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Ovarian Cysts


What are Ovarian Cysts?
In many cases, having an ovarian cyst is normal. The cysts in the ovary come from the roughly 150 follicles (fluid sacs) inside the ovary that develop each month. Normally, only one of these follicles develops fully and releases an egg at the time of ovulation. mother_daughter.jpgThe mature follicle becomes what doctors call the corpus luteum. It lasts until menstruation when it gradually diminishes. If a follicle fails to fully discharge the egg, it can become a cyst that can grow, put pressure on the surrounding tissue and, in some cases, burst and bleed. Functional cysts are normal and follow the menstrual cycle. There are two types of functional cysts:

• Follicular cysts occur when the pituitary gland fails to produce its surge of luteinizing hormone (LH), which normally activates the release of the follicle’s egg. Instead the follicle grows into a cyst. Follicular cysts rarely cause pain and most often disappear on their own within a few menstrual cycles.

• Corpus luteum cyst. Once the follicle has released its egg, the mature follicle produces estrogen and progesterone. This follicle is called the corpus luteum. In instances when the follicle fills with fluid (such as blood), other internal bleeding and sharp pain in the pelvic area can result. Non-functional cysts are a result of problems in ovulation and are not considered normal.

What are the symptoms of ovarian cysts?
While functional cysts come and go with the menstrual cycle, non-functional cysts on the ovaries persist and can cause symptoms related to it. One such symptom is pain in the pelvis that usually occurs on the side of the cyst. It is generally a dull pain that can suddenly become extremely sharp and overwhelming in its strength. This happens when the cyst bursts, releasing fluid and blood into the pelvic cavity. The pain can be brief, lasting only a few minutes, or can last up to several days. Bleeding or spotting may occur with these cysts. In some cases, the doctor will detect an elevated testosterone level but this is not consistent. 

What are the causes of ovarian cysts?
Doctors don’t know the exact cause of ovarian cysts. They are felt by some doctors to be related to emotional trauma or to chronic ongoing stress. Problems with hormone imbalances involving the hypothalamus and/or the pituitary gland may cause these cysts to proliferate. Dominance of testosterone and estrogen is also believed to be a contributing factor. Remember, 
internally-derived estrogen. Xenohormones contribute to estrogen by providing the body with excess estrogen from external sources like beef-containing hormones and chemicals like dioxin. 

Traditional Medical Approach: 

There is no good medical way to shrink ovarian cysts. Doctors treat the pain and give antibiotics if infection in a cyst is suspected. Cysts that don’t resolve on their own can be treated by aspirating (sucking out) the cyst or removal of the cyst and possibly some ovarian tissue. A complete hysterectomy might be indicated if cysts have been excessive, painful and if a woman doesn’t desire a pregnancy. This does not correct the underlying problem and should only be done as a last resort. 

Other treatment from conventional doctors may consist of watchful waiting. In this case the patient has follow up examinations and possible follow up pelvic ultrasounds to see if the cyst has changed in size. Birth control pills may also be recommended to reduce the chance of new cysts starting, but in my opinion this does not help balance your hormones. Surgery is another option that conventional practitioners use if the cyst becomes too large. 

Cystectomy is a procedure that removes the cysts without removing the ovary. Remember the ovaries produce estrogen and progesterone, so I always like to see these left in if at all possible. If a cystic mass is cancerous, however, your doctor will advise a hysterectomy to remove both ovaries and your uterus. 

Please read about hysterectomies and make sure you are informed of all the side effects. 

If you experience severe or spasmodic pain in your lower abdomen, accompanied by fever and vomiting, see your doctor. If you have signs and symptoms of shock such as cold, clammy skin, rapid breathing, and lightheadedness or weakness, this may indicate an emergency and require immediate medical attention.

tennis.jpgFunctional Medicine Approaches: 
First, it is very important to get a baseline on your hormone levels. If there is an elevation of testosterone, then there are several ways to decrease this naturally. The beauty of doing an expanded female hormone panel (e FHP) on cycling women is because we will be able to collect 11 saliva samples over the month throughout your cycle. This will then be graphed out so we can see exactly when the hormones are out of sync or in excess in relationship to one another. This is much better than taking a blood test of your hormones on one particular day. The blood test information is useful but not as detailed as the eFHP and gives us a much better picture of how to properly balance your chemistry. 




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