Ovarian Cysts: Am I At Risk?

Ovarian Cysts: Am I At Risk?

What are ovarian cysts? Ovarian cysts are usually solid or fluid-filled sacs that result from fluid accumulated during ovulation. After the menstrual period,

What are ovarian cysts?

Ovarian cysts are usually solid or fluid-filled sacs that result from fluid accumulated during ovulation. After the menstrual period, these cysts usually shrink or dissolve spontaneously, although they may reoccur in subsequent ovulatory cycles.

Does a cyst mean I have cancer?

No. Cysts are typically a part of the menstrual cycle; even if they continue to grow after they form, they are rarely cancerous. And there is no evidence that women who have benign, or harmless, ovarian cysts are at greater risk than other women for cancerous ovarian growths. You may be at greater risk for ovarian cancer, however, if

  • You have a family history of ovarian cancer.
  • You have been given fertility drugs for artificial reproductive techniques such as in-vitro fertilization. Many physicians have administered the drug Clomid (clomiphene citrate) as a first-line treatment to induce ovulation. A study in the American Journal of Epidemiology suggests that clomiphene increases the risk of uterine cancer.

Other possible risk factors include a high-fat diet and having had talcum powder applied near the vagina, according to the National Cancer Institute. Researchers have not done case-control studies on either talc or high-fat diet and ovarian cancer. But an analysis of sex studies on vaginal exposure to talc and ovarian cancer found a statistically significant risk, and studies have linked high-fat diets to some forms of cancer.

Are cysts bad for me?

Not necessarily. There’s a tendency to view all ovarian cysts with suspicion, but many cause no problems at all. Cysts related to ovulation, for example, don’t cause cancer. But some cysts — such as those found in girls or postmenopausal women — are cause for more concern.

Generally, any cyst that persists for more than two to three menstrual cycles or continues to increase in size warrants close evaluation, according to the American College of Obstetricians and Gynecologists.

Is there more than one kind of cyst?

Yes. Cysts related to ovulation are known as functional cysts. Another variety, the follicular cyst, occurs when the follicle fails to burst and stubbornly continues to grow without releasing the egg. A follicular cyst usually disappears after two to three menstrual cycles. Some, however, can grow as large as 2.75 inches — a little bigger in diameter than a 12 ounce can of soda — and be quite painful; they may require surgery.

A luteal cyst, another type of functional cyst, grows from the corpus luteum, the substance that remains after the egg is released. This substance usually dissolves, but it can sometimes continue growing and become a cyst.

Some women will develop functional cysts over and over. The good news is that neither the follicular nor luteal cysts lead to cancer.

When multiple cysts are growing on the ovaries at the same time, you have polycystic ovarian syndrome . This condition is a sign of hormonal imbalance; if you have it, your body may be producing too many hormones known as androgens, and your ovaries may not produce eggs without treatment.

When should I get medical attention?

If a cyst is not related to ovulation, your doctor will want to do a thorough examination to determine what to do next. A solid cyst, which lingers through many menstrual cycles, is one to watch out for: It requires medical tests to determine whether it’s cancerous.

Since non-solid cysts can also cause problems, you should see a doctor immediately if you’re having persistent pain or any of the other problems listed below. If a cyst doesn’t dissolve after two or three menstrual periods, it may continue to grow and cause a variety of symptoms, including abdominal pain or pressure or pain during intercourse. It can also result in irregular menstrual periods and dull or knife-like pain.

A cyst can also twist or rupture, causing internal bleeding, severe abdominal pain, nausea, vomiting, dizziness, and faintness. Some cysts can even lead to irregular bowel or bladder function, swelling in the legs or vulva, an increase in facial and body hair, or weight gain.

Be aware that cysts can cause symptoms that mimic other illnesses, including pelvic inflammatory disease, tubal pregnancy, endometriosis, and ovarian cancer. Your doctor may need to run tests to rule out those disorders before he or she can make a diagnosis.

What should I do if I have a cyst?

It depends on what the pelvic exam reveals, whether or not you have symptoms, and your medical history. If your doctor feels a growth on the ovary, he or she will probably order an ultrasound to get a picture of your reproductive tract. This image can show you how large the cyst is, what it looks like, and whether it appears to be cancerous. If you don’t have pain, your doctor may want to put you on birth control pills (which help dissolve cysts) and monitor the result.

If you are experiencing pain, nausea, weight gain, an increase in facial hair, or other troubling symptoms, your doctor may also want to do a laparoscopy. A laparoscopy is a micro-surgical procedure that allows your doctor to look at your ovaries and pelvic area through a thin tube with a light at the end, and remove any cysts or growths to examine the tissue.

If the cyst appears to be cancerous, your doctor may do a series of diagnostic tests, since no one test may be conclusive. These include a blood test called CA 125, which detects tumors; other tests allow the doctor to see what’s going on inside your body by looking at images from a an MRI, an abdominal CT scan, a barium enema, or an x-ray of the urinary tract. He or she may also do an ultrasonography to examine the ovaries; a fluid-filled benign cyst and a tumor produce different types of sound waves.

If there still is some doubt about whether there is cancer present, your doctor could elect to do a laparoscopy. If there are strong indications that cancer is present, a more extensive procedure called a laparotomy is performed. This is a surgical procedure in which the abdomen is cut open and the tumor or growth removed, and often some of the reproductive organs as well.

References

Althuis, Michelle D., Moghissi, Kamran S., et al,”Uterine Cancer after Use of Clomiphene Citrate to Induce Ovulation,” American Journal of Epidemiology, Volume 161, Number 7, April 1, 2005

Ovarian Cyst. American Academy of Family Physicians 1998.

Brigham Narins, Editor. World of Health:847-8. The Gale Group 2000.

Burkman RT, et al. Current perspectives in oral contraceptive use. Am J Obstet Gynecol 2001 Aug;185(2 Suppl):S4-12.

Weber AM, et al. Gynecologic history of women with inflammatory bowel disease. Obstet Gynecol 1995 Nov;86(5):843-7.

Ness RB, et al. Factors related to inflammation of the ovarian epithelium and risk of ovarian cancer. Epidemiology 2000 Mar;11(2):111-7.

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