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Ovarian Cysts


Yesheen (dr.) Singh Medical Doctor View profile

Dear S



Thank you for your question. The medication you are using, Fertomid or Clomiphene, is usually prescribed to force ovulation of an egg from an ovary that is not healthy. It does so by increasing the levels of progesterone. The symptoms you describe are all associated with elevated levels of progesterone. Usually a pregnant woman will have higher progesterone levels because the egg itself produces these, and so she will develop pregnancy symptoms like morning sickness and breast tenderness. But because you are falsly increasing your progesterone levle syou may be experiencing the effects of higher progesterone without the presence of a fertilized egg.



I hope this explains the symptoms you are experiencing. If you would like to consider an alternate approach you are welcome to contact us at www.healthnation.co.za for a non-pharmaceutucal option to managing ovarian cysts and infertility.



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear N



Thank you for the questions. The question of the most appropriate management of an ovarian cyst is quite a complex one to answer because of the many factors that contribute to a win-win solution for all. What I can say is that the anatomy of your uterus has very little to do with the development of cysts on your ovaries. Cyst development is more of an inflammatory or hormonal problem. That is why symptoms usually associated with cysts often overlap with other hormone-related issues such as dysfunctional uterine bleeding, PCOS and PMS.



I think that surgery is not the only way to manage cysts, in fact it should be reserved as a last resort because of the after effects of abdonimal scar formation and general anaesthesia. Western medicine relies on synthetic contraceptives to try and reduce the imbalance in the ratio of oestrogen:progesterone that results in the inflammation and subsequent cyst formation. This often works to reduce symptoms but rarely addresses the underlying imbalance that causes changes in the hormone ratios in the first place. Typically surgery and synthetic contraceptives have rapid but temporary results while alternate measures that aim to rebalance the hormone ratio and reduce the inflammation take slightly longer to kick in but usually last much longer.



You are the only person who will be able to say which route you wish to follow. If you decide to continue with the synthetic hormone route (i.e. Primolut) you will have to give it enough time to work. Please note that there are several long term side effects caused by chronic use of synthetic hormones and be sure to research these fully before you decide to follow this path.



If you would like to discuss alternate options that work towards healing the underlying imbalance you are welcome to contact me through www.healthnation.co.za for a consultation.



Many thanks and warm regards

Yesheen Singh

Hi Doc,

Thanks for your previous reply. I ended up in hospital last Friday with severe abdominal pain. I My bloods showed that my white and red blood count was high as well as the CRP markers. They also did xrays and a scan. The trauma doctor said that it looked like a cyst thats bleeding.At the time i was having my periods so he could have been mistaken. I have to admit it was a weird period (dark brown and clotty)The trauma doctor refered my case to my gynae since i had the laparoscopy a week prior to the emergency. The gynae administered pain meds and no other treatment. He said that it could have something to do with my bowel. But never refered me whilst in hospital. He ordered another blood test the following morning and it came back pretty much the same. At that stage i wasnt experiencing any more pain but when pressing at my lower abdomen and aroung my tummy i could feel tenderness inside. He did another blood test on the sunday and the CRP levels had come down to 23, where it was previously 60. He sent me home, no medication. This has left me feeling so depressed because i know something is not right. The pain may have subsided and is intermittend at this stage, but i still am naseous and still have cramping in my thigh as well as lower back ache. He said he’d refer me to a gastroenterologist as he thought it may be a case of diverticulitis, but he’d post me the letter.Meanwhile i feel unwell (but not so bad that warrants another casualty visit). There is definately an improvement but it seems that i have the pain when i am menstruating. I had it last month and this month it was worst. When i was discharged i took an enema hoping that it would give some relief to the pressure inside my abdomen when sitting and all the gas. It did help, but when i have a bm, i have pain in my ovaries. What should be my next step. My medical aid has been exhausted and im paying all the shortfalls of the claims not paid by my pathetic medical aid. Where do i go from here that isnt going to cripple me financially?

Yesheen (dr.) Singh Medical Doctor View profile

Dear Y



Thank you for the feedback. At this stage I have to recuse myself from providing you with further advice. This is because we are bordering on clinical recomendations and I cannot provide you with appropriate guidelines without a personal consultation. I can say that there are other considerations to be taken into account when trying to find out the underlying imbalance of your issues and that there are options available to heal the imbalance in your endocrine and/or GIT system. So don't despaire.



You are welcome to contact us at www.healthnation.co.za to make an appointment.



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear Y



Thank you for question. I am happy to read that your lap-scope was clear. As much as I have been following your case via your messages through this website I have to say that without a proper history and consultation I cannot offer any further advice. The steps I suggested in previous emails were to exclude the more common obvious forms of pathology related to the pain your experience. To go beyond these common diagnoses will require a more detailed history.



I do not hink that pain is ever something you should have to learn to live with. It is your body's way of indicating to you that there is something off balance, with the hope that you will find out what it is and correct it. Scopes and ultrasounds are limited to looking for physical abnormalities visible to the human eye. They do not exclude abnormalities occuring on a hormonal or metabolic level.



If you would like to make an appointment, both physical or telephonic, please contact us through www.healthnation.co.za. Alternatively contact your local functional medicine practitioner.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear Y

Thank you for your question. From the symptoms you describe I suspect that the changes in your cycle stem from the cyst you have present on your right ovary. As the levels of hormones being released from the ovary with the cyst fluctuate so to will the date of onset, duration, level of pain, volume and consistency of your bleed. I think you need definitive management of your cyst, either nutritional, pharmaceutical or surgical depending on the size of the cyst and your personal feelings regarding pharmaceuticals vs. natural alternatives. Please note that some natural remedies are as effective as pharmaceuticals or synthetic hormones, which is what most gynaecologists will recommend as first line therapy for medical management of ovarian cysts.

Warm regards

Yesheen Singh

Angela Lombard Nursing Practitioner View profile

Dear B

Many thanks for your question. You have been on contraceptives for a prolonged period of time without much of a regular break or rest for your body. The ovarian cyst could well be due to this, as is so often the case with a clinical profile like you have mentioned.

I suggest that you consider giving your body a complete break from all oral and injectable contraceptives for at least 3 - 6 months so as to assist in detoxification from the different contraceptives you have been on over the last 12 years plus. - this is an alternative decision to what your doctor has suggested. You will still need to make use of condoms as an affective barrier method so as to prevent an unplanned pregnancy please. To assess you further and in more detail, you are most welcome to make an appointment to see me at the Kloof Well Clinic in Cape Town.

Warm regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear Y

Thank you for your follow-up question. Please refer to my reply to you previous follow-up question, also posted today.

Many thanks and warm regards

Yesheen

Yesheen (dr.) Singh Medical Doctor View profile

Dear Y

Thank you for your follow-up question.

Oral contraceptives do increase your risk for the development of ovarian cysts. If you already have a cysts stopping your contraceptive or changing your type of contraceptive or the dose will create an irregular sex hormone balance and further encourage cysts enlargement. So while I do not think the contraceptive was masking the symptoms it could have contributed to the onset of them.

Fertility depends on many factors. Simple ovarian cysts may make conception slightly more difficult because of the resulting scar tissue on the ovary. The cysts itself rarely negatively impacts on fertility. If the cyst arises from another more underlying physiological imbalance, e.g. obesity or PCOS, then that underlying cause may negatively affect fertility rates.

Many thanks and warm regards

Yesheen

Angela Lombard Nursing Practitioner View profile

Dear Y

Many thanks for your question.

You have virtually answered your question. I am glad that you went for a second opinion. A fibroid is a benign tumour. Fibroids are fairly common, and unless it is too large and causing discomfort, it is not always necessary to have them removed, unless determined otherwise by a medical doctor.

The presence of the ovarian cyst indicates a fluid imbalance. Your back ache, pelvic pain and cramping down the thigh indicate a depletion of mineral salts from your skeletal structure. The contraceptive will have contributed greatly to your clinical profile with these signs and symptoms.

As your doctor is treating you with pharmaceutical medication, I suggest that you continue with this approach, and follow my recommendation in addition to this :

NAT MUR TISSUE SALT NO. 9, as x1 celloid (tablet) taken subliqually from the Allison Effting range of tissue salts, 3 times a day, 10 - 15 minutes before a meal in a clean mouth. This tissue salt will correct the fluid imbalance and release the collection of fluid from the ovarian cyst, thereby also diminishing discomfort. Tissue salts work on vibrationary energy healing.

VITA-LIFE MULTIVITAMIN by Amipro, as x2 capsules twice a day, after breakfast and lunch. This is an excellent multivitamin for replacing the mineral salts loss from your skeletal structure (which all the contraceptive pills do!). Your calcium, magnesium, potassium, zinc, selenium, chromium, boron, and many other important constituents of the bones will be replaced by taking this supplement.

The above two products will work parallel to your pharmaceutical medicine, and assist you in replacing your deficiencies.

I would very much like to review your situation in about 1 - 2 months time again, so would appreciate you communicating with me further.

I do hope you feel more like your old self soon. You are very welcome to make an appointment to see me.

With warmest regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear Y

Thank you for your question. All the symptoms, from the ovarian cysts to the adult acne, can and are most probably related to an imbalance in your oestrogen:progesterone:testosterone ratios of production. Factors that contribute to this imbalance include the use of oral contraceptives (the pill is an independent causal factor of ovarian cysts), carrying extra weight, an unhealthy insulin-spiking diet and a lack of appropriate exercise.

There are no guarantees that either the hormonal or surgical method of treatment for the cysts will be effective in preventing resurgence in the long term if you don't address the underlying reason for the imbalance. I would recommend continuing with your trial of synthetic hormones seeing as you've already begun them but don't fall into the trap of depending on them to prevent the cysts from reforming. In order to healthily prevent cyst formation I would recommend addressing each of the factors mentioned above.

Begin a healthy exercise routine daily. Eat a healthy diet free from red meat and chicken, relying on fish for most of you animal-sources of protein, increase your intake of living foods like raw vegetables in juice, smoothie or meal form, cut out all forms of sugar and artificial sweeteners, cut out white flour in all forms. In addition to these efforts you can try to include high doses of Omega 3 fatty acids (Metagenics make a great product), probiotics (from the fridge section only) and supplements that are known to balance of sex hormone production in the body. These supplements include Saw Palmetto and Maca Powder.

Lastly if the hormones don't work to relieve the pain in 2 weeks I would recommend going the surgical route. These days with laparoscopic surgery the side-effects are minimal and transvaginal surgery even allows you to return to work the next morning!

Many thanks and warm regards

Yesheen

Yesheen (dr.) Singh Medical Doctor View profile

Please refer to my answer to this question in your previous post.

Warm regards

Yesheen

Yesheen (dr.) Singh Medical Doctor View profile

Dear N

Under no circumstances should you consider going for a "womb scrape". This is not medicine but quackery and if not indicated is a very dangerous procedure that causes more harm than benefit.

Yes multiple ovarian cysts are sometimes associated with infertility, usually in a condition known as Polycystic Ovarian Syndrome. I would advise seeking a doctors or gynaecologists opinion on whether you have any symptoms that meet the diagnostic criteria. Cysts often result from an imbalanced lifestyle that supports inflammation in the ovaries. Lifestyle modification is a sustainable healthy method to try and address cyst formation. In addition you can try supplements such as Saw Palmetto or Red Clover but these are only indicated for specific hormonal imbalances.

Many thanks and warm regards

Yesheen

Chase (dr.) Webber Naturopath View profile

I would recommend that you phone your gynecologist who should have been sent the results for your scan already and will know what type of a cyst you have on the ovary. The type of cyst will determine the urgency with which to investigate further and what medications are needed. If your pain becomes more intense or active for longer periods of time it would be a sign to ask for an urgent appointment.

In the meantime by having a short talk on the phone with your doctor he can set your mind at ease on the urgency related to the results of the scan.

Very best wishes

Dr Chase Webber ND

Yesheen (dr.) Singh Medical Doctor View profile

Dear A

Thank you for your question. Yes oral hormonal contraceptives have been known to encourage the growth of ovarian cysts in susceptible individuals over prolonged exposure. SImply trying to swop contraceptives around will not alleviate the pain and discomfort arising from the cysts especially in cases where a contraceptive is one of the contributing factors. Today there are a couple of healthier alternatives to the management of ovarian cyst. These include the use of supplements like Saw Palmetto, Red Clover and natural progesterone creams from day 10 to 26 of your cycle. But before you resort to any of these supplements I think you should have a blood evaluation of your current hormone levels to confirm where the imbalance in your sex hormone cycle lies. Solgar, available from most health shops, make an excellent Saw Palmetto product.

I would also recommend having a second gynaecologist evaluation of your ovarian cysts because they may need surgical removal, which these days can be done via laser and laparoscopy. The fact that they did not stop being symptomatic despite the prolonged use of oral contraceptives is indication enough. Cutting out dietary and lifestyle factors that contribute to an abnormal sex hormone balance will also be beneficial. These include no red meat, preservatives or unfermented soy products.

Prolonged use of the pill has in some studies adversly impacted on one's ability to conceive. Other studies show no such correlation. In my experience it depends greatly on the ability of your body to bounce back to normal metabolism after contraceptive use. Some women fall pregnant while on the pill, whereas other can take up to a year or two before they are is a more fertile cycle. I think you need to consider what your intention around use of the pill is - if it is to control acne then use Saw Palmetto instead. If it is to prevent pregnancy then try alternate means of contraception such as condoms or a diaphragm.

Many thanks and warm regards

Yesheen

Yesheen (dr.) Singh Medical Doctor View profile

Dear T

Thank you for your question. The cost of a procedure is determined by the duration and components of the procedure, and vary from procedure to procedure. The removal of ovarian cysts can be done either via laparotomy or laparoscopy, surgically or with a laser, and can involve the removal of the cyst alone, the cyst and the ovary, on one ovary or on both. If other pathology is found it can also affect the outcome and the cost of the procedure.

The best person to speak to would be the surgeon who diagnosed the ovarian cyst as s/he would have seen the ultrasound and been able to make a guess at the extent of the procedure required. A good idea is to seek a second opinion by visiting another surgeon with your ultrasound scan. If cost is a limitation please don’t hesitate to visit a state hospital as well. There are many well qualified surgeons in the public sector more than capable of performing the procedures discussed above.

Many thanks and warm regards

Yesheen

Sean (dr.) Gomes Medical Doctor View profile

It is unlikely that the odour is related to the ovarian cyst. There are a number of potential causes for vaginal odour/discharge. These can include bacterial and fungal infections. I would recommend that you highlight this to your gynae so that they can take swabs (this can be done prior to surgery or even on the surgical table), which will help rule out any infection that can be treated with either anti-fungal medication or antibiotics. Good luck for the upcoming surgery. Kind regards. Dr Sean Gomes

Angela Lombard Nursing Practitioner View profile

First of all, with the clinical picture you have given, I strongly recommend that you make an appointment to see your gynaecologist. Please do not try and guess a diagnosis for yourself with the picture given. All that you have mentioned could be a number of several conditions, but having ’sharp pains sometimes’ is not to be ignored. There are many different types of cysts. The most common is a follicular cyst which is characteristic of a fluid filled cavity. Depending on the extent of the cyst, its location and size, this can cause discomfort, and sometimes discharge and pain. The best way to diagnose the presence of a cyst(s) is to have an ultrasound, which would have to be done by your specialist. Once your doctor has assessed and examined the abdominal region, he/she can then determine whether you qualify for an ultrasound and then treat you accordingly, and prescribe medication if necessary. Kind regards, Angela, Nursing Practitioner.

Reena Sukdev Homeopath View profile

It is extremely important to have an in-depth consultation with a
qualified professional and the cyst be correctly diagnosed whether you
decide to undergo conventional treatment or natural treatment. A
hysterectomy is usually not considered unless the cyst is cancerous or
there are other factors at play here. Other considerations medically
may be removal of the cyst only or removal of the ovary itself.
It may be necessary to undergo medical treatment as a safer option but
I will help you formulate a guideline from the natural perspective.
Some practitioners use natural progesterone cream from day 10 through
26 as a method of shrinking ovarian cysts working in a similar effect
to the contraceptive pill. This apparently suppresses LH and its
luteinizing effect. There has been much written about this by Dr John
Lee.
Avoiding estrogen-laden foods will definitely help. Cutting out meat
from the diet is a consideration. A good supplement protocol will
also be useful. A good antioxidant formula will be useful. Take at
least a minimum of 1000mg Vitamin C a day. Take a good Omega 3 and 6
combination. Take a good multivitamin that has high levels of Vitamin
B complex. B vitamins assist the liver in converting excess oestrogen
into a less dangerous substance. Blue cohosh (Caulophylum
thalictroides) is often used as a herbal cure. With all the above
said, homeopathy is very effective in such a condition. The
homeopathic maism(disposition) that usually covers this condition is
expressed as a sycotic miasm (not to be confused with psychotic..)
Simply put it refers to a suppressive expression in the body’s
constitution caused by many factors including emotions and medications
over time.The approach would be to remove the layers of suppression. A
homeopath might first consider prescribing Medhorrinum or Thuja in
high potencies and follow with other constitutional remedies after
finding the totality of symptoms. These remedies of course have to be
taken under supervision of a qualified homeopath.

Regards Reena (Cavendish Homeopath)

Sean (dr.) Gomes Medical Doctor View profile

A laparoscopy is a minimally invasive procedure. You will have a general anaesthetic. Following the procedure you may have some discomfort, but you should be prescribed adequate analgesia. You will have 2-3 small incisions on your abdomen. The gynaecologist will remove the cyst and try and preserve as much of the ovary as possible so that it can function normally. Should you be ovulating normally, then there should not be any difficulty in conceiving. Falling pregnant can take longer than 6 months, especially if you have been on hormonal contraceptives for long periods of time. You need to remain patient. Good luck for your operation tomorrow and with your future pregnancy. Regards Dr Sean Gomes MD

Sean (dr.) Gomes Medical Doctor View profile

If your remaining ovary is functioning normally then there should not be any reduction in fertility as the remaining ovary will still release an egg on a monthly basis. Most ovarian cysts are functional in nature, and harmless. They occur most often during a woman’s childbearing years. You do not say what kind of cyst it was. Generally, there is not much one can do to prevent the development of cysts. What I would recommend is to have regular check-ups with your gynaecologist. That way, your gynaecologist will be able to keep a vigilant eye on your remaining ovary to ensure that should another cyst develop, you will be able to treat it early and hopefully preserve your ovary and fertility. Regards Dr Sean Gomes MD

Chase (dr.) Webber Naturopath View profile

Ovarian cysts can be caused by a few problems, one of which is related to endometriosis. I would still advise that you consult your doctor for an examination and scan to check if you have a cyst, then ask him/her to check all your hormonal levels, only after this can we look at the options, as different herbal or nutritional remedies can stimulate different hormones and we would want to ensure that you are doing the right approach. It is difficult to give advise until you have a clear diagnosis. regards Dr Chase Webber ND


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The Wellness Q & A is for informational purposes only, and is not intended to diagnose or provide treatment for any condition. If you have any concerns about your health, you should always consult directly with your healthcare professional. Wellness Warehouse will not be liable for any errors in the Wellness Q & A, or for any actions taken in reliance thereon. The advice on the Wellness Q & A is not comprehensive and does not replace the assessment and advice of your own healthcare professional. Consultation with your healthcare professional is extremely important if you are experiencing persistent or severe symptoms.

Caution:

Consult your doctor, healthcare professional, and/or pharmacist before using any supplements or before making any changes in prescribed medications. If you have a chronic illness or routinely take prescribed or over-the-counter (OTC) medication, or you are pregnant or breastfeeding, it is extremely important to consult your doctor, healthcare professional, and/or pharmacist before taking any new medication. Do not stop taking any prescription medication without consultation and guidance from your doctor.

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