Introduction
Ovarian cysts are fluid-filled sacs or pockets in an ovary or on its surface. Women have two ovaries — each about the size and shape of an almond — on each side of the uterus. Eggs (ova), which develop and mature in the ovaries, are released in monthly cycles during the childbearing years. Many women have ovarian cysts at some time. Most ovarian cysts present little or no discomfort and are harmless. The majority disappears without treatment within a few months. However, ovarian cysts — especially those that have ruptured — can cause serious symptoms.
Signs & symptoms
Most cysts don’t cause symptoms and go away on their own. However, a large ovarian cyst can cause:
- Pelvic pain — a dull or sharp ache in the lower abdomen on the side of the cyst
- Fullness or heaviness in abdomen
- Bloating
- pain during bowel movements
- nausea
- vomiting
- breast tenderness
- pressure on the bladder and frequent urination
Causes
The exact cause of ovarian cysts is not known. But the risk factors include:
- Hormonal problems.
- Pregnancy.
- Endometriosis.
- A severe pelvic infection.
- A previous ovarian cyst.
Pathophysiology
Ovarian cysts are of two types. Functional and pathological. Ovaries normally grow cyst-like structures called follicles each month. Follicles produce the hormones oestrogen and progesterone and release an egg during ovulation.
If a normal monthly follicle keeps growing, it’s known as a functional cyst. There are two types of functional cysts:
- Follicular cyst. Around the midpoint of menstrual cycle, an egg bursts out of its follicle and travels down the fallopian tube. A follicular cyst begins when the follicle doesn’t rupture or release its egg, but continues to grow.
- Corpus luteum cyst. When a follicle releases its egg, it begins producing oestrogen and progesterone for conception. This follicle is now called the corpus luteum. Sometimes, fluid accumulates inside the follicle, causing the corpus luteum to grow into a cyst.
Functional cysts are usually harmless, rarely cause pain, and often disappear on their own within two or three menstrual cycles
Types of cysts not related to the normal function of your menstrual cycle include:
- Dermoid cysts. Also called teratomas, these can contain tissue, such as hair, skin or teeth, because they form from embryonic cells. They’re rarely cancerous.
- Cystadenomas. These develop on the surface of an ovary and might be filled with a watery or a mucous material.
- Endometriomas. These develop as a result of a condition in which uterine endometrial cells grow outside the uterus (endometriosis). Some of the tissue can attach to the ovary and form a growth.
Dermoid cysts and cystadenomas can become large, causing the ovary to move out of position. This increases the chance of painful twisting of ovary, called ovarian torsion. Ovarian torsion may also result in decreasing or stopping blood flow to the ovary.
- Pelvic examination
- Pregnancy test. A positive test might suggest that you have a corpus luteum cyst.
- Pelvic ultrasound.
- Laparoscopy.
- CA 125 blood test.
Treatments
Treatment depends on age, the type and size of cyst, and symptoms. Treatent might include:
Watchful waiting – This is typically an option if there are no symptoms and an ultrasound shows a simple, small, fluid-filled cyst.
Medication – hormonal contraceptives, such as birth control pills, to keep ovarian cysts from recurring. However, birth control pills won’t shrink an existing cyst.
Surgery – to remove a cyst which is large, not a functional cyst, is growing, continues through two or three menstrual cycles, or causes pain. Indications for surgery include suspected ovarian torsion, persistent adnexal mass, acute abdominal pain, and suspected malignancy. Surgery in pre-menopausal women prioritizes the preservation of fertility, and every attempt is made to remove minimal ovarian tissue. Pregnant patients can have cysts that may require surgical management. Although laparoscopy is safe in all trimesters of pregnancy, ideally, it is recommended to perform surgery in the second trimester.
Prognosis
Most ovarian cysts are asymptomatic, and tend to be benign with spontaneous resolution leading to an overall favourable prognosis. Malignant change can occur in few cases of dermoid cysts (associated with extremely poor prognosis) and endometriosis. If an ovarian cyst is suspected to be malignant, then the prognosis is usually poor since ovarian cancer tends to be diagnosed in the advanced stages.
Complications
- Ovarian torsion.
- Rupture.
- Haemorrhage
- Carcinoma
Disease & Ayurveda
In Ayurveda, cysts are considered as granthi which are unwanted and abnormalgrowths which can develop wherever possible in the body. Ayurveda explains that the vitiated doshas travel from their sites throughout the body and get lodged where there are abnormality or damage in the circulatory channels(srotas). When the doshas cause granthi in aartavavahasrotas (reproductive channels) it is called as granthiartava.
Nidana
Causative factors for the vitiation of Kapha and Vaata
Unwholesome diet and lifestyle during menstruation
Purvaaroopa
Not mentioned
Samprapti
When vitiated Kapha and Vaata in women reach the reproductive organs and get lodged in andasaya, artava production is affected and the development of it is delayed & arrested in andasaya. Due to the kapha and vaata doshas, it forms a cyst like growth which leads to granthiartava
Lakshana
Irregular menstrual bleeding with clots
Lower abdominal pain
Divisions
Not mentioned
Prognosis
Saadhya in new cases in healthy women with no complications.
Yaapya in chronic cases
Chikithsa
The aim of Ayurvedic treatment in granthiartava is to remove and expel the kapha dosha blocking the normal functioning of Vaata. This wll help the reproductive system in functioning in the normal way. To eliminate kapha, vamanam and nasyam are done if the patient is suitable. After clearing the obstruction in channels, treatment is given to enhance artava formation and development in a normal way.
Samana
Aamapaachana
Agnideepana
Internal medicines and diet with ushna-teekshna(hot, pungent & penetrating) properties
Krishna Tila, kulattha
Sodhana
Sneha-sweda
Vamana
Virechana
Kashayavasti
Snehavasti
Uttaravasti
Commonly used medicines
Pathadi kashayam
Sukumaram kashayam
Kallyanagulam
Chiruvilwadi kashayam
Kumaryasavam
Asokarishtam
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
No home remedies can completely cure ovarian cysts. But a healthy diet and lifestyle can help manage the discomforts.
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, sesame oil
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from extreme hot climate.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle. Be active
Yoga
As granthiartava develop due to stagnant Kaphadosha due to sedentary lifestyle, regular exercising is advised unless severe pain present. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
Specific asanas for female reproductive health
Vajrasana
Gomukhasana
Bhadrasana
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
https://www.ncbi.nlm.nih.gov/books/NBK560541/#_article-26445_s5_
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.
Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.
Dr. Nair is a regular speaker at Ayurveda-related conferences and has visited Germany to propagate Ayurveda. You can write directly to him-
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