Case Reports

Ovarian Cyst

21 August 2002

Homoeopathy Clinic
Introduction
Ovarian cysts are sacs filled with fluid or semi-solid material that form in the ovaries
or on their surface. They may occur as the result of normal ovarian functions, or they may be
abnormal growths. The majority of ovarian cysts are benign and cause no symptoms, but
some may cause pain, abnormal menstrual bleeding, and irregular menstrual periods

Check Yourself
If you have any of the following
symptoms call your doctor.

Sense of fullness or
pressure or a dull ache in
the abdomen
Pain during intercourse
Painful, irregular or delayed
periods
Swelling of the lower
abdomen, usually firm and
painless
Sudden, sharp pain in the
lower abdomen
Severe and sudden
abdominal pain with a fever
and sometimes vomiting

Contents
Introduction

Types of Ovarian Cysts

Types of Functional

Symptoms

Causes

Risk Factors

Diagnosis

Case Report

Ovarian cysts or functional ovarian cysts, are quite common and occur normally on a
monthly basis with each menstrual cycle. A cyst will form on the ovary in the location where
the ovum (egg) is released from the ovary in the process of ovulation. Occasionally, at the
middle portion of the cycle, a cyst can enlarge and/or rupture causing pain. They're rare in
women who have reached menopause. Ovarian cysts are usually NOT a form of cancer.
The normal function of the ovaries is to produce an egg each month. During the
process of ovulation, a cyst-like structure called a follicle is formed inside the ovary. The
mature follicle ruptures when an egg is released during ovulation. The corpus luteum forms
from the empty follicle and if pregnancy does not occur, the corpus luteum dissolves.
Sometimes this process does not conclude appropriately causing the most common type of
ovarian cyst -- functional ovarian cysts.

Types of Ovarian Cysts

1. Functional Cysts: These normal cysts will often shrink and disappear within two or three
menstrual cycles. Because this type of cyst is formed during ovulation it rarely occurs in
menopausal women because eggs are no longer being produced.
2. Dermoid Cysts: Ovarian cysts which are filled with various types of tissues including hair
and skin.
3. Endometrioma Cysts: These cysts develop in women who have endometriosis, a
condition in which tissue from the lining of the uterus (endometrium) grows in other
areas, such as on the fallopian tubes, the ovaries, and on other organs outside of the
uterus in the stomach. These may be filled with a thick, brown blood and so also are
called "chocolate cysts." Because uterine tissue is sensitive to hormones, it bleeds
monthly, which may cause it to form a growing cyst on the ovary. These cysts can be
painful during sexual intercourse and during menstruation.
4. Cystadenoma Cysts: These are ovarian cysts which develop from cells on the outer
surface of the ovaries
5. Polycystic Ovarian Disease: Cysts that form from a buildup of follicle cysts which cause
the ovaries to thicken. These cysts cause the ovaries to enlarge and create a thick outer
covering which may prevent ovulation from occurring and are often the cause of fertility
problems.
The most common cysts found are the functional cysts. A functional cyst can be one of four
types and are not malignant: follicular, corpus luteum, theca luteum, and polycystic ovaries.

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Types of Functional Cysts

A follicular cyst occurs when the normal follicle, or sac that matured to release an egg,
does not shrink after release of the egg. These are soft, have thin membrane walls, and
contain clear fluid. These can rupture, causing sudden, severe pain which gradually goes
away over several days. Usually, however, they spontaneously disappear over the course
of one or more menstrual cycles. They can cause changes in your periods and pelvic
pain. Depending on the size of the cyst, it can just be observed or treated with birth control pills.
Corpus luteum cysts are less common, but cause more symptoms and problems. They
become larger than follicular cysts, thus causing more pelvic pain. They result when
bleeding occurs in the follicle after an egg is released. This type of cyst often causes a
delayed period and if it ruptures, can cause bleeding into the abdomen which may
necessitate surgery.
Theca luteum cysts,
cysts the least common of the functional cysts, are often associated with
an abnormal pregnancy. They most often occur in both ovaries, unlike the functional
cysts described above. They disappear without treatment after the pregnancy is terminated.
Polycystic ovaries are multiple clear fluid filled cysts in both ovaries and are associated
with menstrual problems and hormone imbalances.

Symptoms
Common symptoms include one-sided lower pelvic pain (or lower abdominal pain),
often radiating to the back. Cysts also may make your periods very painful. Pain is usually
increased with intercourse, resulting in its frequent confusion with pelvic inflammatory disease. Nausea may also occur. In most cases, pain abates within 3 days. In more serious
cases, a ruptured ovarian cyst may result in more pronounced internal bleeding, manifesting
with the signs and symptoms of shock, and/or heavy vaginal bleeding. The cysts also may
put pressure on the urinary tract and cause problems with urine flow.

Causes
The various causes of Ovarian Cysts are:

Disordered folliculogenesis
Hormonal imbalances
Ovarian cancer
Metastatic cancer
Smoking (?)
Body mass (inversely related to the existence of functional cysts)
Early menarche
Infertility (4-fold increase)
Hypothyroidism
Neonatal cysts (increased frequency in babies of mothers with diabetes, toxemia,
and Rh immunization)

When are women most

likely to have ovarian cysts?

Most common during the

childbearing years. Most
often, cysts in women of
this age group are not
cancerous.
Women who are past
menopause (ages 50-70),
however, and have
ovarian cysts, have a
higher risk of having
ovarian cancer. If you are
over 50 and hav e an
ovarian cyst, your doctor
will probably want to do
surgery to remove it.

However, if you think you

might have a cyst, at any age,
you should tell your Doctor.

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Risk Factors
The various risk factors are:
A late onset of menarche is a protective factor concerning ovarian cysts.
A history of previous ovarian cysts with symptoms should be correlated with the
current presentation and symptoms.
A history of infertility points to a 4-fold increase in the incidence of ovarian cysts.
A history of oral contraceptive usage tends to decrease the incidence of cysts.
Tamoxifen treatment for breast cancer is associated with a 10% increase in the
incidence of cysts.
Smoking is a controversial risk factor; some studies show no increased incidence of cysts among smokers, while other studies show up to a 2-fold increase
in the incidence of cysts are found during routine pelvic examinations.

Diagnosis
Ovarian cysts usually are found during routine pelvic examinations. Other diagnostic tests
such as ultrasound and laparoscopy, may be done to detects any abnormalities.

Case Report
A female patient aged 17 yrs was diagnosed to have a ovarian cyst in the right ovary
on 28.9.2001 at Lilavati Hospital, Mumbai, India. The main complaint of the patient was
painful and
irregular menstruation. The attending doctors advised the patient to go for
HORMONAL TREATMENT. The parents of the patient, however, not agreed to this and
hence approached Homoeopathy Clinic, Mumbai for the treatment.
Accordingly on the basis of the diagnosis and her symptoms homoeopathic
medicine: Thuja 30 was prescribed for 3 months. There was however, no remarkable
improvement. As such patient was put on tablets Klimaktolan One TDS for 3 months. After
this duration patient reported no symptoms of the said problem. To verify cliniclly again a
USG was done at same Hospital, showing conformation of the results.
At present the patient is without any medication and she does not have any
complaints. The tests reports along with the Homoeopathic Prescriptions are included in this
document.
The Klimaktolan is a trademark of Dr. Willmar Schwabe India, Pvt. Ltd. The
composition of the tablets(250mg) are as under:

Cimicifuga D2 25 mg,

Sepia D2 25 mg,

Lachesis D5 25 gm,

Ignatia D3 25 mg,

Sanguinaria D2 25 mg.