Ovarian Cystic Disease
Ovarian cysts are fluid-filled sacs that often form during the course of a menstrual cycle. Ovarian cysts form on or in the ovaries. Usually ovarian cysts are harmless and do not cause much discomfort. Most ovarian cysts form when the follicles are not reabsorbed by the body and instead persist and form cysts. While most ovarian cysts are resolved sans any treatment, some cysts may need to be attended to. Rarely are ovarian cysts life threatening; unless there is danger of rupture and internal bleeding. Most often ovarian cystic disease is benign. A woman suffering from ovarian cystic disease may experience dull pelvic pain, menstrual irregularities and pain during intercourse. If there is any sudden pelvic pain accompanied by vomiting or fever, it is imperative to see a doctor at once. Polycystic Ovarian Syndrome (PCOS) is a condition where there multiple cysts lead to metabolic dysfunction. It manifests in symptoms such as obesity, infertility, acne and excessive body hair.
A pelvic examination and ultrasound will reveal presence of ovarian cysts. Hormone levels are tested for abnormalities. A CAT scan or MRI scan can also aid in diagnosing ovarian cysts. Often ovarian cysts may not need any active treatment. The treatment for ovarian cystic disease hinges on the size of the cysts, its growth pattern and the age of the woman. Use of birth control pills is sometimes recommended to reduce the size and symptoms of ovarian cystic disease. Laparoscopy is used to study the ovarian cysts and sometimes remove them. Cystectomy is the surgical procedure to remove the ovarian cysts without removing the ovary. This done for cysts that persist for more than a few months and grow larger than 6 cms in size. A woman can reduce the chances of ovarian cystic disease with healthy diet and fitness regimen, thereby improving overall health condition.
Ovarian cancer us not easy to detect in the early stages. Often the symptoms of ovarian cancer are easily mistaken for other conditions and unfortunately most cases of ovarian cancer are diagnosed only in the advanced stages. Ovarian cancer is normally observed in women over 40 years. Women who have had endometriosis or undergone infertility treatment such as stimulation of the ovaries are at higher risk of ovarian cancer. Women who have given birth to 2-3 children reduce their risk of developing ovarian cancer as also those who have opted for tubal litigation. A woman who has used oral contraceptives has reduced chances of cancer of the ovaries.
A woman suffering from ovarian cancer is likely to suffer from pelvic discomfort and abdominal pressure and bloating. There is increased need to urinate and unexplained change in bowel habits. The other symptoms associated with ovarian cancer are unexplained weight gain or loss and unusual fatigue. Since most of these symptoms are vague, often ovarian cancer is not detected in the early stages. A patient may feel pain during sexual intercourse and urination.
A gynecologist will conduct a recto vaginal pelvic examination of the patient to trace any irregularity in the shape or size of the ovary. If ovarian cysts or tumors above a specific size are noticed, they are usually removed or a biopsy is conducted for better diagnosis. Trans vaginal sonography helps in detecting ovarian irregularities. It can help in locating the site of the tumor. Blood test CA-125 is also helpful in diagnosing ovarian tumor. Women suffering from ovarian cancer tend to have elevated levels of CA125 in their blood. 'Ovarian Pap Test' consists of a smear of the cells from the ovarian surface that is tested for any abnormalities. Surgery is almost always the first treatment ovarian cancer. Both the ovaries, fallopian tubes and uterus are removed.
Polycystic Ovarian Syndrome
In PCOS, under-developed follicles accumulate in the ovaries. Since they fail to mature, they accumulate as cysts in the ovaries. The low levels of follicle stimulating hormone (FSH) and elevated levels of androgens may be the reasons for this condition. When there is no ovulation, the progesterone hormone is not created and the lining of the uterus is not shed in a timely fashion. This increases the chances of endometrial hyperplasia and even cancer.
Another feature associated with PCOS is hyper androgenism or increased responsiveness to testosterone. This usually shows up in oily skin and acne. Excess hair may be noticed on the face and other parts of the body. Women suffering from PCOS have a weight problem, especially around the waist. Insulin resistance is also noticed in some women. This increases the risk of developing diabetes in later years.
Polycystic Ovarian Syndrome Symptom
High levels of insulin can result in symptoms such as high androgen levels, infertility and lack of ovulation. These symptoms are usually noticed when women are in their 20s or 30s. Diagnosis of PCOS is after a physical examination and laboratory tests. Thyroid and prolactin levels in the blood are tested. Serum levels of male hormones (DHEA and testosterone) are tested for higher than normal levels. Tumors in the ovary or adrenal glands can be diagnosed with vaginal and abdominal ultrasounds. Insulin resistance is vital in the diagnosis of PCOS. Insulin is instrumental in regulating the ovarian function. An ovarian biopsy may also be done.
Treatment for Polycystic Ovarian Syndrome
Treatment for women with Polycystic Ovarian Syndrome depends on what stage of a woman's life this condition has manifested and her fertility desires. Birth control pills are prescribed to regularize the menstrual cycle and reduce the risk of uterine cancer. Other medications used in the treatment of PCOS are flutamide and spironolactone.
Clomiphene induces the pituitary gland to secrete more FSH and this stimulates release and maturity of ova. Insulin resistance is reduced with drugs such as Metformin (Glucophage) and Troglitazone. 'Ovarian drilling' is a process of using laser to place small holes in the ovaries so as to normalize the hormonal environment and allow normal ovulation.
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Bibliography / Reference
Collection of Pages - Last revised Date: February 2, 2023