Women's Diseases (Cysts, Fibroids, Polyps and Endometriosis) on Womb, Uterus and Ovary

Sunday 12 July 2020

This post gives you an overview of the 4 main diseases related to women's reproductive organs, namely cysts, fibroids, polyps and endometriosis.

Before that, let's take a look at the functions of 2 major hormones that can cause havoc here, which are estrogen and progesterone.

Functions of Estrogen

1) Send message to uterus to grow and replace the lining that's shed during previous menstruation.

2) Maintain proper rate of bone breakdown (osteoclast) and prevent bone loss (osteoporosis).

3) Develop female sex characteristics - breasts and sexual organ.

4) During pregnancy, reduce the function of thyroid hormone. This reduces metabolism rate, thereby conserving energy for the growth of foetus. As a result, ladies put on weight during pregnancy.

5) Increase production of thyroid binding globulin (TBG), which decreases metabolism and increases fat deposits to have enough energy for the foetus if a pregnancy develops.

6) During puberty and pregnancy, the secretion of estrogen is high but decreases after menopause. Excessive exercise can also lead to lower estrogen because women with too little fat cannot produce sufficient estrogen.

Too high or too low level of estrogen can lead to depression, anxiety and insomnia, decreased sex drive and concentration.

Functions of Progesterone

1) Produced after ovulation to maintain the stability of endometrium and provide the environment for embryo growth. If the lady is not pregnant, progesterone reduces and signals the beginning of menstruation.

2) Reduce response to estrogen receptor. For example, high estrogen secretion can cause breast enlargement; so progesterone appears to stop the continuous growth of breast cells.

3) Stimulate bone osteoblast (make new bones to replace old bones). If not, it increases the risk of osteoporosis.

4) Reduce TBG - stored fats are utilised. Low progesterone level can lead to weight gain. It's common for ladies to take hormone pills for their menstruation problem. But the side effect is, these drugs block the production of estrogen and progesterone thus causing the ladies to put on weight.

5) Stimulate sex drive as it can be converted to testosterone.

6) Affect the brain by reducing anxiety, insomnia and depression.

Now let's look at the different types of reproductive system diseases.

1. Ovarian Cysts

(a) Functional cysts

(i) Follicle cyst (also called water cyst)
During a woman's menstrual cycle, an egg grows in a sac called a follicle, which breaks open to release the egg. But if the follicle doesn't break open, the fluid inside the follicle can form a cyst. It's the most common type.

(ii) Corpus luteum cyst
Follicle sacs typically dissolve after releasing the egg. But if it doesn't and the opening of the follicle seals, additional fluid can develop inside the sac. This accumulation of fluid causes a corpus luteum cyst. They are usually harmless and disappear by themselves.

(b) Others
(i) Ovarian dermoid cysts
Sac-like growths that contain hair, fat and other tissues.

(ii) Ovarian cystadenomas
Non-cancerous growths on the outer surface of ovaries.

(iii) Ovarian endometriomas (also called chocolate cyst)
Tissues which normally grow inside the uterus develop outside and attach to ovaries (15% of cysts types).

(iv) Polycystic ovary syndrome

Cysts (i) and (ii) can become large, causing ovaries to move out of position, leading to pain.

Symptoms - pelvic pain, bloating, heaviness in abdomen.
Complications - twisting of ovary, rupture (causing internal bleeding), ovarian cancer especially higher risk for postmenopausal women.
Causes - functional cysts are due to menstrual cycle. The others are unknown.

2. Uterine fibroids (benign tumour)
(a) Intramural
Grows inside the wall of the womb. It's the most common.

(b) Submucosal
Grows towards the inside of the uterus cavity and hence will affect pregnancy.

(c) Subserosal
Grows towards the outside the uterus.

Symptoms - heavy menstrual bleeding, period lasting more than 1 week, pelvic pressure or pain.
Complications - anaemia from heavy blood loss, infertility, miscarriage.
Causes - genetic, imbalanced estrogen and progesterone hormones, insulin-like growth factor (diabetic patients are at higher risk).

3. Uterine polyps

They are growths attached to the inner wall of the uterus that extend to the uterine cavity. In other words, they are the overgrowth of cells in the lining of uterus (endometrium) which lead to the formation of uterine polyps (endometrial polyps).

They are usually benign although some can eventually turn cancerous.

Symptoms - vaginal bleeding, bleeding after intercourse, heavy menstrual bleeding.
Complications - infertility, miscarriage.
Causes - too much estrogen.
Risk factors - being peri or postmenopausal, has HBP, is obese or takes Tamoxifen drugs for breast cancer.

4. Endometriosis

Endometrial tissue normally grow in the uterus to prepare the lining of the womb for ovulation. Endometriosis is the buildup of these tissues that grow outside the uterus. These displaced tissues cannot be expelled during menstruation. 

It may effect the ovaries (more frequent), fallopian tubes, peritoneum and lymph nodes.

Symptoms - painful period, pain during intercourse, pain during bowel movement or urination.
Complications - infertility, ovarian cancer.
Causes - retrograde menstruation, transformation of peritoneal cells (due to hormones or immune factors), transformation of embryonic cells (due to estrogen), immune system disorder (not able to recognise and destroy endometrial tissues growing outside the uterus).

Would you like to know how to treat them?
Wait for the next post..

Please email askfuiping@gmail.com if you have questions.

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