Follicular cyst, is a sac filled with fluid, normally forms at the time of ovulation as a result of mature follicle has become involution or when ovulation does not occur. That means there is a follicle which doesn't rupture or release its egg but instead grows in the ovaries and becomes a cyst. During every month of menstrual cycle About one-fourth of women with this type of cyst experience pain when ovulation occurs,the follicular cyst may rupture, causing severe pain to about one-fourth of women.
1. In most case there is no symptom at all
2. Serve pain in the ovaries' side of follicular cyst.
3. Sharp pain if the cyst ruptures during ovulation.
4. Nervous tension
As a result of the hormone production of the follicular cysts
5. Changes in general metabolism
As a result of hormonal secretion of the cysts
6. Loss of sexual desire
Diagnosis and testes
Ultrasound is one of the most used to document the follicular cyst, following up with monitoring, but sometimes, as to rule out the case of cancer, CT scan and MRI may also be recommended, if the cyst is causing severe pain, or if it is suspicious in any way.
1. Endo-vaginal ultrasound:
If you doctor suspects that you may have develop follicular cysts, he or she may order an Ultrasound to exam your pelvic organs. follicular cysts can be diagnosed based on the images on the ultrasound.
2. CT scan (Computed Tomography scan)
If your ultrasound image has found follicular cysts, your doctor may want to confirm the abnormalities by ordering a CT scan. CT scan generates a large series of two-dimensional X-ray images taken around a single axis of rotation, to create a three-dimensional picture of the inside of the body in details.The pictures are viewed by your doctor to see the extent of the cystic abnormalities.
3. MRI (magnetic resonance imaging)
MRI (magnetic resonance imaging) is one of many advanced technology used to visualize internal structures cross sectional imaging of your body used effectively in providing the better details of the cysts and surrounding areas.
1. Pituitary gonadotropin in the production of follicle-stimulating hormone causes of failure of ovulation of the mature follicle.
2. Failure of ovulation and luteinization.
3. Mature follicle does not ovulate and
4. Incomplete follicular growth of immature follicle.
5. Prolonged congestion of the ovaries as a result of chronic pelvic inflammatory diseases.
6. Formation of too much fluid around a developing egg.
Since most of follicular cysts are harmless, they do not pose a threat to women's health and Usually, the cyst will dissolve itself two or three months. Many doctors suggest to use ultrasonic observation or endovaginal ultrasound to monitor the growth frequently, unless there is absolutely necessary then surgery may be required to remove them depending to severity, size and the concern of fertility of the patient.
A. Pain killer and Oral contraceptive pills
1. At the same time taking pain killer to relieve pain, oral contraceptive pill may be helpful by
a. Creating a continual pregnancy like state, resulting in relieving menstrual pain
b. Inhibiting the over production of prostaglandins which cause the muscles spam contraction.
c. Stopping or reducing of period blood flow.
g. Shrinking the follicular cysts
2. Risks and side effects
a. Growth of fibroids
Growth of fibroid is caused high level of estrogen and progesterone. The intake of the pill increase the level of both hormones resulting in increase the risk of growth of fibroid.
b. Recurrent of menstrual symptoms
Some women stop taking the pill may see all the menstrual symptoms coming back.
c. Blood clots
Estrogen in the pill may cause blood clots in the small vessels in the leg and the lung.
d. Stroke and heart diseases
Study shows that women who have higher natural estrogen levels may have a higher risk of stroke and heart diseases.
e. Depression and mood swing
At the beginning, it may cause abnormal fluctuations in estrogen and progesterone elevate both physical and psychological stress, eventually resulting in both depression and mood swing
f. Bleeding and spotting
Bleeding and spotting is normal for the first six months for women who begin with any oral contraceptive combination pill treatment.
g. Lost of sexual desire
Some women may experience lower sexual desire
Unless there is absolutely necessary, then surgery may be beneficial
a. If the follicular cyst is small in size, has caused severe pain and fertility is a concern, cystectomy with a laparoscopic, may be a good choice as it is an effective treatment of non cancerous follicular cysts by surgical removal.
b. Risk and side effects
Surgical and anesthetic risks
a. Also known as ovariotomy, oophorectomy is a medical procedure to have one ovary removed, if the size has growth too large and cause intensive pain or has become cancerous. After oophorectomy, the woman will continue to have menstrual cycle and can become pregnant and follow up management may be necessary.
b. Unilateral oophorectomy is performed in the hospital with general anesthesia, In the surgery, a laparoscopic, thin tube containing a tiny lens and light that inserts through a small incision in the navel with a camera on the other end to allow your doctor to see the abdominal cavity on a video monitor. After the ovary is detached, it is removed though a small incision at the top of the vagina.
b.1. Vertical incisions
Vertical incisions give the doctor better view of of the abdominal cavity but it will leave some notable scar.
b.2. Horizontal incision
If the ovary is removed by horizontal incisions it will leave a less notable scar.
c. Risk and side effects
Surgical and anesthetic risks
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