Follicular ovarian cyst is a tumor-like gynecological disease. More often one gland is affected, the process is unilateral. Let's take a closer look at the disease, name its causes, manifestations and methods of combating it.

Follicular ovarian cyst - causes

Follicular ovarian cyst, the causes of which are not always known to women themselves, occurs in women of reproductive age. In this case, the provoking factors of its formation can be:

• inflammatory processes in the gonads - salpingitis, oophoritis,;
• abortions and operations on the reproductive system;
• sexually transmitted infections;
• disruption of the hormonal system;
• long-term use of hormonal drugs;
• thyroid dysfunction
• constant stressful situations, overexertion;
• hormonal surge during pregnancy and childbirth.

Follicular ovarian cyst - symptoms

There are no signs of a follicular ovarian cyst for a long time. Often, pathology is detected during a preventive examination of a woman and a pelvic examination. Thus, cystic formations whose diameter does not exceed 5 cm do not manifest themselves clinically. However, they can be detected by conducting a blood test for hormones. With a follicular cyst, there is always an increase in the concentration of estrogen.

This phenomenon directly explains the main symptoms of the pathology. The first thing a woman notices is menstrual irregularity. However, it can have various manifestations:

• the appearance of scanty, bloody discharge in the period between menstruation;
• discomfort, pain in phase 2 of the cycle;
• decrease .

Can a follicular ovarian cyst hurt?

As the cystic formation grows, the symptoms intensify. Women increasingly complain of discomfort and pain in the groin area. At the same time, they are recorded preferentially on the side of the affected ovary and have a clear localization. Dull pain, a feeling of fullness intensifies after physical activity, long walking, or during sexual intercourse. At the same time, the woman notices fatigue and weakness. In other situations, a follicular ovarian cyst rarely hurts, so girls may not even suspect its presence.

Menstruation with follicular ovarian cyst

When a follicular ovarian cyst forms, a delay in menstruation is its main symptom. This fact directly forces women to seek help from a gynecologist, who, after a comprehensive examination, diagnoses the disease. The absence of menstrual flow in such gynecological pathology is due to the structural features of the follicular cyst. Because of this, doctors call it both the cause and at the same time a consequence of hormonal imbalance.

They say this because the ovarian follicular cyst, its outer shell, is capable of producing estrogens. As a result, there is an increase in these biological compounds in the blood. Estrogens increase endometrial cell division and help delay the onset of menstruation. Directly because of this, the delay occurs. It can last up to 1 month. The onset of menstruation often occurs with complications:

• soreness;
• strong, excessive abundance;
• the appearance of clots;
• transition of menstruation to .

Rupture of ovarian follicular cyst - symptoms

Rupture of an ovarian follicular cyst is one of the main complications of the disease. It develops due to the large size of the cyst. Due to strong overstretching of its walls, rupture of its membranes may occur. This occurs after prolonged physical activity or sexual intercourse. The contents of the cyst pour into the pelvic cavity, which causes an acute abdomen. Noted:

• dizziness;
• weakness;
• nausea;
• decreased blood pressure;
• sharp pain that occurs suddenly in the lower abdomen;
• pallor of the skin.

When a cyst ruptures in the area of ​​a nearby blood vessel, bleeding develops. This complication is characterized by:

• lethargy;
• weakness;
• increased heart rate;
• low blood pressure.

Differential diagnosis of follicular cyst

A follicular ovarian cyst can be diagnosed during a gynecological examination of a woman. In this case, the tumor is already large and therefore palpable through the anterior abdominal wall. The doctor discovers a round formation located on the side and in front of the uterus. Its surface is smooth, there is practically no pain, the cyst itself can be moved and is mobile.

The final diagnosis is made based on ultrasound results. Directly in this way the size of the follicular ovarian cyst, its exact location and structure are determined. The device shows a single-chamber formation. Its diameter is 3-8 cm, and the wall thickness does not exceed 1-3 mm. Against the background of this disorder, changes are also recorded in the tissue of the gland itself, which the doctor sees on the screen of the device. Additional diagnostic methods can be used:

• laparoscopy;
• echography.

Follicular ovarian cyst and pregnancy

Follicular cyst and pregnancy are compatible terms. This confirms the phenomenon when the disease is diagnosed during the first routine ultrasound after pregnancy. With a persistent cyst, when the neoplasm does not resolve for 2 months or more, conception becomes impossible until it disappears. However, the fact of fertilization cannot be completely ruled out. Often the process is one-sided, so the second sex gland functions normally.

Is it possible to get pregnant with a follicular ovarian cyst?

A positive pregnancy test and a follicular cyst are not mutually exclusive. The possibility of conception with this disease is created due to the work of an intact ovary. Ovulation occurs, so intercourse during this time can lead to fertilization. However, in practice, women often experience problems when planning a pregnancy with a cyst. The reason is the increased content of estrogen, which inhibits ovulatory processes in the reproductive system (ovulation may not occur in every cycle).

Follicular cyst during pregnancy

In practice, it happens that often a follicular cyst and pregnancy are diagnosed at the same time. This happens at the 12th week of gestation, when doctors carry out the first screening (examine the fetus using ultrasound for pathologies). If a tumor-like formation is detected, the pregnant woman is monitored - an ultrasound is performed every 2-3 weeks to determine the size of the cyst, and the absence of its growth is monitored.

Gynecologists take a wait-and-see approach. So until 17-18 weeks, doctors monitor the formation. Intervention in the reproductive system earlier than this period is fraught with the development of complications (spontaneous abortion). After this time, a planned laparoscopy is performed. In some cases, when the cyst has a leg, the operation is performed at an earlier stage, due to the high risk of torsion, which threatens not only pregnancy, but also the health of the mother.

How to treat follicular ovarian cyst?

A follicular ovarian cyst, the treatment of which is developed individually, is subject to dynamic observation after detection. When deciding on the method of therapy, doctors pay attention to the size of the formation, symptoms, and stage of the tumor process. So a small follicular ovarian cyst, which practically does not reveal itself, can resolve on its own within 3-4 menstrual cycles. For formations up to 3 cm in diameter, a complex of therapeutic measures includes:

• prescription of hormonal drugs;
• use of anti-inflammatory drugs;
• use of painkillers (if necessary).

Drug treatment of follicular cyst

The basis of drug treatment for a disease such as follicular ovarian cyst is drugs containing sex hormones. Most of them are progesterone-based drugs. This biological compound can reduce the concentration of estrogen in the patient’s blood. As a result, the growth of the cyst slows down and it gradually begins the process of reverse development. The period of treatment with hormonal drugs is long, taking 3-6 months. Among the common drugs:

• Duphaston.

Follicular ovarian cyst, treatment of which with Duphaston is a long process, can be easily corrected with the help of oral contraceptives. Duphaston for follicular ovarian cysts reduces the size of the formation and relieves symptoms. The drug is prescribed exclusively by a doctor. Other known medications used:

• Diana-35;
• Janine;
• Logest;
• Marvelon.

To eliminate the inflammatory phenomena that accompany cystic formations, anti-inflammatory drugs are prescribed. They ease the clinical picture and improve the woman’s well-being. These include:

• Ibuprofen
• Voltaren.

Follicular ovarian cyst - treatment with folk remedies

Follicular ovarian cyst, treatment without surgery is possible in the early stages, can decrease in size and under the influence of medicinal herbs and plants. They are used as additional means. Among the effective folk recipes are:

1. Walnut. Peel 13-14 nuts, crush the shells and pour 0.5 liters of vodka, placing them in a jar. Leave for 7 days in a dark place. Then stored in the refrigerator. Take 1 tablespoon in the morning, before meals.
2. Burdock. 3-5 fresh leaves of a medium-sized plant are crushed and placed in a blender. The resulting pulp is spread on cheesecloth and the juice is squeezed out. Drink it 1 teaspoon, 2 times a day, then after 2 days increase the dosage to 3 spoons.
3. Acacia. Mix flowers and bark in equal parts, 2 tablespoons each, add 200 ml of vodka, leave for a week in a dark place. Strain and take a tablespoon, 3 times a day.

Removal of ovarian follicular cyst

When the symptoms of the disease intensify—the follicular ovarian cyst increases—surgery becomes the only treatment option. This method of treatment is indicated when the formation of a follicular (functional) ovarian cyst in diameter exceeds 8 cm and no regression is observed within 3 months. Surgery is performed by laparoscopy - access to the formation is through small incisions on the anterior abdominal wall. The operation is characterized by a quick recovery period and a low risk of complications.

A follicular ovarian cyst is a benign tumor that grows in the absence of ovulation from the largest follicle (with a diameter of at least 30 mm). The disease is very common - of all patients with ovarian cysts, approximately 83% have the follicular form.

A follicular cyst can occur in any woman of fertile age and in the first 5 years after menopause, but there is a greater risk of becoming an “incubator” for such a cyst in girls during puberty and a little older. There are known cases of the disease being detected in newborns.

Features of the disease

The size of the cyst is on average 3-10 cm. Degeneration into cancer does not occur, however, the follicular cyst can recur due to hormonal disorders. The disease can go away on its own provided that the hormonal balance is normalized.

As a rule, one patient can have either a follicular cyst of the right ovary or a follicular cyst of the left ovary - they are identical to each other and differ only in the location of the dominant follicle in the body.

Causes of development of follicular ovarian cyst

The disease appears due to hormonal imbalances in the female body. They, in turn, can be caused by other reasons:

• severe stress;
• sleep disorders;
• poor nutrition;
• physical overload;
• long-term abstinence from sexual activity;
• gynecological intervention (abortion, poor cleaning or examination, childbirth);
• improper use of hormonal drugs or contraception;
• inflammatory processes in the reproductive system.

In some cases, the causes of hormonal imbalance may need to be explored further. The patient may have a sexually transmitted disease, ovarian dysfunction, or problems with the endocrine glands.

Symptoms of follicular ovarian cyst

The disease has few symptoms, so often detected during routine examination. A follicular cyst should be suspected if a woman has:

• a feeling of fullness and heaviness on the left or right side of the lower abdomen;
• painful sensations that intensify with any physical activity and movement (including sexual intercourse) in the same area;
• discomfort during pre- and post-ovulation;
• basal temperature during ovulation is below average (36.8°);
• spotting or period-like bleeding in the middle of the menstrual cycle;
• delay of menstruation.

In girls, puberty may accelerate.

Complications of the disease

Diagnosis of the disease

Clinically, the presence of a follicular cyst is confirmed using blood tests for hormones, echography, ultrasound and gynecological examination.

On palpation, the tumor is felt as a hard, moving ball with a smooth, tight and elastic surface. Palpation of the cyst does not cause severe pain in the patient.

Pregnancy and follicular ovarian cyst

An ovarian follicular cyst blocks the release of the egg on only one side. The other ovary is healthy, so With this diagnosis, it remains possible to get pregnant safely.

During pregnancy, hormonal levels undergo changes, which in most cases lead to spontaneous resorption of the cyst by approximately 20 weeks or earlier.

However, you should remain cautious and visit your gynecologist regularly. If the ovary twists, it will be extremely difficult to carry the baby to term. If the cyst continues to grow uncontrollably, it must be removed to save the child’s life. Surgery is safe between 16 and 18 weeks. Surgery at an earlier time increases the risk of miscarriage.

Treatment of follicular ovarian cyst

Small follicular cysts are usually left untouched: they are quite capable of resolving on their own within 1-2 menstrual cycles. It is important to get rid of the disease as early as possible so that the cyst does not burst and cause complications.

If after 2-3 months the cyst has not disappeared or even increased in size, the doctor will prescribe drug treatment or removal of the cyst by laparoscopy, cystectomy or ovarian resection.

Attention! During treatment, you should avoid overheating, taking hot baths or procedures, and physical exercise with stress on the muscles in the abdominal area (abs, rectus and oblique muscles).

How to treat a follicular cyst using traditional medicine?

To suppress the growth and recurrence of follicular cysts, complex drug therapy is usually prescribed. It includes hormonal, anti-inflammatory, vitamin and homeopathic drugs.

Broad-spectrum antibiotics are prescribed as anti-inflammatory drugs. To restore hormonal levels in the second phase of the cycle, oral contraceptives are used. Vitamins of group B, as well as A, C, E and K are useful.

Follicular cysts must be treated Duphaston– a popular, harmless and effective drug. The active substance in Duphaston - dydrogesterone - is an analogue of progesterone. Taking pills should be supervised by a doctor. On average, 10 mg of this drug is prescribed twice a day.

In the absence of positive treatment results, surgical therapy should be resorted to.

What are they like? Find out, because it is much easier to prevent the disease.

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Traditional recipes for follicular ovarian cysts

Walnuts. Crush the shells of 14 nuts, put them in a jar, pour vodka (0.5 l). Close the jar tightly and leave for a week in a warm place without light. Then pour into a bottle and store in the refrigerator. Drink 1 tbsp of tincture every morning before meals. l.

Chaga. Rinse the mushroom well under cold water and soak in cooled boiled water. If the chaga is mature enough, it will drown. After 6-7 hours, chop the softened mushroom, put it in the same water and heat it to 50°. Leave for two days. Strain the tincture and drink 30 grams every day before meals.

During the treatment period, you should avoid taking meat, fatty, smoked and canned foods; you should also not take aspirin, antibiotics and glucose (intravenously). Treatment lasts 3-4 months, then a week break and repeating the course.

Collection of herbs:

• stinging nettle – 5 tsp.
• bird cherry flowers – 1 tsp.
• chicory – 2 tsp.
• rose hips – 3 tsp.
• medicinal chamomile – 4 tsp.
• sea ​​buckthorn – 3 tsp.
• plantain – 5 tsp.
• calendula – 4 tsp.
• bird knotweed – 2 tsp.
• great celandine - 2 tsp.

For 1 tbsp. l. herbal mixture needs 1 tbsp. boiling water Leave for 5 hours, take a quarter glass three times a day before meals. Treat in courses of 1 month with breaks of 2 weeks.

Burdock. Grind two bunches of fresh burdock into a pulp and squeeze out the juice. Drink it first 1 tsp. twice a day (2 days), and then increase the dosage to 3 tsp. Treat for a month. Keep the juice in the refrigerator.

Acacia. 2 tbsp. l. pour a glass of vodka over the flowers and acacia bark. Let it brew for 5-7 days in the dark, strain and drink 1 tbsp. l. three times a day for a month.

The reasons for the appearance of ovarian cysts in women in most cases are trivial - these are changes in hormonal levels due to stress, improper rhythm of sleep and rest, nutrition, lack of sexual activity or, conversely, excessive passion for it. In each individual case, the follicular ovarian cyst develops unnoticed, its symptoms can be easily confused with premenstrual syndrome. However, women and girls of any age, including newborn female babies, are susceptible to this disease.

Follicular ovarian cyst is considered a fairly common disease that rarely develops into a serious pathology. However, you should not waste time and ignore alarming symptoms - in severe cases, surgical intervention and complete removal of the ovary may be required. And this can lead to infertility.

A follicular (or functional, or retention) ovarian cyst of the right or left develops from a follicle, which, in the absence of ovulation, grows inside the ovary ( see photo). The disease can be diagnosed when the follicle reaches a size of 3 cm or more. In fact, an unovulated follicle continues to grow inside a woman’s body, eventually causing pain, changes in the menstrual cycle, and hormonal imbalances.

The pathological development of a follicle inside a woman’s body is a benign formation, which, however, never turns into an oncological disease.

But uncontrolled growth of ovarian tissue can lead to twisting of the cyst stalk, rupture of the follicle, and its suppuration. A follicular ovarian cyst is retentional in nature, that is, the body copes with the problem on its own within 1-3 months - the cyst resolves when the level of hormones in the woman’s blood is restored. However, the disease requires examination and constant monitoring by a doctor, as complications requiring urgent surgery are not uncommon.

The disease is endocrine-dependent - proper treatment and the absence of complications make it possible to treat a follicular cyst without surgery in 90% of cases. Hormonal therapy and antibiotic treatment for medical reasons are the main methods of relieving the disease in a hospital setting. If the outcome is unfavorable, laparoscopy of the ovarian cyst is performed - an operation that can lead to infertility ( see photo).

A follicular cyst that develops for more than 2 months is called persistent. An ovarian cyst that appears repeatedly is called recurrent.

While the neoplasm remains, there is no ovulation. But it may happen that the disease appears during pregnancy. During this period, the risk of complications increases sharply.

Symptoms of the disease and diagnosis

The difficulty of early diagnosis of ovarian cysts lies in the absence of pronounced symptoms. A woman is often unaware of problems in her body and consults a doctor only when pain appears in the area of ​​the right or left side, delayed menstruation, or unnatural vaginal discharge. In the presence of concomitant diseases of the genital area (bacterial infections, fibroids, endometriosis, etc.), symptoms of pathological follicle development may develop earlier and cause complications.

A follicular ovarian cyst is formed on one side - the pathology of the left or right organ does not differ in symptoms, their treatment is carried out in the same way. Medicine refutes the myth that cysts of the right ovary occur more often. The opinion is based on the peculiarities of the physiological structure of the female body - due to better blood supply to the right ovary, dominant follicles are more often formed in it. The right ovary is supplied by a direct connection to the main aorta, and the left is supplied by the renal artery. Despite the logical assumption, a follicular cyst of the left ovary appears as often as the right one, which is confirmed by statistical data.

New growths no larger than 4 cm in size do not cause concern and, as a rule, disappear on their own. A follicular ovarian cyst of a larger diameter (6-10 cm) can cause the following symptoms:

For diagnosis use:

After diagnosing a cyst of the right or left ovary, treatment consists of adjusting the level and ratio of hormones in the blood. Doctors take a wait-and-see approach and simply observe the pathogenesis of the follicle for 2 months and measure the woman’s hormonal levels. If necessary, treatment with hormones, antibiotics, and physiotherapeutic procedures is prescribed.

Causes of cyst formation

The pathological development of ovarian follicle tissue inside the ovary in women capable of fertilization has certain causes that are a consequence of an unhealthy lifestyle. An inappropriate attitude towards your own life and health leads to hormonal changes, which, first of all, affect the sexual sphere. Medicine pays great attention to the psycho-emotional state of the patient. Most often, stress, depression, loneliness, panic, and social failure of a woman are the impetus for the formation of ovarian cysts.

The development of a follicular cyst in embryos and newly born girls causes the release of hormones, as well as the effects of maternal estrogens and human chorionic gonadotropin produced by the placenta.

The method for diagnosing a cyst of the right or left ovary in a fetus is ultrasound examination in the third trimester. The size of the cyst in embryos and newborns can reach 10-12 cm. In the absence of growth dynamics and complications, the follicular cyst in infants after childbirth resolves on its own in 50% of cases.

The main reasons for the appearance of cysts:

Treatment of neoplasm in the ovary

The best way to prevent ovarian cysts is a positive attitude, but if the disease makes itself felt, treatment must be started immediately. Since the causes of the disease lie in an inappropriate lifestyle, you need to exclude them first. If necessary, you need to make an appointment with a psychologist to get rid of unpleasant memories, complexes, stress, and change your perception of life. It is necessary to treat cystic neoplasms of the right and left ovaries not only using physical methods and folk remedies, but also on an emotional level.

First steps in changing your lifestyle:

1. Balanced diet - food should be healthy, nutritious, but not fatty. A proper diet will help you adjust your weight, which will have a beneficial effect on the general condition of the body.
2. Taking vitamin-mineral complexes.
3. Sleep and rest schedule - it is important to ensure a healthy night's sleep, if possible - 1-2 hours of daytime rest.
4. Gently ridding the body of waste and toxins using herbal medicine and homeopathy.
5. Maximum oxygen - frequent walks in the forest, park, picnics with friends in the open air perfectly “ventilate” the brain and improve its functioning.
6. Physical rest - treatment of a cyst involves giving up sports, sudden movements, running, and lifting weights.

In medical practice, treatment of follicular ovarian cysts with a diameter of more than 6 cm involves:

Complex treatment usually gives positive dynamics within a few days. Full recovery occurs in 10-20 days.

Along with traditional medicine, follicular ovarian cysts can be treated with folk remedies.

Traditional therapy

In folk medicine, follicular ovarian cyst is called water disease. Previously, it was believed that the disease affects only mature women and is incurable. There are many recipes on how to treat follicular ovarian cysts using natural products and medicinal herbs. Treatment with folk remedies can be combined with medication - herbal medicine will help support the body, restore immunity, and reduce inflammation.

1 way. Treatment of cystic ovarian tumors by collecting chamomile, sweet clover and coltsfoot. 3 tbsp. herbs per 0.5 liters of water is brought to a boil and left for 12 hours. Drink 100 ml 4 times daily.

Method 2. Treatment with boron uterus is indicated only in the absence of endometriosis, since the herb improves blood supply to the genitals, which can cause bleeding. It is recommended to treat follicular ovarian cysts with an infusion or decoction of boron uterus. For this, 2 tbsp. raw materials are boiled in 1.5 glasses of water, left for 30 minutes. Separate the decoction from the sediment, take 1 tbsp before meals 30 minutes 3 times a day.

3 way. A mixture of 5 components: chamomile, motherwort, rowan berries, viburnum bark, rosea radiola roots, pour 200 ml of boiling water and leave for 12 hours. Decant the sediment and drink 75-100 ml before meals for 2 months.

Treatment with bee products gives good results: placing honey swabs, taking propolis and honey orally. Bee products are extremely beneficial for the body, but it should be remembered that they often cause allergies.

When choosing a treatment method, there can be no alternative - follicular ovarian cyst requires mandatory medical supervision. Treatment with folk remedies, herbal medicine and homeopathy can only be used as an auxiliary one. And you should always remember that the best prevention of cystic neoplasms is a healthy lifestyle, a positive attitude and spiritual harmony.

Follicular ovarian cyst- symptoms and treatment

What is an ovarian follicular cyst? We will discuss the causes, diagnosis and treatment methods in the article by Dr. E. V. Popenko, a gynecologist-endocrinologist with 32 years of experience.

Definition of disease. Causes of the disease

Follicular ovarian cyst(non-bursted follicle) is a retention functional tumor-like formation of the ovary, represented by a cavity filled with fluid.

Benign ovarian tumors account for 12-25% of tumors of the female reproductive system, reduce a woman’s ability to become pregnant and are often an indication for surgical intervention. Ovarian cysts account for an average of 17% of all ovarian formations, a significant part of which are retentional - 70.9% of cases. Follicular ovarian cysts are the most common pathology in women of reproductive age. Among benign ovarian tumors, their share, according to domestic and foreign authors, accounts for up to 80% of cases. These formations occur in women at any age.

A follicular cyst develops from mature preovulatory follicles or antral follicles and is a single-chamber thin-walled formation filled with transparent and light contents. Most often it is one-sided. Sizes vary from 2 to 20 cm.

This pathology occurs with high frequency in women with infertility. It is known that in women with follicular cysts the content of estradiol in the blood increases, which, according to the literature, is one of the factors involved in the formation of follicular cysts.

Tumor-like processes most often develop against the background of long-term inflammatory diseases, inadequate use of antibiotics and hormonal drugs. All this leads to persistent destabilization of immune homeostasis, which is the background against which ovarian cystic formations arise.

For the first time, a follicular ovarian cyst was described in 1827 as a “watery disease” in a childless forty-year-old woman. At that time, this disease was considered incurable. Since then, scientists around the world have tried to understand the etiology and pathogenesis of these ovarian tumors. In 1972, the concept of apoptosis (programmed cell death) was introduced. Researchers have begun to study the relationship between apoptosis, steroidogenesis and ovarian function. As a result of the study, one of the theories of the occurrence of follicular ovarian cysts arose - a hormonal-genetic factor.

At the beginning of the twentieth century. Two more theories of the occurrence of ovarian cysts have been put forward, based on disturbances in the functioning of the hormonal system and inflammatory processes of an infectious nature in the appendages.

To date, the exact etiology of follicular cyst formation is not known for certain. The main reason is considered to be lack of ovulation. In turn, the lack of ovulation is most often associated with hormonal disorders. Hormone imbalance manifests itself in the form of hyperestrogenism, increased levels of follicle-stimulating hormone and lack of luteinizing hormone.

The most significant risk factors for the development of follicular ovarian cysts today they are considered:

When developing therapeutic and preventive directions, doctors today try to take into account all three theories of the occurrence of follicular ovarian cysts.

Most studied Causes of follicular ovarian cysts:

If you notice similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!

Symptoms of follicular ovarian cyst

When a hormonally inactive ovarian cyst forms, there are usually no symptoms. Such cysts are determined only by ultrasound examination and disappear on their own in subsequent menstrual cycles.

When hormonally active follicular cysts form, a woman may be bothered by:

• menstrual irregularities with delayed menstruation or bleeding during the intermenstrual period;
• heaviness in the lower abdomen;
• pain from the location of the ovarian cyst.

Pathogenesis of follicular ovarian cyst

Every woman has a genetically determined ovarian reserve. At birth, each girl has about 1 million eggs. At the time of puberty, there are about 300 thousand of them. With the onset of menstruation, several follicles with eggs begin to grow each month, and only one reaches the ovulatory state. This is ensured by atresia of the remaining follicles that began to grow in a given menstrual cycle. If the follicle does not rupture during ovulation and it does not become atretic, then when filled with fluid as a result of effusion from the bloodstream and secretion of follicular cells, a cyst is formed.

Complications of follicular ovarian cyst

A follicular ovarian cyst is dangerous because there is a risk of torsion of its stem and rupture of the cyst (ovarian apoplexy). Signs of torsion of the cyst leg are sharp pain in the lower abdomen from the side where the cyst is located, rapid heartbeat, weakness, nausea, vomiting, drop in blood pressure up to loss of consciousness, cyanosis of the skin.

The rupture of the cyst is manifested by dagger pain from the localization, fainting, nausea and vomiting, while the body temperature remains normal. If bleeding into the abdominal cavity occurs, a rapid heartbeat (tachycardia), a drop in blood pressure develops, the skin becomes pale bluish, weakness, drowsiness appears, and a state of shock develops.

Torsion of the cyst stalk and ovarian rupture are acute conditions requiring emergency surgical care. The adhesive process after the operation can lead to obstruction of the fallopian tubes and, accordingly, to tubal infertility. In addition, the very presence of a follicular cyst will prevent the maturation of a new follicle to the ovulatory stage, and infertility in this case will be associated with a lack of ovulation.

Diagnosis of follicular ovarian cyst

Diagnosis of follicular ovarian cysts primarily involves taking an anamnesis, bimanual examination (bimanual), and ultrasound examination of the pelvic organs. In addition to ultrasound, methods of computed tomography and magnetic resonance imaging of the pelvic organs and laparoscopy are used, in which both diagnosis and treatment are possible.

When an ovarian cyst is detected, the level of CA 125 in the blood serum is necessarily examined. The examination plan includes:

1. blood hormone studies: FSH, LH, AMG, estradiol, progesterone;
2. general blood and urine analysis;
3. blood biochemistry;
4. smear for flora and oncocytology;
5. Ultrasound of the mammary glands;
6. colposcopy.

This list of examinations is determined by the need to use hormonal therapy during the presence of a cyst, rehabilitation and prevention of relapses after treatment.

Treatment of follicular ovarian cyst

Treatment tactics for follicular ovarian cysts are chosen depending on the size and growth dynamics of this formation, the age of the patient and the need for reproductive function.

Questions about the need for active medical intervention for newly diagnosed asymptomatic cysts, surgical treatment in the absence of complications, the choice of the extent of surgery and the method of hemostasis are debatable. Laparoscopic cystectomy in compliance with the principle of functional surgery is the “gold” standard for surgical treatment of cysts. Despite the fact that this operation allows you to save the organ, it has not yet been fully established how surgical treatment of cysts affects reproductive function.

If the cyst is less than 5 cm, has asymptomatic development and does not cause functional impairment, a wait-and-see approach is practiced. Ultrasound monitoring of the cyst is carried out over three menstrual cycles without the use of drugs. When using medications to treat ovarian follicular cysts, oral contraceptives may be used. For these purposes, single-phase low-dose oral contraceptives are prescribed. Their action blocks the functioning of the ovaries, thereby preventing the formation of new follicular cysts. The action of oral contraceptives can reduce the growth of a follicular cyst, up to complete resorption. The menstrual cycle as a whole is normalized, and the risk of ovarian cancer is reduced.

The question of surgical treatment arises in emergency situations that threaten the patient’s life: torsion of the pedicle of an ovarian cyst, ovarian apoplexy. Also, removal of a follicular ovarian cyst is indicated for the persistent form of the cyst, rapid growth of the formation, and large size.

Most often, removal of a follicular ovarian cyst is carried out laparoscopically with enucleation of the cyst, sometimes with resection of the ovary. At the same time, surgical treatment using resection of part of the ovaries sharply reduces the follicular reserve, which leads to the need to use donor oocytes in the IVF program even in young patients. Considering the fact that follicular retention cysts are the most common (according to histological examination), it is most important to avoid ovarian resection to preserve the follicular reserve. Currently, the method of fine-needle aspiration followed by cytological examination of the aspirate is widely used for the treatment of ovarian cysts. This method allows you to completely preserve the existing follicular reserve, remove the ovarian cyst, and examine its contents without surgery, without anesthesia, without loss of ability to work.

Removal of an ovarian cyst using fine-needle aspiration under ultrasound guidance is performed in an operating room.

Under local anesthesia with a 10% lidocaine solution (6 dose spray), an ultrasound machine with a vaginal sensor and a sterile puncture adapter is used. An ultrasound sensor is used to bring the ovary with the cyst into the puncture line into the lateral fornix of the vagina, and the cyst is punctured through the vagina with a 16G needle.

After inserting a needle into the cavity of the ovarian cyst, aspiration of its contents is carried out with a syringe. A visual inspection of the resulting aspirate is carried out, the quantity is measured and its nature (color, presence of impurities) is assessed. The aspirate must be sent for cytological examination to an oncology clinic.

Forecast. Prevention

The prognosis for ovarian follicular cysts is favorable. This pathology is highly treatable. But you need to remember that cyst recurrence is possible. For this reason, dynamic monitoring of the patient using ultrasound is necessary.

Prevention of ovarian follicular cyst formation includes:

• prevention of abortion and promiscuity;
• timely treatment of inflammatory diseases of the female genital organs and menstrual dysfunction;
• exclusion of stressful situations;
• maintaining a healthy lifestyle;
• regular visits to the gynecologist.