Ovarian cyst are fluid-filled sacs within or on the surface of an ovary. Many women have ovarian cysts at some time during their lives. Most ovarian cysts present little or no discomfort and are harmless. The majority of ovarian cysts disappear without treatment within a few months. Ovarian cyst — especially those that have ruptured — sometimes produce serious symptoms.
The symptoms of ovarian cyst, if present, may include:
• Menstrual irregularities
• Pelvic pain — a constant or intermittent dull ache that may radiate to your lower back and thighs
• Pelvic pain shortly before your period begins or just before it ends
• Pelvic pain during intercourse (dyspareunia)
• Pain during bowel movements or pressure on your bowels
• Nausea, vomiting or breast tenderness similar to that experienced during pregnancy
• Fullness or heaviness in your abdomen
• Pressure on your rectum or bladder that causes a need to urinate more frequently or difficulty emptying your bladder completely.
Infrequent complications associated with ovarian cysts include:
• Ovarian torsion- Cysts that become large may cause the ovary to move out of its usual position in the pelvis. This increases the chance of painful twisting of your ovary, called ovarian torsion.
• A cyst that ruptures may cause severe pain and lead to internal bleeding.
To identify the type of cyst, your doctor may perform the following procedures:
CA 125 blood test
The treatment depends upon the type/ stage of the cyst; or the presence of complications. Please talk to your gynecologist for treatment options.
Polycystic ovary syndrome (PCOS) is a common endocrine system disorder among women of reproductive age. Infrequent or prolonged menstrual periods, excess hair growth, acne, and obesity can all occur in women with polycystic ovary syndrome. In adolescents, infrequent or absent menstruation may raise suspicion for the condition. Women with PCOS may have enlarged ovaries that contain small collections of fluid — called follicles — located in each ovary as seen during an ultrasound exam.
The exact cause of polycystic ovary syndrome is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications, such as type 2 diabetes and heart disease.
Most gynecologist treat PCOS with a combination of medication and lifestyle changes.
Cancer of the cervix is the most common genital cancer among women worldwide. The best way to detect cervical cancer is by having regular Pap smear. A Pap smear is a microscopic examination of cells taken from the uterine cervix.
A Pap smear can detect certain viral infections such as human papilloma virus (HPV), that is known to cause cervical cancer. Risks factors for cancer of the cervix include the following:
-Multiple sexual partners (or sexual partners who have had multiple partners)
-Starting sexual intercourse at an early age
-Weakened immune system
-Previous cancer of the lower genital tract
Cervical cancer screening by PAP smear is now recommended every 3 years starting at age 21. Screening may be carried out every 5 years for women over age 30 if a Pap smear and HPV test are performed.
Women over age 65 or older who have had three or more normal Pap tests in a row and no abnormal Pap test results in the last 10 years may choose to stop having Pap tests.
A negative or normal test finding means that the cervix looks healthy. All the cells are of a healthy size and shape. A positive or abnormal test finding means that there is something unusual in the sample. The test found cells of a different size and shape. An abnormal Pap smear result does not always indicate cancer. Cells sometimes appear abnormal but are not cancerous. The woman will have to return to the doctor for follow-up care.
An infection of the cervix may cause an abnormal test result. A yeast, trichomonas, chlamydial, or gonorrheal infection can cause the cervical cells to appear inflamed. If the Pap smear result is positive because of an infection, the underlying cause should be treated. The test should then be repeated in 2-3 months, because cancer of the cervix can be hidden by an infection. After the infection is treated, the Pap smear result usually returns to normal. A check-up with a doctor is necessary. A vaccine is now available to prevent HPV infection.
Painful Menses / Dysmenorrhoea
Painful periods are common in teenagers and young adults.
Primary dysmenorrhoea is the most common type of painful periods. This is where there is no underlying problem of the womb (uterus) or pelvis. It often occurs in teenagers and women in their 20s.
Secondary dysmenorrhoea is pain caused by a problem of the womb or pelvis. This is less common, and is more likely to occur in women in their 30s and 40s.
The main symptom is crampy pain in your lower abdomen.
May spread to your lower back, or to the top of your legs.
Usually starts as the bleeding starts, but it may start up to a day before.
Usually lasts 12-24 hours, but lasts 2-3 days in some cases.
Can vary with each period. Some periods are worse than others.
Tends to become less severe as you get older, or after having a baby.
The following may indicate secondary dysmenorrhoea:
If you have a change in your usual pattern of pain. For example, if your periods become more painful than they used to be, or the pain lasts longer than it used to. In some women with secondary dysmenorrhoea the pain starts several days before the period begins, and lasts all the way through the period
Other symptoms may include.
Bleeding between periods.
Pains between periods.
The bleeding becomes heavier than previously.
Pain during sex.
It is important to differentiate between the primary and secondary dysmenorrhoea; the treatment depends on the underlying cause. Supportive care and Anti-Inflammatory medication help control the severity of symptoms.
Excessive Bleeding/ Menorrhagia
Menorrhagia is defined as menstruation at regular cycle intervals but with excessive flow and duration. Clinically, menorrhagia is defined as total blood loss exceeding 80 mL per cycle or menses lasting longer than 7 days.
Young patients, from menarche to the late-teen years, most commonly have anovulatory bleeding due to the immaturity of their hypothalamic-pituitary axis.
Women aged 25-50 years may have organic or structural abnormalities. Uterine Fibroidsor polyps are frequent findings.
Postmenopausal women with any uterine bleeding should receive an immediate workup for endometrial cancer.
Pregnancy should be excluded before further testing or medications are advised.
Other differential diagnoses must be kept in mind while assessing a patient with menorrhagia
Investigations : Pelvic ultrasound is the best noninvasive imaging study to assess uterine shape, size, and contour; endometrial thickness; and adnexal areas.
Successful treatment of chronic menorrhagia is highly dependent on a thorough understanding of the exact etiology. Treatment must be individualized based on the cause of bleeding.