with intense irritation of the cervix, regardless of the day of the menstrual cycle. A similar phenomenon is widespread in mammals (dogs, cats, cattle, etc.)etc.).

Question: The situation is as follows: my boyfriend and I have been together for the 4th year. During this time, they were protected, and not. Recently (since the end of December) we have been practicing interrupted intercourse again. The cycle seems to be constant. The last M were from 31.12 to 02.01. Two days ago there were discharge (the liquid is clear, like water) and the lower abdomen aches, bloating. Is it ovulation? (I just never specially calculated these days, but just 11-13 days). This happens periodically.These days there were also interrupted intercourse, as a result of which sperm got on the labia and vagina. I could wash myself no earlier than an hour or half an hour later. Given all this, I would like to know if pregnancy is possible? I really want to, but the young man has not yet. A.I., Grozny.
Answer: The probability of getting pregnant if sperm gets only on the external genitals is extremely small.

Question: I started taking birth control and I keep forgetting to take the contraceptive pill after dinner.Is it possible to sew a contraceptive container in the Spa Women’s Health Clinic?
Answer: In our Clinic it is possible to insert a contraceptive implant intradermally (“sew in”). Service cost

Question: I started taking contraceptives. Is it true that women get fat when taking oral contraceptives? Asem, Ust-Kamennogorsk, Kazakhstan.
Answer: COCs (oral contraceptives) can help increase body weight by stimulating appetite and fluid retention in the body.This effect is common to all hormonal contraceptives (COCs). But with the correct selection of COCs, the risk of weight gain is minimal.

Question: Is it possible to get pregnant if unprotected intercourse occurred on the days of the delay. (The delay is not related to pregnancy)?
Answer: With unprotected intercourse on the days of missed periods, there is a chance of getting pregnant.

The doctors of the Spa Women’s Health Clinic will tell you about all the methods of contraception and will select an individual method of contraception for you: “good contraceptives” in the form of oral contraceptives (COCs), a contraceptive container, a contraceptive ring, contraceptive suppositories and cream in the vagina, pregnancy “), will teach you how to use a vaginal contraceptive diaphragm, explain how to protect yourself without pills using the Ogino-Knauss method (rhythm method) and basal temperature measurements.

Doctors and midwives of the Women’s Health Resort Clinic are always ready for regular patients and those who at least once applied to the Clinic to comment remotely (by phone, Internet) on the existing or new situation and suggest ways to resolve it.

Each doctor of the Clinic has a long work experience, several specializations and is able to comprehensively assess the situation.

We work without weekends and holidays:

Monday – Friday from 8.00 to 20.00,
Saturday, Sunday, holidays from 8.00 to 17.00.

Reception by appointment by multi-channel phone 8 (800) 500-52-74 (call within Russia is free), or +7 (928) 022-05-32, or info @ kurortklinika.ru.

We are AT FULL your ORDER if you have any doubts or wishes.

You can ask your question at [email protected]

Subsections

articles of the medical center Oxford Medical Dnipro

Fluctuation and unevenness of menstruation is an absolutely normal physiological process, because of which you should not immediately panic. It is important to understand that a delay of up to 5 days is normal. One of the most common causes of missed periods is, of course, pregnancy.The test will help determine the presence of pregnancy. If the test is negative, a visit to the gynecologist to find out the reasons for the delay is mandatory. In addition to pregnancy, there are a great many reasons for the failure of the menstrual cycle, some of them may be associated with serious pathologies. That is why advice from friends, relatives and the Internet in this matter is not appropriate. Only an experienced specialist can accurately determine the cause of the failure of the menstrual cycle and, if necessary, prescribe treatment.

Below we will tell you about 10 main reasons for delayed menstruation, in addition to pregnancy:

Reason number 1.Ovulatory anomaly . The reason for it can be the intake of hormonal drugs, a strong emotional shock, acute inflammatory processes of the pelvic organs.

Reason # 2. Hormonal contraceptives . During the use of hormonal contraception and for several months after, menstrual dysfunction is possible. Most often this can happen due to abrupt cessation of the course, or due to emergency contraception (the so-called “pills of tomorrow”)

Reason number 3.Functional ovarian cyst . In about 7-10% of normal cycles, certain endocrine syndromes can occur that are associated with impaired ovarian function. An example of such a disorder is a corpus luteum cyst. When a cyst has been “in existence” for too long, menstruation may be delayed. If this happens often, a mandatory consultation with a gynecologist is necessary, because the consequences can be dangerous.

Reason # 4. Polycystic ovary disease (PCOS) .This disease is characterized by disturbances in the functioning of the hormonal system and prevents ovulation.

Reason # 5. Various gynecological pathologies , such as a benign tumor of the wall of the uterus (myoma), inflammation of the fallopian tubes and / and appendages (salpingo-oophoritis), and many others. All these pathologies can delay menstruation for a long time.

Reason # 6. Terminated pregnancy . Both medical and voluntary abortion cause hormonal imbalances in a woman.Also, during termination of pregnancy, the tissues of the uterus can be damaged, which can cause dysfunction.

Reason # 7. Stress. Any strong emotional outburst, especially a negative one, can lead to a disruption of the menstrual cycle.

Reason # 8. Sharp and significant weight loss . It has been scientifically proven that strong weight loss in a short period of time entails disruptions in all processes of the woman’s body. This also applies to reproductive health.

Reason # 9. Failure of metabolic processes, lack of vitamins. Improper nutrition, lack of nutrients, minerals and vitamins also leads to a delay in menstruation.

Reason # 10. Excessive physical activity . Excessive sports activities or heavy lifting lead to a shift in the first day of menstruation by several days.

Any woman should know that not only a delay in the menstrual cycle, but also hyperpolymenorrhea (too heavy menstruation) is a possible indication of various gynecological pathologies.If you observe dysfunction in yourself, be sure to contact your gynecologist. This should be done as quickly as possible, without postponing “until later.” Gynecological diseases, like any others, are much easier to treat in the early stages. If you allow the disease to develop, you will get complications and many irreversible processes.

Take care of your women’s health – consult a doctor!

Published: 09/19/2014

Updated: 03/05/2019

(Rating: 4.38, votes: 66)

Taking hormonal contraceptives, or About the “rest” of the ovaries

If you create a book of absurd medical statements that have passed into the category of rumors, myths, prejudices, but then are perceived by people as the truth, then you get a publication in several volumes.And if “all doctors say so” (meaning all post-Soviet doctors), then a completely different opinion of a knowledgeable and thinking doctor will rather cause distrust and surprise than save a person from false beliefs. It is difficult to explain something progressive in the darkness of the obscurantism of illiteracy.

One of the widespread myths was the assertion, invented by doctors, that while taking hormonal contraceptives, the ovaries “rest” . To say simply that it is not true, that the ovaries do not “rest” at all, just as the heart, lungs, liver, kidneys and other organs do not rest, is usually not enough.“Please provide links to articles and research results that say the ovaries do not rest because all our doctors say they are resting! All doctors cannot lie! ” – the demand from some women sounds as an ultimatum. But the very expression “ovarian rest” is not scientific, not medical, and is not mentioned in the professional literature. And then I want to ask a counter-question: give a scientific, medical definition of the concept of “resting ovaries”. How do you imagine it? And then a counteroffensive: cite at least one article written not by order of contraceptive manufacturers, but based on serious clinical research, where at least a glimpse of such an unscientific term as “ovarian rest” is mentioned.There are no such articles, and never have been.

If you have logic, then rest implies not doing the main work, and not forcibly, right? For organs and organ systems, “doing work” means functioning. In other words, organs perform a specific function. Violation of this function can lead to a malfunction of the whole organism, and we often call such deviations in work specific diseases.

From the moment the organs are laid and their gradual development and maturation, they perform a specific function.Without this, the life of a fetus, then a child and an adult is impossible. Of course, you can live without some organs, and if they are paired, then the absence of one may not affect too negatively human health. People live with one kidney, and one lung, and without a spleen, and with a part of the liver. However, life is impossible without a number of organs.

Now let’s talk about the ovaries . What is their function? The ovaries are the reproductive organs or gonads. Without them, there can be no reproduction of offspring, therefore one of the functions of the ovaries is the maturation of female reproductive cells – eggs.In parallel with the maturation of the germ cells, the process of producing hormones is underway – primarily progesterone, which is used to produce male sex hormones (androgens), and from them – female sex hormones (estrogens). The maximum production of sex hormones is observed in the growing vesicles (follicles) during the maturation of the germ cells. Therefore, the ovarian follicular apparatus is the most important part of these organs.

However, it must be remembered that sex hormones and progesterone are produced not only by the follicle in which a full-fledged egg will mature, that is, the dominant one.These hormones are also produced in other types of follicles that are not growing, slowly growing and very small in size. This means that in the body of a woman (in the overwhelming majority of women) always has a certain amount of hormones, which are sufficient for the normal function of the reproductive system and the entire female body, from the newborn period to the climacteric period. It does not happen that the indicators of hormone levels are at zero. If only because there are also adrenal glands, and a number of other cells and tissues that produce sex hormones.Even if one ovary or part of the ovaries is removed, the lack of hormones will not be observed in all cases, however, there will never be compensation for the lost follicles.

Who or what controls ovarian function? With sexual development in girl , the relationship between the ovaries and those parts of the brain that produce certain substances with hormonal properties that stimulate or suppress ovarian function will improve. First of all, it is the hypothalamic-pituitary system. The process of improving the mechanism of regulation of ovarian function is completed by the age of 21-22, and even later in some women. Without delving into the jungle of this relationship, it is important to understand that the increasing and circulating levels of ovarian hormones in the blood during the maturation of the follicles trigger the production of certain substances in the brain, also hormones that will inhibit the growth of follicles. Conversely, lowering hormone levels will stimulate the production of those hormones from the hypothalamus and pituitary gland, which will stimulate the maturation of eggs.There are also a number of interconnections between the ovaries and other organs, and the ovaries themselves use some of their hormones to support their own function.

And now let’s talk about what the contraceptive effect of hormonal drugs is based on. Without exception, all hormonal contraceptives contain synthetic progesterone (progestin), because their action is based on progesterone action. If you ask doctors what a “progesterone effect” or “progesterone property” is, most of them will have no answer or the answer will turn out to be false. Progesterone action is determined by the amount of progesterone (or progestin), which is sufficient to suppress the maturation of sex eggs, that is, suppress ovulation. Of course, progesterone and progestins may additionally have other properties, which may also increase the contraceptive effect.

When a woman starts taking hormonal contraceptives, an artificial hormonal background is immediately created, and at the same time a cycle. At the same time, the growth and maturation of follicles stops, although not always completely (depending on the dose and the frequency of taking the drug), there is no ovulation, the natural (natural) menstrual cycle stops.If hormonal contraceptives are taken on a continuous basis (without a break of 7 days or dummy tablets), then there will be no menstruation, although breakthrough bleeding may sometimes occur. It must be remembered that women who take hormonal contraceptives not only do not have their own natural menstrual cycles, but also have no natural menstruation. After taking 21 hormone pills and taking a break, withdrawal bleeding occurs. This mode of taking hormonal drugs was created for the convenience of women.

An artificially created cycle with a new level of taken hormones suppresses the maturation of follicles and the production of its own hormones by the ovaries. The ovaries do not rest – their function is suppressed, and violently. After all, they did not ask the woman to take hormones.

Now imagine, for comparison, that one day someone appeared in the family and locked a woman-wife-mother in a dark closet without any warning. And this someone, obviously another woman, began to do all the work of the housewife, including the role of wife and mother.The hostess herself sits in the dark and does not understand what is happening in her house. It is clear that it does not work. But can such a suspension from work be called a rest? The same thing happens with the ovaries when their function is artificially suppressed.

How will the ovaries react after this suppression is removed? And how will a woman react when she is released from the dark closet to freedom? Women are different, so the reaction to what has happened will be different: some will come to work quickly, others will need several months to recover, and others will be so shocked that they will not be able to start their routine worries and duties for a very long time.The same can be said about the ovaries – each woman’s reaction is individual.

Thus, when taking hormonal contraceptives, the ovaries do not rest. It is also necessary to get rid of other myths on this topic: taking hormones, including contraceptives, does not rejuvenate the ovaries, does not preserve ovarian reserve, does not save at all from old age and menopause, does not improve the quality of germ cells, and even more so, does not lead to conception child. Therefore, it is absurd to take hormonal drugs ostensibly to “align” the menstrual cycle and at the same time planning pregnancy. This is not only a waste of money, but also of time (and for women over 35, such a waste of time can end up losing their chances of getting pregnant). It is also a life of deception, for they hope for one thing, but they have no idea that they are getting another.

I would like to tell our women a lot about women’s health so that they get rid of the false beliefs that stuffed their thinking. And I want to believe that my explanation of how the female body works and functions will help at least some of them understand the absurdity of a number of myths, unfortunately, spread by doctors.