OVARIAN CYSTS

Ovaries make cysts for a living and are a very common complaint of both young women and older women. Ovarian cysts are fluid-filled sacs or pockets within or on the surface of an ovary. The ovaries are two organs — each about the size and shape of an almond — located on each side of a woman's uterus. Many women have ovarian cysts at some time during their lives. Most ovarian cysts present little or no discomfort and are harmless. The majority of ovarian cysts disappear without treatment within a few months.

 About 8% of women from 25 to 40 have ovarian cysts larger than a walnut and have no symptoms. Medical studies have shown that 87% - 93% of ovarian cysts found prior to menopause are benign, meaning not cancerous.  Of the cysts found in menopausal women, 55% - 92% are benign.

 

         Signs and symptoms of Ovarian Cysts  

        ·         Menstrual irregularities

·         Pelvic pain — a constant or intermittent dull ache that may radiate to your lower back and thighs

·         Pelvic pain during intercourse (dyspareunia)

·         Nausea, vomiting or breast tenderness similar to that experienced during pregnancy

·         Fullness or heaviness in your abdomen

·         Pressure on your rectum or bladder — difficulty emptying your bladder completely

         Immediate medical attention should be sought if you have the following symptoms:

·         Sudden, sharp, severe abdominal or pelvic pain

        ·         Pain accompanied by fever or vomiting

 

        Types of Ovarian Cysts

• Follicular cyst. Your ovaries normally grow cyst-like structures called follicles each month. Follicles produce the hormones estrogen and progesterone and release an egg when you ovulate. Sometimes a normal monthly follicle just keeps growing. When that happens, it becomes known as a functional cyst. Follicular cysts are usually harmless, rarely cause pain, but may cause severe pain, and often disappear on their own within two or three menstrual cycles.

·         Corpus luteum cyst. A follicular cyst later in the monthly cycle, after ovulation, becomes a corpus luteum. If it fills with blood, this corpus luteum cyst may rupture, causing internal bleeding and sudden, sharp pain. The fertility drug clomiphene citrate (Clomid, Serophene), used to induce ovulation, increases the risk of one or more corpus luteum cyst developing after ovulation.

·         Dermoid cysts. These cysts are the ugliest of all ovarian cysts. They may contain tissue such as hair, oil, skin or teeth because they form from cells that produce human eggs. They are rarely cancerous, but they can become large and cause painful twisting or torsion of your ovary.

·         Endometriomas. These cysts develop as a result of endometriosis, a condition in which uterine cells grow outside your uterus. Some of that tissue may attach to your ovary and form a growth.

·         Cystadenomas. These cysts develop from ovarian tissue and may be filled with a watery liquid or a mucous material. They can become large and cause torsion or twisting of your ovary.

·         Ovarian cancers. These cancers can sometimes present as ovarian cysts and be very silent with no pain, no discomfort

 

     Screening and diagnosis

       A cyst on your ovary may be found during a pelvic exam or on an ultrasound or sonogram.

·         Pelvic ultrasound. In this procedure, a wand-like device (transducer) is used to send and receive high-frequency sound waves (ultrasound) through your pelvic area, creating an image of your uterus and ovaries on a video screen. These images are photographed and analyzed by a radiologist to confirm the presence of a cyst. Sonograms help to identify location and the cyst is solid, filled with fluid or mixed.

·         Pregnancy test. A positive pregnancy test may suggest that your cyst is a corpus luteum cyst, which can develop when the ruptured follicle that released your egg reseals and fills with fluid.

 

• CA 125 blood test. Blood levels of a protein called cancer antigen 125 (CA 125) often are elevated in women with ovarian cancer. If you develop an ovarian cyst that is partially solid and you are at high risk of ovarian. Elevated CA 125 levels can also indicate non-cancerous conditions such as endometriosis, uterine fibroids and pelvic inflammatory disease.

·         Laparoscopy. Using a laparoscope — a slim, lighted telescope inserted into your abdomen through a small incision — allows Dr. Goodrich to see your ovaries and remove the ovarian cyst.

 

      Treatment

        Treatment depends on your age, the type and size of your cyst, and your symptoms. Your doctor may
    suggest:

·         Watchful waiting. You can wait and be re-examined in one to three months if you're in your reproductive years, you have no symptoms and an ultrasound shows you have a simple, fluid-filled cyst, and a non-suspicious reading. In postmenopausal women, this is a common treatment option recommended for postmenopausal women if a cyst is filled with fluid and less than 2 inches in diameter.

·         Birth control pills.  Birth control pills may be recommended to reduce the chance of new cysts developing in future menstrual cycles.

·         Surgery. Dr. Goodrich may suggest removal of a cyst if it is large, doesn't look like a functional cyst, is growing or persists through two or three menstrual cycles. Cysts that cause pain, tenderness, recurrent abnormal bleeding, pain with sex or other symptoms may be removed. Laparoscopy is usually suggested, and the cyst can usually be removed leaving the ovary. Sometimes the ovary is removed leaving the other intact in a procedure known as oophorectomy. Leaving at least one ovary intact allows you to still become pregnant, and also has the benefit of maintaining a source of estrogen production, thus avoiding menopause. If a cystic mass is cancerous, however, Dr. Goodrich will advise a hysterectomy to remove both ovaries and your uterus. This procedure helps to prevent the possible spread of the cancer.

 

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                               KENNETH GOODRICH, M.D.  -  OBSTETRICIAN- GYNECOLOGIST  
     
                                           Certified by the American Board of Obstetrics and Gynecology

           Specializing in General Obstetrics and Gynecology, Minimally Invasive Gynecological Surgery- Hysterectomies
              and Uterine Fibroids, HPV treatment for Women and Men, Surgery on Obese Women,  Chronic Vaginal
              Discharges, Sexually Transmiited Diseases, Menopause, Abnormal Bleeding ,Cellulite Reduction and
                                                                                 Aesthetic Services