Wednesday, July 22, 2009

The Scoop On: Ovarian Cysts

What they are:
Ovaries make cysts for a living—each month your ovary “recruits” microscopic eggs to pick a candidate for ovulation. After the best-looking egg of the bunch is released, a small cyst is left behind (like a big pimple on your ovary). Normally, this cyst is absorbed by the ovary, but sometimes it seals over and fills with fluid or blood. Less commonly, an ovarian cyst is filled instead with mucus or fibrous tissue, and in some cases, hair and teeth.

What does it mean:
In most cases, nothing. Most cysts are considered “functional”—a sign that your ovary is working normally. If your gyno finds one on your exam, she may want you to have a follow-up visit, or an ultrasound, or both. Fluid-filled cysts will eventually be absorbed, but may linger for awhile, and may even get bigger before they get smaller. Sometimes, the cyst will rupture; this may happen randomly or during intercourse. While very painful, a ruptured cyst generally has no lasting consequences to your health or fertility.

How can you treat it:
Your gyno may decide that your cyst needs treatment: it looks suspicious for cancer on the's rapidly's really large (6-10 cm in diameter)'s twisting your ovary from its weight. If this is the case, surgery is the only option - there's no medication that can get rid of a cyst. Most of the time, the cyst can be removed laparoscopically. While you're under anesthesia, your gyno makes a tiny incision in your naval and places a skinny camera inside. Two or three other tiny incisions are made in your lower abdomen, and long skinny instruments are used to remove the cyst--in most cases, leaving your ovary behind.

How you can prevent them:
Using systemic hormonal birth control--pills, patches, rings--will reduce the amount of activity in your ovaries each months, and helps to prevent cysts from forming.


Emily said...

Dr. Kate,

I recently discovered I have two cysts, one on each ovary. One is the size of a walnut and the other is the size of a tennis ball. My OBGYN put me on Femcon for two months and then I am supposed to get a follow up ultrasound. In the meantime the Femcon is supposed to be "giving my ovaries a rest" and I was told this would "shrink the cyst." However, from what I'm reading here, (and what I've always thought) it sounds like hormonal BC will not shrink the cyst, but merely prevent new cysts from forming or growing larger.

I am in a lot of pain and discomfort and do not want to waste two months on Femcon only to find out I need surgery anyway. What is your input?

Dr. Kate said...

Emily, I understand where you're coming from. But just giving the cysts time to resolve - on OR off the birth control pill - may save you from a surgery that you don't need. One of the best things I was taught in my training was that sometimes, "don't just do something, stand there." Try taking 2 Aleve every 12 hours, to reduce the pain. My fingers are crossed for you.