How is the cyst

Follicular cyst of ovary Ovarian cysts - normal or dangerous?   a thin-walled circular formation with a smooth surface and the liquid contents, the quantity of 2 to 7 cm in diameter and more, located in one of the ovarian tissue. Sometimes, these cysts can be a few, but all of them are single-chamber, without partitions.

This cyst is formed from unexploded follicle. Follicle - a vial of clear content, wherein the first half of the menstrual cycle oocyte matures under the action of hormones. The most active hormone of the first half of the menstrual cycle are follicle-stimulating hormone pituitary (FSH) and estrogen secreted by the ovaries. As soon as the egg matures, the follicle bursts and released from the ovary, this moment is called ovulation Ovulation - How to determine as accurately as possible? . In some cases, the follicle ruptures and egg remains in the ovary. This is called anovulatory menstrual cycle. Because not burst follicle and follicular cyst is formed, which can be both hormonally active and inactive.

The reason for the formation of follicular cysts are usually hormonal disorders and inflammatory diseases of the female reproductive organs. It is common in women of childbearing age and before menopause. Bilateral multiple cysts can occur after infertility treatment (against the background of enhanced stimulation of the ovaries). Girls under 15 years of follicular cysts are not less than 1/3 of all ovarian cysts and tumors that occur in this age group. Follicular cysts are found even in the ovaries of the fetus and newborn.

How does follicular cysts

Manifestations of follicular cysts are largely dependent on their hormonal activity and the presence of a woman related gynecological diseases (uterine fibroids, endometriosis, inflammatory processes).

In cases where the follicular cyst exhibits hormonal activity (highlights female sex hormones estrogen), there is a proliferation of the mucous membrane of the uterus, uterine bleeding, the girls celebrated precocious puberty Puberty child - stages of a complex path . When cysts larger patients may complain of pain in the lower abdomen.

If hormonally inactive follicular cysts women usually are not aware of their existence, they are detected incidentally during ultrasound and disappear on their own within a few months.

Complications

The most common complication of ovarian follicular cysts, especially in children, is a torsion leg cysts, which can cause rupture of its wall and subsequent abscess cyst content with the development of peritonitis (inflammation of the peritoneum - a thin inner membrane lining the inside of the abdominal cavity). Such a complication begins acutely, often after physical exertion or sudden change in body position. Pain in the lower abdomen, extending to the perineum, hip, lumbar region, often accompanied by nausea and vomiting. The body temperature during the first hours usually remains normal. Sometimes, the pain quickly subsides, and accomplished torsion leg cysts do not affect the condition of the woman. If peritonitis begins, the high fever, there are severe abdominal pain Abdominal pain: Types and Symptoms .

Diagnosis of ovarian follicular cysts

If the follicular cyst is large enough, it was discovered during routine inspection obstetrician-gynecologist: it is felt in the form of a smooth dense sedentary elastic formation rounded, usually painless.

Ultrasound can be seen as single chamber circular formation with a uniform content and with thin walls.

Treatment of ovarian follicular cysts

Identification of follicular cysts observed and treated conservatively in two to three months. To make it faster resorbed, used electrophoresis with potassium iodide, hormones, anti-inflammatory treatment is carried out.

If, despite treatment, the cyst increases in size, it is removed. In addition, the indication for surgical removal of cysts are follicular its large diameter (greater than 8cm), increased mobility (risk of twisting), torsion or bleeding in the cyst, abscess and its suspicion of a malignant tumor.

Surgery to remove the follicular cyst is usually performed laparoscopically, through small incisions when the body is introduced into the special tools and use them to remove a cyst (a picture of this process, the surgeon sees on the screen).

Hyperandrogenism - is the most common endocrine disorder in women of reproductive age. Male sex hormones, or androgens in women are produced mainly by the adrenal glands and ovaries. However, from the peripheral tissues such as adipose tissue and skin, also depends on the level of androgens in the body, as they play a role in the transformation of weak androgens more potent. Hyperandrogenism, or an excess of androgens can affect various tissues and organs, causing a number of violations, among them - acne, hirsutism Hirsutism - when femininity leaves , Virilization, and dysfunction of the reproductive system.

Sources and types of male sex hormones in women

The glands of the endocrine system produce a total of five kinds of androgens: testosterone, dehydroepiandrosterone sulfate (DHEAS), dehydroepiandrosterone (DHEA), androstenedione and androstenediol. Last possesses both androgenic and estrogenic properties. Testosterone and its biologically active form - dihydrotestosterone (DHT), are the only androgen capable of directly providing androgenic effect. DHEAS, DHEA and androstenedione are precursors of testosterone.

• Androgens are produced by the ovaries

The ovaries produce 25% of testosterone circulating in the blood of women. Its secretion of luteinizing hormone dependent, which in turn allocates anterior pituitary. The ovaries also produces 50% of androstenedione and DHEA 20%.

• Androgens are produced by the adrenal glands

Produced in the adrenal glands in the body all the available DHEAS, DHEA and 80%. They produce 50% and 25% of androstenedione testosterone. The secretion of adrenal androgen independent of adrenocorticotropic hormone, which is produced in the anterior pituitary. In the adrenal glands can also be influenced by estrogen and prolactin.

• Peripheral conversion of testosterone

Skin, adipose tissue, liver, and organs of the urogenital system also influence the level of testosterone in the blood. For example, androstenedione and, to some extent, DHEA is converted to testosterone in the skin.

• The metabolism of androgens

Of all androgen circulating in the blood only testosterone and dihydrotestosterone can activate androgen receptors. In women of childbearing age 25% of testosterone is produced in the adrenal glands, and the same - in the ovaries. Rest of testosterone produced during the conversion of androstenedione and other androgens in peripheral tissues. Normally, 80% of testosterone is associated with binding globulin sex hormones (SHBG), 19% - with albumin and a 1% testosterone circulating freely in the bloodstream. The level of androgens in the body depends mainly on whether the number is associated with SHBG.

The level of SHBG may increase:

• Estrogens;
• Pregnancy;
• Drugs, which include estrogen.
• The level of SHBG is reduced:
• Synthetic progestins (norethindrone, norgestrel, desogestrel, norgestimate);
• Glucocorticoids;
• Growth hormone;
• Insulin;
• Obesity;
• Acromegaly;
• Hypothyroidism;
• Hyperinsulinemia.

DHEAS, DHEA and androstenedione almost completely bound to albumin.

The adrenal glands start to produce more male sex hormone that raises the level of adrenocorticotropic hormone (ACTH), but the feedback in this process is not - that is, the level of androgens in the body does not affect the secretion of ACTH. Androgens are produced by the ovaries, is also not affect the level of luteinizing hormone. Thus, even at an elevated level of androgens organism can continue to produce them more and more.

Most circulating testosterone Five myths about testosterone   in the liver and processed into androsterone etioholanolon which then react with glucuronic acid and other substances, and excreted in urine in the form of 17-ketosteroids. Only 20-30% contained in urine 17-keto steroids obtained during metabolism of testosterone. The remaining part thereof formed as a result of processing of steroid hormones.

The role of androgens in the body

Male sex hormones have a direct impact on the various systems of the body, and are precursors of estrogen Estrogen - the key to bone health . Androgen receptors are present in many tissues, such as the skin, skeletal muscle, gastrointestinal tract, genitourinary system, bones, brain, cardiovascular system, placenta and adipose tissue. The effects of androgens have not been studied thoroughly. Then we talk about how male sex hormones and excess observed at hyperandrogenism, affect different organs and body systems.

• Brain

Androgen receptors in the brain are located in close proximity to the estrogen receptors. In certain areas of the brain contains enzymes 5-alpha reductase and aromatase ability to convert testosterone into dihydrotestosterone or estradiol Estradiol, the most important hormone .

With an increase in testosterone levels as a result of intravenous injection (to treat certain diseases), many women have atypical aggressive behavior.

Numerous data suggest that androgens are responsible for sex drive in women. Patients who are prescribed for the treatment of hyperandrogenism drugs that inhibit the activity of male hormones, there was a significant weakening of the sex drive. On the other hand, increased levels of androgens can become a cause of increase libido.

• Bone

Male sex hormones play an important role in bone mineralization. Reduced levels of androgens associated with a decrease in bone density - is one of the reasons why anti-androgen drugs for the treatment of hyperandrogenism should be taken with caution.

• Mammary gland

In epithelial cells, along with estrogen and progesterone receptors and androgen receptors are. Studies have found that androgens, particularly testosterone and DHEA, prevent the proliferation of epithelial cells in female monkeys. The opposite effect was observed when the animals were injected with drugs antiandrogenic action. The action of androgens on the human breast is not well studied, but now experts believe that elevated levels of male sex hormones do not significantly affect the likelihood of developing breast cancer.

• The endometrium

Laboratory studies have shown that androgens can inhibit the proliferation of the endometrium and may prevent the development of endometrial cancer. However, human studies that could confirm this hypothesis has not yet been carried out.

• Cardiovascular system

Women suffering from hyperandrogenism and polycystic ovary syndrome, the risk of cardiovascular disease is significantly higher than average.