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Thursday, 29 December 2011

Ovarian Cyst

Ovarian cysts are so common that I see almost 3-5/ week in my practice. Very often they have little or no symptoms and are found routinely at the yearly gynaecological check-up. The most common are the functional cysts which are related to the menstrual cycle. These cysts are due to an imbalance of the bodies hormones and they will often correct themselves or can be treated simply by balancing the hormones. Pathological cysts on the other hand are abnormal and will not disappear with medical treatment. They will need surgery as they are sometimes cancerous. The cysts may be filled with fluid or blood. Some are present from birth and grow to a size that can eventually be detected by ultrasound scanning. They are filled with hair, teeth, bone and sebum!. Symptoms may include painful periods, heavy or irregular periods, painful sexual intercourse and abdominal bloatedness and pain.

Ultrasound scan, blood hormonal tests and ovarian cancer screens are some of the tests done before deciding on whether surgery is needed. Unless a cancer is suspected, most ovarian cysts can be removed by key hole surgery.

Wednesday, 28 December 2011

Fibrocystic disease of the breasts

This very common condition is characterised by painful lumps in the breast. There are both solid and cystic lesions seen when an ultrasound scan is performed. They are usually multiple in nature. Typically the patient will experience swollen and painful breasts before and sometimes during her period. This condition should be distinguished from a fibroadenoma which is a single solid lump. Whatever the nature of the lesion it is always advisable to have a biopsy ( surgical removal) to exclude a cancer even though the mammogram or ultrasound scan shows that it is likely to be benign. I had a patient recently who had a 7 cm lump in her breast. She did not go to see a doctor out of fear and had left the lump to fester for many years. The scan showed that it was likely to be benign but at removal there was a focus of cancer. Breast cancer is the most common cancer in women today, and every woman should have a mammogram at least once in 2 years after 40 years of age.

Having confirmed that the fibrocystic disease is of a benign nature, a hormone profile done will often show an oestrogen predominance and low progesterone ( hormone levels). Prevention of recurrence and control of the disease is possible by balancing the hormone levels. One should also reduce salt intake, and consume less soy products. Evening primrose oil will also help reduce the effect of oestrogen on the breasts.