Ovarian cyst- causes, symptoms, diagnosis, treatment, pathology
Possible causes of ovarian enlargement
Enlarged ovaries are considered by many women a sign of developing gynecological disease. Unfortunately, in most cases this is true, but this condition can be a variant of the norm.
If the increase is not accompanied by other symptoms, then the woman may not know about her illness, and in the meantime, she progresses and becomes chronic.
Causes of an enlarged ovary
It should be noted that the right ovary is more often affected. Why this happens is difficult to say. The most common provoking factor is pelvic inflammatory disease. The infection is often asymptomatic and becomes chronic.
The increase occurs due to the formation of adhesions and infiltration, and not due to the growth of the organ itself. With a severely advanced pathological process, the doctor cannot palpate the uterus and ovary separately.
Inflammation and, accordingly, an increase can be triggered by erosion of the cervix. In this disease, a relatively small area of the organ is injured, but pathogenic microflora joins it, as a result of which inflammation appears that can reach the uterine appendages.
This can happen due to cysts if they exceed 3 cm in diameter. It is possible to determine the presence of a smaller neoplasm only with the help of an ultrasound scan. It is almost impossible to detect a small cyst on palpation.
The reasons for the increase may be hidden in cancer of the pelvic organs. However, only greatly enlarged organs can be palpated, that is, in the later stages of the disease. The cause may be metastases from other organs.
The time of ovulation is the most harmless reason. In this case, the increase in size is temporary and will go away on its own after a few days.
What to do in this case? First you need to see a doctor. He can prescribe such procedures as transvaginal and transabdominal ultrasound, assessment of hormonal levels, thyroid function, STIs.
Why the ovary is painfully enlarged during inflammation
Oophoritis is an inflammation of the paired sex glands. It is often accompanied by salpingitis, an inflammation of the fallopian tubes. Inflammation can be unilateral or bilateral.
The causes of inflammation can be associated with opportunistic and pathogenic flora: chlamidia, Trichomonas, gonorrhea, mycoplasma, tuberculosis; streptococci, staphylococci, candida, Escherichia coli, etc. The provoking factors are also: childbirth, hypothermia, abortion, use of the IUD, diagnostic / surgical manipulation of the genitals. Often the infection spreads to the glands from the cervix, fallopian tubes, less often - through the blood and lymph (with tuberculosis, sore throat, appendicitis, caries, etc.).
With inflammation, the ovary is painful and enlarged, but other symptoms are also present: discomfort when urinating; temperature rise; bleeding between periods; pain during sex; profuse purulent / serous vaginal discharge.
With chronic inflammation of the ovaries, slightly different symptoms are observed: dull, aching pains before the onset of menstruation, with a cold, hypothermia; decreased libido; scanty but persistent leucorrhoea; cycle disturbances; inability to get pregnant even with regular sex life; paired glands are slightly enlarged, sensitive to palpation.
The doctor should conduct a standard gynecological examination, study the history, send for blood tests, urine, ultrasound, take a smear from the vagina.
You may also need PCR analysis, bacterial culture, RIF and ELISA, laparoscopy, hysterosalpingoscopy. Treatment depends on the cause, stage of the disease, and the symptoms present. Acute inflammation requires a hospital stay.
In the early days, the patient needs painkillers, antibiotics, sulfonamides, and fortifying drugs. Physiotherapy procedures are prescribed with caution. In case of chronic course, balneotherapy and physiotherapy are prescribed.
If the increase occurs against the background of a bacterial infection, penicillin and aminoglycosides are prescribed; in the presence of anaerobic flora - metronidazole. In mild cases, antibiotics can be given orally, in other cases - intramuscular injections. At the same time, antihistamines are prescribed (suprastin, diphenhydramine, etc.).
What is the diagnosis of polyxitosis when the ovaries are enlarged?
Polycystic disease can occur as an independent disease or against the background of other pathologies.
It is spoken of in the following cases:
- Confirmation based on ultrasound results;
- Scanty, irregular periods, or their absence for six months;
- Increased concentration of androgens in blood plasma, clinical signs of hyperandrogenism (pr. male pattern hair growth).
The disease is accompanied by a decrease in the production of follicle-stimulating hormone. As a result, the follicles produced by the sex glands do not form into mature eggs. Since the latter are absent, ovulation does not occur, and hence pregnancy. Even if you allow the full maturation of the follicle, it still will not be able to leave and ovulate, because the ovaries increase in size and are covered with a dense capsule.
When the ovary is enlarged with polycystic,treatment can be conservative and surgical with an enlarged ovary. In the first case, hormonal drugs are used that promote the development of follicles and ovulation. The conservative technique is mainly aimed at reducing clinical manifestations (excessive hair growth, acne).
Taking oral contraceptives for several months in half of cases of the disease allows you to restore ovarian function, ovulation occurs and pregnancy becomes possible. Hormone therapy is also used when a woman is not yet planning a pregnancy. Otherwise, when its goal is to have a baby, ovulation is stimulated for several months.
With obesity, efforts are directed to weight loss. It happens that such a measure is enough to restore reproductive function.
Surgical intervention involves the removal of an enlarged ovary or the destruction of that part of it that synthesizes androgens. The effect of the operations is short-term, so if you want to get pregnant, they do it in the next couple of months. It is recommended to carry out laparoscopy, since after it the risk of adhesions and other complications is significantly reduced than after laparotomy.
Enlarged follicles in one or both ovaries
In this case, we are talking about such a diagnosis as multifollicular ovaries. This means that many enlarged follicles have appeared in the paired glands.
What is this state?
Normally, a week after the start of the cycle, a woman forms 4-7 follicles, of which 1 or 2 mature, but sometimes much more - 8-12. It is in the latter case that such a diagnosis is made. Enlarged follicles are normal and do not interfere with ovulation and pregnancy. Do not confuse this concept with polycystic disease.
In the latter case, the volume of the gland itself increases 2 times, its capsule thickens, along the periphery under it there can be more than 10 follicles with a diameter of 1 cm.With multifollicular ovaries, the picture is similar only externally: the volume of the gland remains unchanged, only the number of follicles increases, with this rarely changes in the hormonal background.
Enlarged follicles can appear against the background of prolonged use of hormonal drugs, lactation, stress, a sharp drop in weight, and disorders in the endocrine system. Usually these appear when the cycle is disturbed, often accompanied by amenorrhea and oligomenorrhea, but in this case the syndrome acts as the initial stage of polycystic disease.
To exclude additional pathologies, an analysis is prescribed for luteinizing, follicle-stimulating hormone, testosterone and insulin. Therapy is required only if ovulation is disturbed. It consists in normalizing hormonal levels.
It should be noted that such a condition does not prevent conception and successful bearing of a child. They can only pose a threat if hormonal levels are disturbed.
Take care of your health and do not self-medicate!