Luteal cyst: diagnosis and treatment
In that case, when the woman discovered the luteal ovarian cyst, surgery is often not required. However, for the normalization of the status of the reproductive system it is necessary to understand the causes of this disease and to take measures to eliminate them.
What is this pathology
Luteal ovarian cyst, or cyst of the corpus luteum, belongs to the category of so-called functional cysts. Its formation is possible only after the genitals in women will happen all of the changes that occur during the menstrual cycle.
The formation of yellow body – physiological process. It is preceded by such stages of the menstrual cycle, as the maturation of one of the ovarian follicles (the dominant follicle) and the output of it into the abdominal cavity. On the spot left the confines of the ovarian follicle, which has already become the egg, and formed yellow body. It is a temporary gland of internal secretion and produces large quantities of the hormone progesterone, which is responsible for relaxation of smooth muscles of the reproductive organs, the formation of the secretory layer of the mucous membrane of the uterine cavity and creating, thus, the most favorable conditions for the attachment of a fertilized egg.
Enough progesterone necessary after implantation of the ovum: the body is trying to rid of foreign inclusions and progesterone prevents the reflex increase motility of the genital organs. So if implantation occurs, the corpus luteum continues its existence until the moment when will be able to take enough formed placenta. The responsibility for the continuation of the yellow body in this case is human chorionic gonadotropin hormone, which was isolated villi of the ovum. Therefore, when pregnancy is the continued existence of the yellow body is the physiological norm.
This is not the case with the death of the unfertilized egg. The level of hormones in a woman’s body is changing, again increases the amount of estrogen and overgrown endometrium begins to gradually reject. Yellow body gets back to normal and disappears. As a rule, the process of resorption begins three weeks after the beginning of the cycle and ends in a few days.
In various pathological processes (often with hormonal disorders) reverse the development of the corpus luteum does not occur or occurs too late. It can accumulate fluid (serous fluid). This pathology is considered a cyst of the corpus luteum.
The main reasons
Violation of the process of maturation and reverse the development of the corpus luteum may be due to hormonal disruptions that result from such factors as:
- psycho-emotional stress;
- physical fatigue, heavy physical load;
- concomitant somatic diseases;
- pathology of the endocrine system (often the decrease in functional activity of the thyroid gland);
- pregnancy and its termination;
- inflammatory diseases of the genital organs;
- hypothermia or overheating of the body at the time of development and resorption of the corpus luteum.
Some experts believe that lead to the formation of cysts can hormonal contraceptives, especially those that contain large amounts of progesterone. Quite often functional ovarian cysts occur on the background of the application progesteronethe intrauterine devices and resolve spontaneously after removal of the contraceptive. However, other doctors believe that the use of hormonal contraception not only increases the risk of functional cysts but significantly reduces it.
Usually luteal cysts do not show subjective symptoms. In rare cases, women have noticed the slight pain of pulling character in the lower abdomen or on one side – depending on in what region of the ovary – left or right – localized cyst. Sometimes the pain becomes more intense during physical exercise or sexual intercourse.
The long-term presence in the ovary of cysts of the yellow body can lead to the disorder of hormonal background. If the corpus luteum continues to secrete progesterone, there is a decrease in estrogen levels and a woman noted intermenstrual spotting from the vagina. It is possible to increase the duration of menstruation, prolonged bleeding spotting after it and change the menstrual cycle.
However, in most cases, luteal cysts do not produce hormones, so their effect on the hormonal background of woman small. In this regard do not exist and objective symptoms of disease. Most often, luteal cysts are detected by chance during an examination for another reason. An objective examination of the patient, the doctor may note an increase in one of the ovaries: one of them – left or right – will exceed the size of the other ovary. But the most reliable and informative method of diagnosis is ultrasound.
When ultrasound determines the size of the cyst, its location and structure. Usually luteal cysts, are those of follicular size and can reach 5 – 6 inches in diameter. Luteal cysts often take the form of other cancer formations, therefore, making a final diagnosis can cause some difficulties.
To differentiate luteal cysts and to exclude other hormone-producing cysts and cyst diagnostic tests, i.e. blood tests for levels of essential sex hormones. If you suspect the presence of malignancy and high risk of its development is performed endoscopic intervention in the abdominal cavity, in which is taken a piece of the diseased tissue for further histological analysis.
Principles of treatment
Within a few cycles (usually two or three) cyst resolves spontaneously, without leaving scarring on the surface of the ovary. Women at statement of the diagnosis it is recommended to undergo ultrasonic inspection every two to three months.
When establishing the likely causes of the cysts are aimed at their elimination. In particular, propeciaus all inflammatory diseases of the pelvic organs, adjusted for endocrine disruption. If the cyst is identified on the background of other signs of disorders of the menstrual cycle or takes a relapsing course (that is, after a certain period of time, it formed again), perhaps the appointment of hormone therapy. As a rule, women of reproductive age who do not intend to pregnancy, is assigned to a combined oral hormonal contraceptives.
Many experts hold the view that when a luteal cyst larger than 6 cm, it is necessary routinely to produce the laparoscopic surgery, and to remove it.
Large cysts create a higher risk of ovarian torsion and rupture of the tissue with subsequent internal bleeding. In practice, however, such tumors are rare.