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Cyster in the ovaries

Questions:

Dear network doctor

I am a 34-year-old woman who has been suffering a lot of cysts in her abdomen in the last 4 years.

In 1998 I was admitted because of violent pain in the abdomen that led up under the shoulder blade. (it was not a pregnancy outside the abdomen) It ended with going to the floor because of pain. I was hospitalized and examined. I was made a laparoscopy where they could see that there was a broken cyst that there was blood in the abdominal cavity, which was then sucked away.

I still have pain because of cysts, but they fail themselves. I think it's about to be very busy with pain every month, even though I know what it is. Can anything be done to get rid of the problem. A friend was about to mention that if the ovaries were removed, I was out of the problem. Is it correct and is that the solution?

I hope you can help me a little bit.

Yours sincerely, Solveig

Reply:

Dear Solveig

Cysts in the abdomen are located to the ovary - right, left or on both sides. A cyst is usually a liquid-filled room. Cyster can also have a more massive content or be blood-filled. Some of them are benign, others - fortunately, rarely - malignant. Cysters can get very big without notice. Even cysts of 4-5 cm in diameter may not necessarily feel. However, in the case of gynecological examination, it is probable that such a relatively large cyst will be detected. Safe assessment of cysts is best done by ultrasound scanning - even cysts measuring less than one centimeter in diameter can be diagnosed in this way. Only when cysts are more than 3-4 cm are they significant.

In childbearing age, women develop so-called follicle cysts / egg blisters against ovulation. Before ovulation occurs, such cysts are 20-25 mm in diameter. They come and go. A cyst may burst spontaneously and, as in your case, may cause severe pain in the abdomen. This is due to a reaction from the peritoneum that becomes irritated, almost as experienced by for example appendicitis. In some cases, a less sore bleeding occurs when a cyst is broken. In other cases, the cyst, as in your situation, contains blood. During surgery, it may be necessary to remove the cyst and there is also a certain risk that larger or smaller parts of the ovary itself will be removed. In some cases, both are removed.

Removing the cyst and what it is in the acute situation can of course solve an immediate problem, but does not guarantee that new cysts can not occur, nor does it always tell you what the cause of cyber formation has been. Cysts that contain blood may be endometriosis. In this disorder, tissues of the same type found inside the uterus are passed outside and can - with hormonal effects - cause themselves to bleed. Endometriosis may be a cumbersome condition that may require special attention and treatment.

Whether you have children or not, you will be reluctant to remove the ovaries in a 34-year-old woman who, by the way, does not fail anything. If you do, you will automatically suffer from hormone deficiency, probably with severe transition symptoms that will require hormone replacement. There is no way to get it if necessary, but the ovaries must be in a bad condition or contain changes of serious nature before doing so. I do not think that's the solution for you.

I would suggest talking with your doctor or the doctors who worked in your time to explain what the reason may be for a cyst and what it contained besides blood. If you have endometriosis, you may need special treatment for this. In any case, it may be a good idea to regulate the hormonal balance and bleeding. If nothing speaks against, birth control pills might be a good idea.

Yours sincerely

Erik Fangel Poulsen

specialist in gynecology


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