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How can ovarian cyst be treated?

Q: I am a 25 years old woman having a left ovarian cyst containing about 100 ml fluid detected on a CT scan a month back. The doctor told me to use Nevlon for 5 months. I took the medicine for a month but when I got my period next month, bleeding was normal on the first two days but on days 3 to 7, I did not bleed on my pad but inside the vagina there was lighter coloured blood. Last month I did not have any problem like this. Should I consider this as a period or unexpected bleeding? I am still taking the tablet. Can I conceive now?

A:I do not have any information if you had any blood tests (tumour markers) to indicate if the cyst is likely to be benign (harmless). Management of ovarian cyst depends on the type of the cyst it is suspected to be. Most cysts at your young age are benign and not sinister, especially if there is no significant family history. If it is a small ovarian cyst, all it needs is a repeat scan (ultrasound scan), may be in 8 weeks time. On repeating the scan, one of the following three things is likely to happen:

  1. The cyst has increased in size – in this case, the best way to manage is treating it surgically, i.e. removing the cyst, as it is likely to be pathological
  2. The cyst has decreased in size – it is reassuring. All it needs is another scan in a couple of months time to make sure it disappears completely. The reason is that more often small cysts do tend to disappear spontaneously without any treatment.
  3. The cyst has remained same in size – it is still reassuring. It is more likely to be a benign cyst e.g. dermoid cyst. There are two options:
    • Remove it and complete the treatment.
    • Managing it expectantly i.e. further scans to make sure it is not increasing in size or changing its appearance.
There is no role of hormonal treatment in managing ovarian cysts. I am not sure why you are prescribed – what sounds to me like a hormone – although I must admit that I did not succeed in getting more information on ‘Nevlon’, which you are taking. Your irregularity in periods / bleeding pattern is more likely to be because of this medicine and should return to normal when you stop taking this. You can of course keep relationship with your husband and may become pregnant (provided there are no adverse factors preventing you from conceiving). But the best advise would be to deal with your cyst before planning pregnancy as it may create problems while pregnant.

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