How dangerous is that?
A cyst in the uterus is not uncommon and, at first, is not a cause for concern. Since cysts also fall under the umbrella term “tumor”, many women initially suspect something bad. However, a cyst is a cavity filled with fluid.
In this context, “tumor” merely refers to the swelling caused by this fluid-filled cavity on the organ. Many women have cysts in the uterus (and/or ovarian cysts), which can occur either singly or in clusters and in principle at any age. Most uterine cysts are completely harmless and are asymptomatic. Sometimes, however, there may be symptoms such as bleeding disorders.
- Uterus – uterus
- Cervix – Fundus uteri
- Endometrium – tunica mucosa
- Uterine cavity – Cavitas uteri
- Peritoneal cover – Tunica serosa
- Cervix – Ostium uteri
- Uterine body – Corpus uteri
- Uterine constriction – Isthmus uteri
- Vagina – Vagina
- Pubic symphysis pubica
- Urinary bladder – Vesica urinaria
- Rectum – rectum
Symptoms
In most cases, such cysts are not even noticed by the patient herself, but are conspicuous as a random finding during routine ultrasound diagnostics. If the cysts do not cause any discomfort and also look inconspicuous in ultrasound, it is recommended to wait and see. The cysts are then regularly monitored by palpation or another ultrasound scan, but as long as they do not change (some cysts even regress on their own after taking certain drugs such as the pill), there is no need to do anything about them.
However, some women also suffer from symptoms caused by the cysts. These include bleeding disorders (i.e. an altered increased bleeding during menstruation or bleeding outside menstruation) and acute abdominal pain, which can sometimes be comparable to the pain of labor. The pain is particularly severe when a cyst becomes twisted, which causes blood vessels to be squeezed.
As a result of this interrupted blood flow, the organ is no longer adequately supplied with blood and a painful stimulus is produced in the tissue. If blood vessels rupture or if the cyst itself bursts, bleeding can occur, which either runs off to the outside or, less frequently, enters the abdominal cavity, which can quickly become dangerous. If cysts in the uterus are symptomatic and cannot be reduced in size even by medication, or if they are suspected to be malignant, then it is usually recommended to have them removed.
Nowadays, it is rarely necessary to open the abdominal wall for such an operation. Most of these operations can be performed either through the vagina or by means of laparoscopy. In most cases, however, the therapy for cysts consists of observation, since so-called functional cysts usually regress on their own within six weeks.
However, benign and asymptomatic cysts should also be regularly checked by ultrasound and palpation to avoid complications. If the cyst does not recede on its own, the doctor may prescribe hormone preparations that promote the regression of the cyst. In the course of the hormone preparations, newly developed estrogen antagonists, so-called GnRH antagonists, can be used to reduce the size of the cyst.
A hormone deficiency is often responsible for the development of cysts. This deficit can be remedied, for example, by normalizing the prolactin level. Another possibility to make cysts burst is the corpus luteum hormone progesterone.
Here, it is not so much the hormone itself that is effective, but rather its reduced level after about ten days, which leads to the cyst bursting. Progesterone can be used in the form of a tablet or as a vaginal suppository, whereby the suppository achieves better results. The contraceptive pill is also often used to treat cysts, as the pill suppresses ovulation, so no follicles are formed during the monthly cycle from which cysts can develop.
Glucose metabolism also appears to play a role in the development of cysts. Therefore, if cysts occur, the patient’s insulin resistance should be clarified.If insulin resistance exists, drugs that improve insulin resistance can prevent the development of further cysts in these patients. Overall, however, a cyst does not necessarily have to be treated with medication. The attending physician may also decide to closely monitor the cyst and wait to see whether it recedes on its own.
