Ovarian Cyst. Homoeopathy Clinic. Introduction. Types of Ovarian Cysts. Contents. Case Reports. 21 August 2002

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1 Case Reports 21 August 2002 Ovarian Cyst Homoeopathy Clinic Check Yourself If you have any of the following symptoms call your doctor. Sense of fullness or pressure or a dull ache in the abdomen Pain during intercourse Painful, irregular or delayed periods Swelling of the lower abdomen, usually firm and painless Sudden, sharp pain in the lower abdomen Severe and sudden abdominal pain with a fever and sometimes vomiting Contents Introduction 1 Types of Ovarian Cysts 1 Types of Functional 2 Symptoms 2 Causes 2 Risk Factors 3 Diagnosis 3 Case Report 3 Introduction Ovarian cysts are sacs filled with fluid or semi-solid material that form in the ovaries or on their surface. They may occur as the result of normal ovarian functions, or they may be abnormal growths. The majority of ovarian cysts are benign and cause no symptoms, but some may cause pain, abnormal menstrual bleeding, and irregular menstrual periods Ovarian cysts or functional ovarian cysts, are quite common and occur normally on a monthly basis with each menstrual cycle. A cyst will form on the ovary in the location where the ovum (egg) is released from the ovary in the process of ovulation. Occasionally, at the middle portion of the cycle, a cyst can enlarge and/or rupture causing pain. They're rare in women who have reached menopause. Ovarian cysts are usually NOT a form of cancer. The normal function of the ovaries is to produce an egg each month. During the process of ovulation, a cyst-like structure called a follicle is formed inside the ovary. The mature follicle ruptures when an egg is released during ovulation. The corpus luteum forms from the empty follicle and if pregnancy does not occur, the corpus luteum dissolves. Sometimes this process does not conclude appropriately causing the most common type of ovarian cyst -- functional ovarian cysts. Types of Ovarian Cysts 1. Functional Cysts: These normal cysts will often shrink and disappear within two or three menstrual cycles. Because this type of cyst is formed during ovulation it rarely occurs in menopausal women because eggs are no longer being produced. 2. Dermoid Cysts: Ovarian cysts which are filled with various types of tissues including hair and skin. 3. Endometrioma Cysts: These cysts develop in women who have endometriosis, a condition in which tissue from the lining of the uterus (endometrium) grows in other areas, such as on the fallopian tubes, the ovaries, and on other organs outside of the uterus in the stomach. These may be filled with a thick, brown blood and so also are called "chocolate cysts." Because uterine tissue is sensitive to hormones, it bleeds monthly, which may cause it to form a growing cyst on the ovary. These cysts can be painful during sexual intercourse and during menstruation. 4. Cystadenoma Cysts: These are ovarian cysts which develop from cells on the outer surface of the ovaries 5. Polycystic Ovarian Disease: Cysts that form from a buildup of follicle cysts which cause the ovaries to thicken. These cysts cause the ovaries to enlarge and create a thick outer covering which may prevent ovulation from occurring and are often the cause of fertility problems. The most common cysts found are the functional cysts. A functional cyst can be one of four types and are not malignant: follicular, corpus luteum, theca luteum, and polycystic ovaries.

2 Case Report Page 2 Types of Functional Cysts A follicular cyst occurs when the normal follicle, or sac that matured to release an egg, does not shrink after release of the egg. These are soft, have thin membrane walls, and contain clear fluid. These can rupture, causing sudden, severe pain which gradually goes away over several days. Usually, however, they spontaneously disappear over the course of one or more menstrual cycles. They can cause changes in your periods and pelvic pain. Depending on the size of the cyst, it can just be observed or treated with birth control pills. Corpus luteum cysts are less common, but cause more symptoms and problems. They become larger than follicular cysts, thus causing more pelvic pain. They result when bleeding occurs in the follicle after an egg is released. This type of cyst often causes a delayed period and if it ruptures, can cause bleeding into the abdomen which may necessitate surgery. Theca luteum cysts, the least common of the functional cysts, are often associated with an abnormal pregnancy. They most often occur in both ovaries, unlike the functional cysts described above. They disappear without treatment after the pregnancy is terminated. Polycystic ovaries are multiple clear fluid filled cysts in both ovaries and are associated with menstrual problems and hormone imbalances. Symptoms Common symptoms include one-sided lower pelvic pain (or lower abdominal pain), often radiating to the back. Cysts also may make your periods very painful. Pain is usually increased with intercourse, resulting in its frequent confusion with pelvic inflammatory disease. Nausea may also occur. In most cases, pain abates within 3 days. In more serious cases, a ruptured ovarian cyst may result in more pronounced internal bleeding, manifesting with the signs and symptoms of shock, and/or heavy vaginal bleeding. The cysts also may put pressure on the urinary tract and cause problems with urine flow. When are women most likely to have ovarian cysts? Most common during the childbearing years. Most often, cysts in women of this age group are not cancerous. Women who are past menopause (ages 50-70), however, and have ovarian cysts, have a higher risk of having ovarian cancer. If you are over 50 and have an ovarian cyst, your doctor will probably want to do surgery to remove it. However, if you think you might have a cyst, at any age, you should tell your Doctor. Causes The various causes of Ovarian Cysts are: Disordered folliculogenesis Hormonal imbalances Ovarian cancer Metastatic cancer Smoking (?) Body mass (inversely related to the existence of functional cysts) Early menarche Infertility (4-fold increase) Hypothyroidism Neonatal cysts (increased frequency in babies of mothers with diabetes, toxemia, and Rh immunization)

3 Case Report Page 3 Risk Factors The various risk factors are: A late onset of menarche is a protective factor concerning ovarian cysts. A history of previous ovarian cysts with symptoms should be correlated with the current presentation and symptoms. A history of infertility points to a 4-fold increase in the incidence of ovarian cysts. A history of oral contraceptive usage tends to decrease the incidence of cysts. Tamoxifen treatment for breast cancer is associated with a 10% increase in the incidence of cysts. Smoking is a controversial risk factor; some studies show no increased incidence of cysts among smokers, while other studies show up to a 2-fold increase in the incidence of cysts are found during routine pelvic examinations. Diagnosis Ovarian cysts usually are found during routine pelvic examinations. Other diagnostic tests such as ultrasound and laparoscopy, may be done to detects any abnormalities. Case Report A female patient aged 17 yrs was diagnosed to have a ovarian cyst in the right ovary on at Lilavati Hospital, Mumbai, India. The main complaint of the patient was painful and irregular menstruation. The attending doctors advised the patient to go for HORMONAL TREATMENT. The parents of the patient, however, not agreed to this and hence approached Homoeopathy Clinic, Mumbai for the treatment. Accordingly on the basis of the diagnosis and her symptoms homoeopathic medicine: Thuja 30 was prescribed for 3 months. There was however, no remarkable improvement. As such patient was put on tablets Klimaktolan One TDS for 3 months. After this duration patient reported no symptoms of the said problem. To verify cliniclly again a USG was done at same Hospital, showing conformation of the results. At present the patient is without any medication and she does not have any complaints. The tests reports along with the Homoeopathic Prescriptions are included in this document. The Klimaktolan is a trademark of Dr. Willmar Schwabe India, Pvt. Ltd. The composition of the tablets(250mg) are as under: Cimicifuga D2 25 mg, Sepia D2 25 mg, Lachesis D5 25 gm, Ignatia D3 25 mg, Sanguinaria D2 25 mg.

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