Parovarian cyst of the ovary - education, emerging near the ovaries or fallopian tubes, similar to a normal ovarian cyst. It is a fluid-filled "bag" usually forms near the ovary but not attached thereto.

Parovarian cyst ovaries, usually very small in size, are formed from the remaining eggs or embryological material. These cysts are in most cases no symptoms and do not cause any harmful effects, showing up during a routine pelvic exam or laparoscopic examination.

Although usually paraovarialnye cysts have a very small size (an average of several millimeters to one or two centimeters in diameter), in some cases, they may reach a considerable size, providing, depending on the arrangement, the pressure on the bowel or bladder and causing pain in the pelvic area and discomfort during intercourse.

Small parovarian cyst usually occur in women of childbearing age from twenty to forty years - they can be easily confused with normal ovarian cyst. Parovarian cyst larger especially common in pregnant women because of hormonal fluctuations and increase the hormone estrogen Estrogen - the key to bone health .

Symptoms

In most cases, parovarian cyst does not cause any symptoms, in rare cases, when sprouting cyst to a large size, you may experience irregular menstruation, abnormal vaginal bleeding, discomfort or pain during sexual intercourse, a feeling of pressure, caused by exposure to an expanding cysts on other abdominal organs .

In addition, the main symptom parovarian cyst of the ovary - periodic aching pain in the abdomen Abdominal pain: when to sound the alarm?   or in the lower back, which may be increased after exercise, appear and disappear at random. As a rule, the size of cysts causing any distinct symptoms, significantly higher than the norm and ranged from six to fifteen centimeters in diameter.

Diagnosis and treatment

Paraovarivalnaya ovarian cyst Ovarian cysts - normal or dangerous?   It is usually detected during a pelvic exam Gynecological examination: an important component of women's health   palpation pelvic area. To diagnose parovarian cyst of the ovary, to determine its location and size is used transvaginal ultrasound.

If you suspect a parovarian cyst is very important time to seek medical help. Timely diagnosis and treatment parovarian cyst allow to keep the ability to conceive. Being a very common phenomenon, parovarian cyst, however, do not lead to infertility - provided timely treatment cyst chances of becoming pregnant are very high.

Mikrofollin - is estrogen drug intake which is assigned to suppress the symptoms of menopause caused by estrogen deficiency, and for the prevention of osteoporosis in women who are contraindicated to other means of preventing the disease. Mikrofollin also used as a palliative in some forms of prostate cancer.

Mikrofollin may appoint at any function of the ovaries, infertility, menstrual irregularities (in combination with progesterone) and secondary estrogen deficiency.

The properties of the drug

Ethinyl estradiol, which is part of mikrofollin, biologically and chemically identical estradiol, which is produced in the human body. It can replace the estrogen production is significantly reduced after the menopause, as well as in certain diseases, and to facilitate the attendant symptoms. In particular, estrogens prevent bone loss, which often occurs after menopause or ovariectomy.

This effect seems to persists for as long as treatment continues. After some time after the cessation of hormone replacement therapy, bone density is reduced to about the same level that it reaches the women who did not undergo the treatment.

Ethinyl estradiol is rapidly and completely absorbed by the intestinal wall, and there goes the first stage of processing. For a brief period of time he rasrpdelyaetsya most of body tissues; the highest concentration of ethinyl estradiol is observed in the fatty tissues. Final processing of ethinyl estradiol in the liver, after which 60% of the dose excreted in the urine, and 40% - with the feces. The rate of metabolism of ethinyl estradiol may affect a number of factors, such as antibiotics and smoking.

Shelf life is 36 months mikrofollin. Keep it should be at a temperature not higher than 25C.

Dosage regimen

Symptoms caused by estrogen deficiency, and prophylaxis of osteoporosis. It is necessary to assign the minimum effective dose and the least long-term treatment. Generally, doses are from 10 to 50 micrograms (mcg) per day. Take mikrofollin cycles (for example, three weeks after one).

Palliative treatment of cancer Cancer Treatment - difficult, but necessary   prostate. The daily dose - 150 micrograms to 1.5 mg.

Hormone therapy for ovarian hypofunction. 10-50 mg daily, in most cases taking the medication cycles.

Menstrual irregularities. 20-50 mg per day, 5 to 25 days within each cycle. In addition to taking progesterone mikrofollin Progesterone - norm and pathology   - Either over the cycle, or from the 15th to the 25th day of the menstrual cycle The days of the menstrual cycle: Four phases . If the patient forgets to take medication, it can lead to smearing bleeding between periods.

Contraindications

• Cardiovascular disease in history, such as angina or myocardial infarction;
• Idiopathic venous thromboembolism, deep vein thrombosis, pulmonary embolism;
• Breast Cancer - active or transferred in the past, and a suspicion of this type of cancer. Furthermore, mikrofollin contraindicated in other estrogen-types of cancer (e.g., endometrial cancer);
• Endometrial hyperplasia;
• Vaginal bleeding of unknown origin;
• Acute liver disease. Mikrofollin can be taken after the treatment if the test is to check the function of the liver will show normal results;
• Porphyria;
• Hypersensitivity to the mikrofollin.

Cautions and precautions

Mikrofollin should be administered for the treatment of menopausal symptoms only in those cases where the symptoms have a significant impact on quality of life of the patient. In any case, the patient will need to undergo regular inspections (at least once a year), and the treatment should last only as long as the risks associated with it will not be greater than the benefits of treatment.

Before the start of hormone replacement therapy the patient should undergo a thorough medical examination. The doctor should examine her personal and family history, conduct a pelvic examination, blood tests and swab. During treatment, the patient should spend each month breast self-examination, and consult your doctor if there is any change in its structure.

Even before the start of treatment the patient should be informed that the use of hormonal preparations containing estrogen only, which include mikrofollin may lead to aggravation of the symptoms of the following offenses:

• Uterine fibroids;
• Endometriosis;
• Hypertension;
• Liver disease (eg liver adenoma);
• Diabetes;
• Cholelithiasis;
• Otosclerosis;
• Asthma;
• Migraine;
• Epilepsy;
• Systemic lupus erythematosus;
• Endometrial hyperplasia.

Reasons why you should immediately stop taking mikrofollin:

• Jaundice, or a significant deterioration in liver function;
• Significant increase in blood pressure;
• Repeated migraine attacks;
• Pregnancy.

Drug Interactions

Antiepileptic drugs (eg, phenobarbital, phenytoin, carbamazepine), drugs used to treat a variety of infections, such as rifampicin, rifabutin, nevirapine, efavirenz, and modafinil may accelerate the metabolism of estrogen. Ritonavir, nelfinavir, and St. John's wort also affect the processing mikrofollin in the body, so the time for estrogen replacement therapy is not recommended to take them. Accelerating the metabolism of estrogens may decrease effectiveness of mikrofollin.

Receiving more than 50 mg of ethinyl estradiol (mikrofollin active ingredient) per day can cause serious side effects of imipramine in patients who simultaneously receive two of these drugs.

Mikrofollin may decrease in the efficiency of anticoagulants, such as warfarin, phenindione, and others.

Women with diabetes before taking mikrofollin may need dose adjustment of insulin and other diabetes drugs. Furthermore, mikrofollin may interact with theophylline and lamotrigine. Be sure to tell your doctor if you are taking these medicines.

Pregnancy and lactation

Mikrofollin not be taken during pregnancy. If pregnancy occurs during treatment, you should immediately stop taking mikrofollin. Most studies suggest that the impact on human mikrofollin during fetal development can cause severe birth defects.

Nursing women mikrofollin also contraindicated.

Side effects

Mikrofollin may cause the following side effects:

• Endometrial neoplasia;
• Endometrial cancer and breast cancer Breast cancer: what every woman needs to know   (the risk of developing these diseases increases, depending on how long a woman takes mikrofollin);
• Intermenstrual bleeding;
• Endometrial proliferation and aggravation of endometriosis;
• excessive secretion of cervical mucus;
• Increased sensitivity and breast tenderness;
• Nausea and vomiting;
• High blood pressure;
• Thrombosis, thrombophlebitis, thromboembolism;
• Chloasma;
• Rash;
• Uncomfortable to wear contact lenses;
• Headache;
• Sudden unexplainable mood changes (development of depression);
• The change in weight;
• Gynecomastia and impotence in men.

Overdose

A large overdose of ethinyl estradiol may cause nausea, vomiting, and vaginal bleeding.