An adnexal mass, or adnexal cyst, is a growth that occurs in or near the organs attached to the uterus in women. This is what is called the adnexa region and includes the fallopian tubes, ovaries, uterus, and the connecting tissues.
Prevalence of Adnexal Cyst and Mass
Usually, an adnexal mass or cyst affects the adnexa, but when it is metastatic in nature, it may originate somewhere else, such as in the breast or stomach.
An adnexal cyst can be found in women of all ages. A malignant adnexal cyst may develop in females as young as 15, but more often, the mass is a functional cyst that will likely disappear on its own without treatment.
Women aged 40 and above with an adnexal cyst or mass have a greater chance of developing ovarian cancer.
Symptoms of Adnexal Cyst and Mass Growth
Some women with the condition will not experience adnexal cyst symptoms while being unaware an adnexal mass growth is even present. It is through a routine pelvic exam that an adnexal mass is typically discovered.
In some cases, adnexal cyst symptoms will occur, but this depends largely on the size of the mass. It is important to consult your doctor if you experience any of the following adnexal cyst symptoms, since they may also be present in other conditions and further investigation is likely required.
- Pain or pressure in the pelvic region
- Abdominal distension
- Constipation and gastrointestinal disorders
- Bleeding at the site of the cyst or mass
- Back pain
- Irregular periods in women experiencing pre-menopause
- Difficulty with urination
- Frequent urination
Causes of Adnexal Cyst and Mass Growth
There are a variety of different adnexal cysts and masses. Some fluid-filled growths arise in the woman’s ovaries; others have both solid and liquid matter (called septated) and are especially dangerous.
There is also what is called a complex adnexal cyst or mass, which will evolve from an ovarian adnexal mass or cyst. A complex adnexal mass or cyst can be further classified into categories of dermoid cysts, endometriomas, and low malignant tumors.
There are thought to be hundreds of adnexal mass causes. Adnexal cyst symptoms are often similar between the potential causes, especially endometriomas, ectopic pregnancy, and ovarian cancer. That being said, an adnexal mass differential diagnosis will be made based on the unique cause.
The following are some of the most common:
Ectopic Pregnancy
Ectopic pregnancy occurs when a fertilized egg doesn’t make it to the uterus. Instead, the egg implants in the fallopian tube, and therefore the pregnancy is unable to grow to term.
When the egg continues to grow in the fallopian tube, it will lead to a rupture, severe abdominal or pelvic pain, and heavy internal bleeding. An untreated ectopic pregnancy can be fatal for women.
Ovarian Cancer and Other Cancers
Ovarian and fallopian tube cancers commonly form a tumor in women that can grow and spread to areas other areas of the body. Common ovarian cancer symptoms include back pain, constipation, heartburn, indigestion, fatigue, irregular periods, difficulty urinating, abdominal or pelvic distension, and painful sex.
Breast and gastrointestinal tract cancers may spread to the adnexal region as well.
Ovarian Cysts
Ovarian cysts will also cause adnexal cysts. These liquid-filled sacs will develop on the ovaries; however, ovarian cysts are often painless and don’t produce symptoms.
When it contains tissue from the endometrium or uterine lining, this type of ovarian cyst is called an endometrioma. This will produce abnormal uterine bleeding and worsening pain from menstruation. This process can lead to endometriosis—a painful disorder of the endometrium.
Benign Ovarian Tumors
An ovarian tumor is solid, whereas a cyst is filled with fluid. However, when the cells inside the tumor are not cancerous, it is a benign tumor. As such, it won’t invade or spread to other parts of the body. It may not even produce symptoms.
Common benign ovarian tumors that may produce an adnexal cyst or mass include dermoid cysts, fibromas, and cystadenomas.
Polycystic Ovary
Small follicles lead to the development of an enlarged polycystic ovary. It is common in women with polycystic ovarian syndrome. Symptoms will include multiple cysts, irregular periods, high testosterone levels, and excessive hair growth.
Tubo-Ovarian Abscess
This is a collection of pus in the ovaries and tubes due to pelvic inflammatory disease (PID). Symptoms will include fever, abdominal pain, and vaginal discharge. PID can be sexually transmitted, and can also lead to infertility. A tubo-ovarian abscess is considered an acute infection; therefore, immediate attention is necessary.
Hydrosalpinx
This is a benign condition in which fluid becomes trapped inside a fallopian tube. Pain and reduced fertility rates may result.
Adnexal Cyst and Mass in Pregnancy
To avoid complications, it is ideal to discover an adnexal mass and treat it before a woman gets pregnant. That being said, adnexal masses are sometimes exposed in pregnancy during a routine pelvic exam or ultrasound.
Since most adnexal cysts or masses are not harmful and resolve without treatment, many doctors choose to simply monitor the mass very closely during pregnancy. Women will only require surgery if a complication occurs, the mass is so large that it will likely cause an issue with the pregnancy, or the doctor suspects the adnexal cyst or mass is malignant and therefore may be cancerous.
A clinical review published in OBG Management in 2007 found that about 10% of adnexal masses discovered during pregnancy are considered malignant. However, since the cancer is in often its early stages, this is good news for the mother.
If the malignant tumor is discovered during pregnancy, the doctor will only interfere with a pregnancy if it is no longer safe for the mother.
Diagnosis
A physical pelvic exam will help the doctor diagnose an adnexal cyst or mass. The doctor will feel the woman’s ovaries, uterus, vagina, bladder, and rectum, and make note of a lump or anything else unusual. The doctor will also retrieve information about the woman’s medical history, symptoms, and a possible family history of cancer or adnexal cysts.
An ultrasonography is done after the physical exam. This pelvic ultrasound will confirm if a cyst or mass is near or in the adnexa region. After being diagnosed, the doctor will decide if the adnexal cyst or mass is cause for emergency. Often, it is not an emergency, and this is when the doctor will look to discover the cause of the cyst or mass.
A MRI or CT scan may be used to determine the underlying cause of an adnexal cyst or mass. A pregnancy test may also be given to rule out an ectopic pregnancy.
Final Thoughts
An adnexal mass or cyst is often non-cancerous and will resolve without treatment. That being said, when uncomfortable symptoms are experienced, a pelvic exam and ultrasonography may be needed to determine the cause of the adnexal cyst or mass.
Adnexal cyst symptoms are similar to those of many of the potential causes of this condition, including ectopic pregnancy or ovarian cancer. When treated before it spreads outside the ovary, the five-year survival rate of ovarian cancer is considered 92%.
When a liquid-filled cyst becomes solid, surgery may help manage an adnexal cyst or mass. If cancerous, further treatment may be necessary to ensure all cancer has been eliminated from the body.
Allopathic treatment for Adnexal Cyst and Mass
In allopathy, there is no treatment for adnexal cyst. According to theory of allopath’s, when an adnexal mass or cyst is small and no symptoms are present, treatment may not be required. Allopathic doctor may want to monitor the situation with regular ultrasounds and pelvic exams.
Surgery is needed when the mass begins to grow, the cyst becomes solid, or the patient develops adnexal cyst symptoms. Adnexal masses that exceed eight centimeters (cm) to 10 cm in size should be managed with a type of abdominal surgery called a laparotomy.
After it is removed, the adnexal cyst or mass will be examined to determine whether the cells within it are cancerous. If cancerous, further treatment may be needed to ensure all the cancer has been removed from the body.
Homeopathic Treatment of Adnexal Cyst
According to Homeopathic theory, “never allow a disease to grow (chronic).
Low-salt diet will cause inflammation in arteries that’s why patient shouldn’t stop talking raw (non -clocked) salt (Dr Qaisar Ahmed), however patient have to take potassium rich products/food as much as possible and stop eating pork, broiler and white sugar, this will allow kidney cysts to respond to Homeopathic medicines and it will increase in fluids and cyst will be subside in few days of Homeopathic treatment.
Here are few Homeopathic medicines for different types of cysts:
Lachesis Muta
Lachesis Muta is best for left sided ovarian cysts. Swelling and pain in the left ovary that gets better during menses, short and scanty menses, and menstrual bleeding that is blackish in color. Climacteric troubles, palpitation, flashes of heat, hemorrhages, vertex headache, fainting spells; worse, pressure of clothes. Menses too short, too feeble; pains all relieved by the flow. Left ovary very painful and swollen, indurated. Mammae inflamed, bluish. Coccyx and sacrum pain (ovarian cysts), especially on rising from sitting posture. Acts especially well at beginning and close of menstruation.
Lycopodium Clavatum
Lycopodium Clavatum is best for right side ovarian cysts. Burning or boring pains may be felt in the ovary. Menses too late; last too long, too profuse. Vagina dry. Coition painful. Right ovarian pain, Ovarian cyst. Varicose veins of pudenda. Leucorrhea, acrid, with burning in vagina. Discharge of blood from genitals during stool. Nymphomania with terrible teasing desire in external organs. Itching, burning, and gnawing in vulva.
Menstruation too late; lasts too long; sometimes suppression of; profuse, protracted; flow partly black, clotted, partly bright red or partly serum; with labor-like pains followed by swooning. Varices on the genitals.
Colocynthis
Boring pain in ovary. Must draw up double, with great restlessness. Round, small cystic tumors in ovaries or broad ligaments. Wants abdomen supported by pressure. Bearing-down cramps, causing her to bend double. Ovarian Cysts.
The pain varies in character, ranging from cramping, stitching to tensive. Burning sensation in the ovaries that gets better upon bending over double and a sensitive ovarian region that seems hard and swollen are the symptoms that indicate the need for this medicine.
Apis Mellifica
Cysts that cause pain during intercourse. A stinging, sharp, cutting pain from the ovary radiating down the thigh, soreness and tenderness over the ovarian region, heaviness in the ovarian region and pain in the ovaries during menstruation. Edema of labia; relieved by cold water. Soreness and stinging pains; ovaritis; worse in right ovary.
Amenorrhea or menorrhagia. Inflammation, induration, swelling, and dropsy of the ovaries. Weight and pain in either ovarian region, predominantly right side. Ovarian cysts. The ovaries feel better by lying on right side. Enlargement of the right ovary with pain in the left pectoral region and cough. Sharp, cutting, stinging pain in the swollen ovary; worse during menstruation.
Ovarian tumors, with stinging pains like bee stings. Metritis, peritonitis, with stinging, thrusting pains. Dropsy of the ovaries; dropsy of the uterus. Threatened miscarriage in the early months. Abortion. Dropsy in the latter part of pregnancy attended with puerperal convulsions. Ulceration and engorgement of os uteri. Large and painful swelling of the labia, with heat and stinging pains.
Erysipelatous inflammation of the breasts. Swelling and hardness of the mammae threatening to ulcerate. Scirrhous or open cancer of the mammae, with stinging, burning pains. Dysmenorrhea, with severe ovarian pains. Ovarian cysts. Metrorrhagia profuse, with heavy abdomen, faintness, stinging pain. Sense of tightness. Bearing down, as if menses were to appear. Ovarian tumors, metritis with stinging pains. Great tenderness over abdomen and uterine region.
Pulsatilla Nigricans
Nymphomania. Drawing, pressive, spasmodic and contractive pain extending towards uterus with qualmishness, ovarian cysts. Burning (sticking) pain in vagina and pudenda. Metrorrhagia (discharge now stopping, and then stronger again, of coagulated, clotted blood, or with false labor-pains). Menstrual blood black, with clots of mucus, or pale and serous. Catamenia irregular, tardy, or premature, of too short or too long duration, or entirely suppressed, with colic, hysterical spasms in abdomen, hepatic pains, gastralgia, pain in loins, nausea and vomiting, shivering and paleness of face, megrim, vertigo, moral affections, tenesmus of anus and bladder, stitches inside, and many other sufferings before, during, or after period.
Suppression of menses (especially in elderly women in whom they usually occur at full moon). Delay of first menses. Leucorrhea, thick, like cream. False pregnancy. During pregnancy: nausea, morning sickness; varicose veins, bluish (cyanotic).
Calcarea Carbonica
Before menses, headache, colic, chilliness and leucorrhea. Cutting pains in uterus during menstruation. Menses too early, too profuse, too long, with vertigo, toothache and cold, damp feet; the least excitement causes their return. Uterus easily displaced. Leucorrhea, milky. Burning and itching of parts before and after menstruation. Increased sexual desire, easy conception. Hot swelling breasts. Much sweat about external genitals. Sterility with copious menses. Uterine polypi.
Sabina Officinalis
Almost insatiable desire for coition with corresponding gratification. Sexual desire greatly increased (almost amounting to nymphomania). Contractive pain in region of uterus. Ovarian cysts. Stitches deep in vagina. Sanguineous congestion in uterus. Hemorrhages of partly pale red, partly clotted, or of very thin, discolored, offensive-smelling blood.
Metrorrhagia with discharge of clotted or bright-red blood, and pains resembling labor pains in the sacrum and in the groins. Metrorrhagia, bright blood. Menses continue too long. Menstrual discharge partly fluid, partly clotted and offensive; it may be either bright red or dark and coagulated; flows mostly in paroxysms, which are brought on by slightest motion; or flow ceases when walking about (menses only when lying down).
Suppressed catamenia with very offensive-smelling leucorrhea (like rotten meat). Miscarriage (especially in the third month). Perceptible swelling of mammae. Tingling in mammae. Inflammation of the uterus after parturition. Retained placenta. After-pains with sensitiveness of abdomen.
Nitricum Acidum
External parts sore, with ulcers. Leucorrhea brown, flesh-colored, watery, or stringy, offensive. Hair on genitals falls out. Uterine hemorrhages. Menses early, profuse, like muddy water, with pain in back, hips and thighs. Stitches through vagina. Metrorrhagia after parturition.
Sepia Succus
Pelvic organs relaxed. Bearing-down sensation as if everything would escape through vulva, must cross limbs to prevent protrusion, or press against vulva. Leucorrhea yellow, greenish; with much itching. Menses Too late and scanty, irregular; early and profuse; sharp clutching pains. Violent stitches upward in the vagina, from uterus to umbilicus. Ovarian cysts. Prolapse of uterus and vagina. Morning sickness. Vagina painful, especially on coition.
Silicea Terra
A milky acrid leucorrhea, during urination. Itching of vulva and vagina; very sensitive. Discharge of blood between menstrual periods. Increased menses, with paroxysms of icy coldness over whole body. Nipples very sore; ulcerated easily; drawn in. Fistulous ulcers of breast. Abscess of labia. Discharge of blood from vagina every time child is nursed. Vaginal cysts hard lumps in breast.
Aconite Nepalis
Inflammations. Gland inflammations. Nephritis. Menses too abundant and too protracted. Suppressed menstruation. Puerperal peritonitis. Maniacal fury on the appearance of the menses. Stitching pains in fundus uteri; sharp shooting pains, abdomen exceedingly sensitive. Ovaritis from suddenly checked menstrual flow. Dysmenorrhea. Uterine hemorrhage; active, much excitability; giddy, cannot sit up; fear of death. Vagina dry, hot, sensitive. Leucorrhea.
Belladona
Sensitive forcing downwards. Dryness and heat of vagina. Dragging around loins. Pain in sacrum. Menses increased, bright red, too early, too profuse. Hemorrhage hot. Cutting pain from hip to hip. Menses and lochia very offensive and hot. Labor-pains come and go suddenly. Mastitis pain, throbbing, redness, streaks radiate from nipple. Adnexal cyst.
Gloninum
Menstruation suppressed. Adnexal cyst. At climaxes, flushes of heat, pressure in head, nausea, loss of senses, vertigo, swelling of feet. During pregnancy headache, congestions of blood to the head and chest. Eclampsia; unconscious; face bright red; puffed; pulse full, hard; urine copious and albuminous.
Mercuris Corresive
Bright’s disease. Cancer. Adnexal cyst. Chancre (syphilis). Intense inflammation of the vulva. Painful glandular swellings about nipple.
Cantharis
Cantharis is a well-known homoeopathic medicine for its marvelous effects on cysts, inflammations and infections of urinary tract. Adnexal cyst. In cases of micturition (burning), it brings immediate relief. Bladder cystitis. Interstitial cystitis where the root cause is chronic inflamed bladder. Nymphomania. Puerperal metritis, with inflammation of bladder. Menses too early and too profuse; black swelling of vulva with irritation. Constant discharge from uterus; worse false step. Burning pain in ovaries; extremely sensitive. Pain in os coccyx, lancinating and tearing.
Convalaria Majalis
Aching in bladder; feels distended. Polyuria. Offensive scanty urine. Adnexal cyst. Venous stasis. Dyspnea, dropsy, aneurism (tendency). Anasarca. Soreness in uterine region, with sympathetic palpitation of heart. Pain in Sacro-iliac joints, running down leg. Itching at urinary meatus and vaginal orifice.
Staphysagria
Itching, needle like stitches in region of kidneys. Constant urging in young married women. Parts very sensitive, worse sitting down. Irritable bladder in young married women. Leucorrhea. Prolapsus, with sinking in the abdomen; aching around the hips.
Arsenicum Album
Menses too profuse and too soon. Burning in ovarian region. Leucorrhea, acrid, burning, offensive, thin. Pain as from red-hot wires. Fatigue. Adnexal cyst. Menorrhagia. Stitching pain in pelvis extending down the thigh.
Berberis Vulgaris
Pinching constriction in mons veneris, vaginismus, contraction and tenderness of vagina. Adnexal cyst. Burning and soreness in vagina. Desire diminished, cutting pain during coition. Menses scanty, gray mucus, with pain in kidneys and chilliness, pain down thighs. Leucorrhea, grayish mucus, with painful urinary symptoms. Neuralgia of ovaries and vagina. Flat warts – itching, burning and smarting.
Sarsaparilla
Before menstruation, itching and humid eruption of forehead. Cysts. Menses late and scanty. Moist eruption in right groin before menses.
Kali Carbonicum
Menses early, profuse or too late, pale and scanty, with soreness about genitals; pains from back pass down through gluteal muscles, with cutting in abdomen. Pain through left labium, extending through abdomen to chest. Delayed menses in young girls, with chest symptoms or ascites. Uterine cysts. Difficult, first menses. Complaints after parturition. Uterine hemorrhage; constant oozing after copious flow, with violent backache, relieved by sitting and pressure. Syphilis. Tic-douloureux. Ulcers.
Lycopodium Clavatum
Menses too late; last too long, too profuse. Vagina dry. Coition painful. Right ovarian pain. Varicose veins of pudenda. Leucorrhea, acrid, with burning in vagina. Discharge of blood from genitals during stool. Cystitis. Proctalgia. Prostatitis. Involuntary micturition. Oily urine.
Tilia Europaea
Intense sore feeling about uterus; bearing down, with hot sweat, but without relief. Much slimy leucorrhea when walking. Soreness and redness of external genitals. Pelvic inflammation, tympanites, abdominal tenderness and hot sweat which does not relieve.
Thuja Occidentalis
Vagina very sensitive. Warty excrescences on vulva and perineum. Profuse leucorrhea; thick, greenish. Severe pain in left ovary and left inguinal region. Menses scanty, retarded. Polypi; fleshy excrescences. Ovaritis; worse left side, at every menstrual period. Profuse perspiration before menses.
Sanicula Aqua
Bearing down, as if contents of pelvis would escape; better, rest. Desire to support parts. Soreness of uterus. Leucorrhea with odor of fish-brine or cold cheese. Vagina feels large.
Hepar Sulphuricum
Discharge of blood from uterus. Itching of pudenda and nipples, worse during menses. Menses late and scanty. Abscesses of labia with great sensitiveness. Extremely offensive leucorrhea – smells like old cheese. Profuse perspiration at the climacteric.
Phosphorus
Metritis. Chlorosis. Phlebitis. Fistulous tracks after mammary abscess. Slight hemorrhage from uterus between periods. Menses too early and scanty-not profuse, but last too long. Weeps before menses. Stitching pain in mammae. Adnexal cyst. Leucorrhea profuse, smarting, corrosive, instead of menses. Amenorrhea, with vicarious menstruation. Suppuration of mammae, burning, watery, offensive discharge. Nymphomania. Herpes circinate. Uterine polyps.
Bromium
Swelling of ovaries. Menses too early; too profuse, with membranous shreds. Low spirited before menses. Tumor in breasts, with stitching pains; worse left. Stitch pains from breast to axillae. Sharp shooting pain in left breast, worse, pressure.
Terebinthina
Intense burning in uterine region. Metritis; puerperal peritonitis. Metrorrhagia with burning in uterus. Cysts. Micturition. Urethritis, with painful erections. Stricture of urethra.
Kali Bichromicum
Having a good antibiotic and anti-viral effects. Burning in urethra. Adnexal cyst. Ropy mucus in urine. Yellow, tenacious leucorrhea. Pruritus of vulva, with great burning and excitement. Prolapsus uteri; worse in hot weather.
Apocynom Cannabinum
Amenorrhea, with bloating; metrorrhagia with nausea; fainting, vital depression. Cysts. Hemorrhages at change of life (menopause). Blood expelled in large clots. Polycystic kidney disease.
Sabina
Menses profuse, bright. Uterine pains extend into thighs. Threatened miscarriage. Sexual desire increased. Leucorrhea after menses, corrosive, offensive. Discharge of blood between periods, with sexual excitement. Retained placenta; intense after-pains. Menorrhagia in women who aborted readily. Inflammation of ovaries and uterus after abortion. Promotes expulsion of moles from uterus. Pain from sacrum to pubis, and from below upwards shooting up the vagina. Hemorrhage; partly clotted; worse from least motion. Atony of uterus.
Baryta Carbonica
Diminution of sexual desire in women. Cysts. Catamenia too feeble, and of too short duration. Leucorrhea a little before the catamenia. Swelling and induration of the glands. Tumors. Warts.
Eupionum
Amenorrhea. Cramps. Glandular swellings. Groins, pain in. Hemorrhages. Headache. Leucorrhea. Menorrhagia. Neuralgia. Night-sweats. Phthisis. Pruritus. Toothache. Tumors. Vicarious menstruation.
Lobelia Erinus
Menses come on too often, Bearing down. Cancer.
Lobelia Inflata
During menstruation violent pain in sacrum. Violent pain in the sacrum, with fever. Suppression of the menses. Amenorrhea. Dysmenorrhea. Serous discharges from vagina.
Lilium Tigrinum
Bearing down sensation. Sharp or gasping pains in ovarian region. Pains in ovaries extending into inside of thighs. Ovaries sore and painful to touch. Feels pressure on ovaries. Severe neuralgic pain in uterus. Fundus of uterus low down. Leucorrhea, leaving brown spots on clothes.
Medorrhinum
Severe pain in ovaries, sensation of sac in abdomen. Intense, excruciating, neuralgic pains in whole pelvic region, extending downwards through ovarian region to uterus. Profuse menses: dark clotted, stains difficult to wash out; also, bright blood, with faintness and some pain. Intense menstrual colic.
Piper Nigrum
Ovaries and uterus congested, with pricking and lancinating pains. Contraction of uterus with sensation as if something strove to penetrate into it. Burning and distending pains in uterus. Menses: difficult, retarded; capricious, irregular, with colic and black blood. Cysts. Infections in uterus.
Plumbum Metallicm
Vaginismus, with emaciation and constipation. Induration of mammary glands. Vulva and vagina hypersensitive. Stitches and burning pains in breasts. Tendency to abortion. Menorrhagia with sensation of string pulling from abdomen to back. Disposition to yawn and stretch. Adnexal cyst mass.
P. S: This article is only for doctors having good knowledge about Homeopathy and allopathy, for learning purpose(s).
For proper consultation and treatment, please visit our clinic.
None of above-mentioned medicine(s) is/are the full/complete treatment but just hints for treatment; every patient has his/her own constitutional medicine.
Dr. Sayyad Qaisar Ahmed (MD {Ukraine}, DHMS), Abdominal Surgeries, Oncological surgeries, Gastroenterologist, Specialist Homeopathic Medicines.
Senior research officer at Dnepropetrovsk state medical academy Ukraine.
Location: Al-Haytham clinic, Umer Farooq Chowk Risalpur Sadder (0923631023, 03119884588), K.P.K, Pakistan.
Find more about Dr Sayed Qaisar Ahmed at:
https://www.youtube.com/Dr Qaisar Ahmed
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