Follicular cyst after childbirth. The development of cystic education after childbirth and during lactation

A cyst is a cavity formed in the ovary filled with liquid contents. In order to understand how it arises, one must have an idea of \u200b\u200bthe structure and function of the ovaries.
   Even during the intrauterine development of the girl, about 2 million of the smallest vesicles, follicles, are laid in her ovaries. Inside each of them is an embryo egg. By the time of puberty, 200-400 thousand follicles remain in the ovaries, the rest undergo reverse development.
   Under the influence of hormones that control the work of the ovaries, one or more embryonic follicles begin to mature and grow. From the group of growing eggs, one is randomly selected, growing more actively. It will turn into a mature follicle, carrying in its wall an egg that has matured to exit the ovary and produces sex hormones - estrogens, androgens and, to a lesser extent, progesterone. Under the influence of hormones, a ripe, significantly increased follicle ruptures, and the egg enters the abdominal cavity. This occurs in the first phase of the menstrual cycle - follicular. The flow of fluid from the ruptured follicle directs the egg into the funnel of the fallopian tube. In the fallopian tube, under favorable conditions, fertilization occurs. And on the site of the ruptured follicle, a yellow body forms, so called because of the yellow, or luteal (luteus in Latin "yellow") pigment contained in it. It is produced by the same cells as the hormone progesterone, which provides the second - luteal - phase of the menstrual cycle. Corpus luteum progesterone not only promotes fertilization, but also supports pregnancy until the placenta begins to fully function. If fertilization has not occurred, the corpus luteum lives in the ovary for 10-14 days, and the production of progesterone in it gradually decreases. When it falls below a certain level, menstruation occurs, or, as obstetricians sometimes say, "the uterus cries with bloody tears after an aborted pregnancy." The first day of bleeding is the beginning of the growth of a new group of eggs, the beginning of a new cycle.
   This is normal, ideally.

Slight deviations from the norm

But in our body, rarely everything happens perfectly. Especially now, when the ecological situation leaves much to be desired, and many women use drugs excessively and unjustifiably, especially antibiotics and hormones. Therefore, in young women of childbearing age, ovarian function is increasingly impaired, cycle failures occur. For example, an egg "freezes" in the stage of incomplete ripening. And stopped at a certain stage of development of the follicle due to increased production of female hormones by its cells, it turns into a follicular cyst, which sometimes can reach 6 cm in diameter. The egg does not exit the ovary, the endometrium - the mucous membrane that lines the uterus from the inside - does not mature and menstruation is delayed for 10-15 days. Or another option: the corpus luteum, instead of "quiet, calm wilting," begins to develop rapidly, actively produces progesterone and, due to its abundance, is converted into a luteal cyst.
   Cysts, the formation of which occurs during the functioning of the ovary (which is why doctors call them functional), do not need surgical treatment. After the death of the egg or corpus luteum, such cysts dissolve and the changed menstruation occurs (more abundant than usual, or more scarce, or longer smearing blood discharge from the genital tract).
   Functional cysts are diagnosed mainly by ultrasound, and sometimes a second examination is required in the first and in the second phase of the cycle. If such a patient is examined for an ultrasound after menstruation, then there will be no ovarian cysts. If, after menstruation, the cyst persists, diagnostic measures will have to be continued, best of all - with the help of laparoscopy, the most sparing surgical method in which the abdominal wall incision is minimal and the diagnostic possibilities are significant.
   If your period is delayed, you need to make sure that you are not pregnant with tests and ultrasound. If a woman is not pregnant, doctors in some cases medically stimulate the onset of menstruation.
   If bleeding develops instead of regular menstruation as a result of ovarian dysfunction, then it is recommended that diagnostic and curettage curettage be done to remove excessively grown mucous membranes.

ADVERSE OPTIONS

True, non-functional ones, i.e. not associated with the function of the ovaries, cysts (essentially an ovarian tumor). There are several options for true ovarian cysts. They differ in structure, growth rate, propensity for malignancy (some from this point of view are practically not dangerous, while others, on the contrary, are especially aggressive).
   The reason for the formation of true ovarian cysts is still unknown, but one of the “persistent” hypotheses is a violation of the ratio of the pituitary hormones that regulate the operation of the ovaries, luteinizing (LH) and follicle-stimulating (FSH), the release of which, in turn, is regulated by the central nervous system. Constant stresses, strict diets for losing weight, a large number of genital infections, often affecting the uterus, are all factors that affect the functioning of the ovaries. A large number of ovarian tumors are detected in women older than 40 years: it is at this age that restructuring occurs in the system that regulates the ovaries.
   These cysts are subject to exclusively surgical treatment, since they represent an oncological danger. Therefore, if the ovarian cyst is re-detected by ultrasound, the doctor will offer the patient a more thorough diagnosis and, if necessary, prompt removal of the cyst. Optimally, if the diagnosis is carried out using laparoscopy.
   In some cases, the disease is asymptomatic and is detected by chance at the next visit to the gynecologist, in others, the formation of a cyst is accompanied by obvious signs of distress.
   An example of ovarian tumors that a woman may suspect on her own can be hormone-active ovarian cysts. Some of them come from tissue that is close in structure to the male testicles, therefore, during their development and existence, they secrete male hormones, changing the face of a woman, making her look like a young man. Unfortunately, these tumors are almost always malignant. Among hormone-active cysts, there are also those that secrete female hormones in large quantities. As a result, girls begin premature puberty. In women of childbearing age, the menstrual cycle changes, erratic bleeding occurs associated with excessive growth of the uterine mucosa, because female hormones contribute to the development of this tissue. In older women, the body seems to be rejuvenated, menstruation returns. This variant of the cyst also poses a serious danger.

WHAT YOU SHOULD PAY ATTENTION TO

The leading symptom of cysts is pulling pains in the lower abdomen and lower back, associated with the fact that the cyst stretches the capsule of the ovary, irritating the sensitive nerve endings in the peritoneal pelvic membrane. If you are concerned about pain, consult a doctor. If there are signs of the influence of male hormone - increased hair growth on the face and body has begun, acne has appeared, hair has become greasy - you will also need to consult a specialist. The reason for the examination should be an irregular menstrual cycle. In this case, the doctor will definitely give you an ultrasound referral.
   Often due to a careless attitude to her health, when a woman neglects regular visits to the gynecologist, the tumor is detected late. Therefore, even if you have no complaints, you need to undergo an examination by a gynecologist at least once a year.

Ovarian cysts in pregnant women

With the onset of pregnancy, progesterone is needed more and more, because it is necessary to maintain pregnancy until the formation of the placenta. Therefore, during pregnancy, the corpus luteum does not live for 10-14 days, as in the menstrual cycle, but for three whole months. Sometimes the corpus luteum of the pregnancy is converted into a luteal cyst, which is a sign of increased ovarian function. As already mentioned, this is a functional, temporary formation. After 12-14 weeks, the placenta takes on the production of progesterone and some other hormones, and the cyst dissolves on its own.
   There is no follicular cyst during pregnancy, prolactin prevents the development of follicles (this explains the impossibility of a new pregnancy on the background of an existing one).
   Thus, if you have an ovarian cyst during an ultrasound scan in the first trimester, then this is most likely a luteal cyst formed due to the strong need for pregnancy hormone - progesterone. Nevertheless, the woman will be prescribed a re-examination between the first and second trimester to exclude a true tumor.

Follicle overheating is the most common cause of the development of this disease in nursing mothers. The follicle is the formation within which the egg matures. When it does not burst, but is filled with fluid, it degenerates into a cyst. Although there are several types of ovarian cysts, a follicular cyst is much more common than others.

To make it as clear as possible: an ovum ripens in the follicle, ripens, the follicle breaks, releases the female reproductive cell outward, and itself is reborn into the so-called yellow body, which may be needed if conception occurs. If the follicle remains in the ovary and does not rupture, but instead is filled with fluid, this condition is already considered a disease and is called a cyst. Most often, the cyst will resolve itself by the next menstruation, however, there are times when it begins to grow in size and thereby create problems.

Causes of other ovarian cysts:

• functional neoplasm appears due to the fact that the corpus luteum expands;
• a hemorrhagic cyst appears due to the fact that a rupture of blood vessels occurs in the follicle or corpus luteum;
• a deontogenetic cyst occurs due to the underdevelopment of the ovaries (such a neoplasm is characteristic of puberty).

Symptoms

Most often, the occurrence of ovarian cysts during lactation goes unnoticed. The neoplasm appears on the internal organ of the nursing mother and disappears by itself. The representative of the fair sex herself is not even aware of what is happening inside her. However, it also happens that the development of the disease is accompanied by one or more symptoms from the list below:

• acute pain in the lower abdomen,
• pelvic pressure sensation
• protracted spasmodic pain during menstruation (if they have already begun with a nursing mother),
• nausea,
• the occurrence of a gag reflex,
• a feeling of pressure at the time of the chair (whether going to the toilet in a small or big way).

If any of the signs listed above is combined with one or more of the signs listed below, then you must urgently seek help from a medical specialist:

• fever above thirty eight degrees,
• the appearance of dizziness,
• feeling of total weakness
• growth of the abdomen,
• the appearance of hair in the face (like men), constant thirst and plentiful trips to the toilet in a small way,
• lump in the stomach, which the nursing mother felt and felt on her own,
• severe weight loss for unknown reasons.

Diagnosis of ovarian cysts in nursing

It is unlikely that a nursing mother will be able to guess that a cyst appeared on her ovary. Firstly, after childbirth, the head of the fair sex is occupied by completely different things. And secondly, the cyst does not manifest itself in any way, and this complicates the diagnosis - all the more independent, amateur, produced at home. The only exception is the ovarian cyst, whose leg is twisted. In this case, the patient will feel acute pain, which is similar to pain with appendicitis.

• If torsion of the legs is absent, then only a gynecologist will be able to detect a neoplasm. In the case when a medical specialist has any suspicions, he sends his patient to an ultrasound scan. An ultrasound examination of the small bodies of the nursing mother will determine whether a cyst is present or the doctor made a mistake in his assumptions.
• Also, as a diagnostic method, doctors use a blood test for hormones.
• Cases that are characterized as particularly severe require laparoscopy. This diagnostic procedure is based on the following algorithm: the doctor makes several punctures in the patient’s peritoneum, special medical optics are introduced into the abdominal cavity of the nursing mother through the created hole. The device allows you to see an enlarged image of all internal organs.

Complications

Complications are fraught with those neoplasms that live longer than three months, and those that are of impressive size:

• bleeding from the neoplasm cavity;
• violation of cystic integrity (in simple words - rupture of the walls of the tumor);
• torsion of cysts and, as a result, peritonitis and death.

Treatment

What can you do

If you suspect something is wrong with your own health, you need to seek medical help as soon as possible. Many representatives of the fair sex believe that folk remedies can help them in this matter better than traditional medicine. But unfortunately, no effective method of treating cysts with folk remedies currently exists. A nursing mother should understand that in this case, self-medication is dangerous not only for her health, but also for the health of the growing person whom she is feeding. Therefore, do not self-medicate: only a specialist will be able to make the correct diagnosis and give an adequate assessment of the disease.

What can a doctor do

• If the cause of the appearance of the cyst is hormonal failure, then the doctor prescribes hormonal drugs to the nursing mother. However, as a rule, if it is possible to wait and not start treatment before the end of the lactation period, the medical specialist chooses this path.
• If the neoplasm appeared due to the development of inflammation, doctors use physiotherapy, antibiotic drugs and vitamins.
• The elimination of neoplasms on the ovary is performed using laparoscopy.
• If the cyst is too large and it is impossible to remove it using laparoscopy, the doctors perform abdominal surgery

Prevention

Preventive measures in this case are extremely simple:

• passing a planned examination by a gynecologist (especially in the postpartum period);
• regular examinations in case paraovarian or follicular cysts have already occurred;
• refusal of a sunbed (at least, from frequent visits there) and long stay in direct sunlight.

anonymously

Hello. I am 25 years old, there were 2 cops, now I am breastfeeding (1.6 years old child). I did an ultrasound scan at 7 d.c., the conclusion: education (cyst? With heterogeneous contents) in the right ovary. She passed tests for hormones at 5 d.c., everything except prolactin (because I breastfeed) and progesterone (he was told to pass in the second phase). LH 7.06 (fol.f. 1.1-8.7), FSH 7.23 (fol.f. 1.8-11.3), testosterone 0.96 (0.2-4.3), DHEA-S 3.49 (0.8-3.9), cortisol 381.5 (morning 150-660 nmol / L), estradiol 42.0 (fol.f. 30-150), 17-hydroxyprogeserone 3.48 (fol.f. 0.2-2.4). In general, irregular periods (delays) are of concern and often pulls the lower abdomen (mainly on the right somewhere in the pubic area), although I always attributed this to cesarean sutures, the temperature also sometimes rises to 37-37.5. There are problems with the thyroid gland - a cyst of the right lobe and a node according to the last ultrasound (I did 9 months ago), but the hormones were in order (I donated the last time in September-October). I’m not going to see a doctor soon, unfortunately. I want to find out from you this: can an excess of hormones (17-hydroxyprogesterone) pass into breast milk? How can this affect a child? And yet, what treatment is provided in my case? Only hormonal or can some kind of homeopathy be harmless? In general, will it be necessary to complete the guards, most likely? And yes, do you advise any other examinations before going to the doctor? Thank you in advance for your reply.

Good afternoon. In your question, I was most concerned about the indication of a temperature increase. Maybe this is a chronic inflammatory process, mistaken for an ovarian cyst, or maybe mastitis. Also, the temperature may increase with thyroid disease. Irregular menstruation can be due to lactation and against a background of chronic inflammation. Continue breastfeeding, hormones will not pass to the baby. Do not use any treatment now, without finding out the reason, this also applies to homeopathy! Donate blood for Ca-125, a blood test, and be sure to consult a gynecologist to prescribe treatment and select a method.

A consultation with a gynecologist on the topic “Ovarian cysts during breastfeeding” is given for reference purposes only. Following the consultation, please consult a doctor, including to identify possible contraindications.

About the consultant

Normally, a woman has two ovaries, in which the eggs are located and from where they subsequently enter the uterine cavity. The ovary is similar in size to walnut and is located from the uterus. Each month, it releases one egg, which is located in a membrane called the follicle.

A dermoid cyst often develops in young people and can reach 15 centimeters in diameter. Such a cyst is best examined using computed or magnetic resonance imaging, because it has the ability to inflame and twist, causing severe pain in the abdomen.

Endometrioma and endometrioid cysts appear when cells of the inner layer of the uterine walls enter the ovaries. This disease is also characteristic of childbearing age. It is accompanied by chronic pain.

Cystadenoma is a benign tumor that is formed from the ovarian cells themselves. Sometimes, they are filled and can reach a diameter of 30 centimeters.

After 50 years, a benign formation on the ovary can turn into a malignant one, therefore it is necessary to carefully monitor your health.

Causes of ovarian cyst formation

The most important reason is hormonal changes in the female body. Associated, they can be with severe nutritional restrictions (diets), overweight, frequent stress, smoking or climate change.

A secondary cause of the disease is gynecological interventions. As a rule, these include abortion, childbirth, a cesarean section, as well as the use of an intrauterine device as a means.

Excessive physical exertion, overwork, early sexual activity or prolonged abstinence and frequent changes in sexual partners increase the risk of developing a disease such as an ovarian cyst.

Based on the foregoing, we can conclude that childbirth is not a direct cause of the development of ovarian cysts, but if all the negative factors add together, then a woman after childbirth increases the risk of developing this disease.

Most organs and systems of the female body change their structure and their functions during the period of gestation. After the birth, the reverse process takes place, however, such recovery requires a certain time.

It was during this period that many patients turned to the antenatal clinic with complaints of various disorders and discomfort in the pelvic area in the postpartum period. Quite frequent complaints include ovarian pain.

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The average recovery time after childbirth

According to the majority of domestic and foreign authors, a young mother usually needs from 6 to 10 weeks to complete a baby after giving birth. The duration of this period depends on how the pregnancy progressed, whether there were any complications in childbirth.

If the patient underwent a cesarean section, then the period of involution may be longer. Even a sick leave list for such wards of gynecologists who have undergone pathological births is given for a significantly larger number of days.

The reverse process occurs in almost all the organs of a woman, excluding the mammary glands and the hormonal system. This is due to the fact that the lady's body is being rebuilt to successfully feed.

First of all, such a restructuring concerns the internal genital organs of the patient, especially the uterus. For 7 - 8 weeks, the female reproductive organ decreases in size by almost 10 times, which can not but affect the health of the mother.

Often during this period, girls complain of pain in the pelvic area of \u200b\u200bvarying intensity, aggravated while feeding the baby. Many patients believe that it hurts the ovaries, however, they are mistaken. Most often, the hormone oxytocin causes painful sensations, which not only stimulates lactation, but also enhances contractions in the postpartum uterus.

The rate of normalization of the functioning of the ovaries directly depends on the hormonal background of the woman, while the main condition is whether the mother is breastfeeding or not. If the child is on artificial feeding, then the restoration of normal ovarian function is possible after 30 - 45 days.

Another thing is if a woman breastfeeds her baby. Due to the effects of hormones that enhance the secretion of milk, the ovaries can return to their normal state only after 6 to 7 months. Of course, such figures are approximate, since the recovery time of the female body after childbirth is purely individual.

Reasons for ovarian pain after childbirth

It should be noted right away that pain in the ovary can be a symptom of the presence of a pathological process. Most often, this is a sign of an inflammatory disease - adnexitis, which developed as a result of the entry of various bacteria into the uterine cavity.

This usually occurs when the uterus is infected during childbirth or in the early postpartum period. In this case, inflammation of the ovaries will be a complication of endometritis.

If the patient has such a combined pathology, the pain will not have a clear localization, discomfort can occur throughout the abdomen. It is difficult to treat adnexitis, but it is necessary, since this problem is fraught with possible infertility in a young mother.

In addition to adnexitis, pain in the ovaries can cause the following diseases:

•   due to pregnancy has increased in size.  This formation can put pressure on the pelvic organs and provoke pulling pains. Especially dangerous is the torsion of the ovarian cyst, which can cause inflammation in the abdominal cavity. In 90% of cases, such a pathology requires surgical intervention.
• Pain in the pelvis and lower back often provokes the presence of inflammation of the ovarian appendages.  In gynecology, this disease is called oophoritis. Experts often confuse the symptoms of this pathology with renal colic in women, therefore, before starting a specific treatment, laboratory tests of urine and blood are required.
• When breastfeeding, special preparations containing hormones can be prescribed to enhance lactation.  These drugs can provoke an excess of hormones in the ovaries in women after childbirth, which is also often manifested by painful sensations.
• The medical literature describes cases of hemorrhage in the ovary itself. Pathology is quite rare and amounts to no more than 0.2% of the causes of abdominal pain in young mothers.

However, most often painful sensations have no real basis. In many women, this symptomatology is the result of a painful childbirth or surgery. Gynecologists call such conditions psychogenic pain syndrome and consider it as a component of postpartum changes on the part of the central nervous system of a woman.

Do not forget that after childbirth the menstrual function of the female body begins to recover, the ovaries resume their work in the usual way. This process, after temporary stagnation caused by pregnancy, can also provoke pain, especially during the period after the first delivery of menstruation.

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If the ovaries hurt a month after giving birth, do I need to worry and when to sound the alarm

Pain in the ovary after giving birth is most often not a sign of pathology on the part of the female genital organs. This condition may be due to the natural restructuring of the female body, which lasts from 6 to 10 weeks.

Painful sensations most often result from the restoration of the full functioning of the ovaries, the beginning and stabilization of the woman’s usual menstrual cycle. In this case, the main role is played by the improvement of metabolism in one of the most important female glands of internal secretion - the hypothalamus.

To sound the alarm and immediately seek help from a specialist should in cases where other disturbing factors join in the painful sensations in the abdomen. First of all, this is a change in the consistency of vaginal discharge.

If the discharge has become, and a high temperature has been added to the pain in the abdomen, it can be assumed that the patient has a formidable postpartum complication. Most often, pain in the ovary area, which worries the lady after the end of the postpartum period, is a consequence of past inflammation of the uterine wall.

A woman should not diagnose herself and prescribe treatment, especially during breastfeeding. At the end of 30 days after birth, doctors recommend that all young mothers attend a antenatal clinic, even if they have no specific complaints about the condition and functioning of the genitals.

Does one ovary hurt after childbirth - the reason for going to the doctor?

If a woman after childbirth is concerned about pain in the pelvic area, then both ovaries most often hurt. However, there are options when discomfort occurs only on one side, more often on the right.

In the presence of such a pathology, an acute surgical problem, such as appendicitis, should first be excluded. To this end, a woman should visit the surgeon's office and pass the appropriate tests.

The high frequency of pain in the right ovary is due to the anatomical structure of the female internal genital organs. The right ovary is more massive, located closer to the uterus, and the right fallopian tube exceeds the left tube in diameter.

Most often, inflammatory processes occur precisely in the right appendages, and the percentage of tubal pregnancy on the right exceeds 65%. Pain after childbirth caused by an infection, increased hormonal effects or cysts that a woman has before pregnancy, also most often occurs in the right half of the abdomen.

Many patients note that in ordinary life, painful sensations associated with the menstrual cycle occur more often on the right side. This is due to a more extensive network of vessels and capillaries in the region of the right ovary.

After childbirth, the trend does not change. Restoring the normal functioning of the female genital organs and the menstrual cycle is often accompanied by pain in the ovary and, of course, such sensations will be more pronounced on the right.

For the female body, weakened by pregnancy and childbirth, any pathological conditions in the uterus and appendages, accompanied by pain, present a certain danger, depending on whether the right ovary or the left is involved in the process. The treatment and consequences for the patient will practically not differ from each other.

The urgency of contacting a doctor for help with abdominal pain on the right is due to the need to exclude surgical pathology. Female diseases, in spite of severe pain, rarely require immediate surgery, and surgical diseases without emergency surgery can pose a threat not only to the health, but also to the life of a young mother.

Diagnose a problem

In order to determine whether ovarian pain is a symptom of inflammatory disease, hormonal disorders, psychogenic disorder, this is a manifestation of the usual recovery process in the uterus and appendages after childbirth, in medical institutions there is a wide selection of appropriate examination methods. They usually begin with a general examination and interview.

Pain in the ovaries in the postpartum period can be a consequence of a caesarean section or simply a long and difficult birth in a lady. Important is the condition of the woman in the first 2 to 4 weeks after the birth of the child, the absence of signs of endometritis.

To establish the cause of unpleasant sensations in the ovaries, doctors recommend that patients undergo computed tomography as well. Routine laboratory tests should not be ignored. It is with their help that one can confirm or exclude the presence of an inflammatory process in a woman, detect hormonal failure, sow pathogenic flora, which caused inflammation and pain in the ovaries.

To conduct differential diagnosis, ladies are often connected to the examination by urologists.  In controversial cases and in the absence of the effect of the treatment, ovarian biopsy can be performed using laparoscopy.

Ovarian pain after childbirth is most often the result of the restoration of the female body, stabilization of the hormonal background and menstrual function. However, it is highly likely that such symptoms are a signal of the presence of pathological problems in a young mother. Without consulting a doctor in the presence of pain in the abdomen just can not do.