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What are the various ovarian cysts and their treatments?

Q: I am 47 years old. Two years back I got an ultrasound done and was told that I have a 3 cm cyst in my right ovary. I want to know afer what period of time do I have to repeat my test? I still get my periods regularly. I am taking Tenormin 50mg for blood pressure for the past one year. I am allergic to penicillin. I get stressed fast.

A:Ovarian cysts are fluid-filled sacs that are formed in the ovaries. These are common in women in their reproductive years. Most of these cysts are non-cancerous (benign). The various types of cysts are: Functional cyst: This is the most common type. It is formed due to an aberration in the development of an egg. In a normal course a mature follicle ruptures in the ovary to release the egg and then forms a mass called the Corpus Luteum. If pregnancy does not occur in that cycle, the Corpus luteum normally disintegrates. If this does not happen then a functional cyst is formed. The functional cysts normally do not produce any symptoms and disappear within one-three menstrual cycles. Dermoid cyst: These are ovarian cysts filled with cheesy material and may have various types of tissue including hair and skin in them. Cystadenoma: These are cysts which develop from the outer surface of the ovary. Majority of them are benign (non- cancerous). Endometrial or chocolate cyst: Sometimes clusters of cells normally found in the lining of the uterus (endometrial cells) attach themselves to the ovary causing an endometrial cyst to form. This is a dark and red-brown coloured cyst and hence is also called chocolate cyst. Polycystic ovary: In this condition the ovaries have multiple small cysts. These result from hormonal imbalance. These women are usually overweight and can have excessive facial hair and difficulty in conceiving. Ovarian cysts usually do not cause any symptoms. However if the symptoms occur, they are: A feeling of fullness in the stomach or a slight pain. Irregular or painful periods. They may be detected by a pelvic examination which could be confirmed by other tests. Ultrasound is a test in which sound waves are used to create pictures of the organs found inside the body. It can be used to confirm the presence of the cyst and many times the nature of the cyst. The treatment depends upon the size and type of the cyst, the women’s age and overall health, her future pregnancy plans and the symptoms that she is experiencing. The treatment options include: Expectant – Where the cysts are small (< 8 cm) and appear functional, they can be observed for 2-3 months as many of them resolve. In the past hormones have also been given particularly with irregular periods. Currently their use is not found to be of any benefit. Surgery – can be decided upon if the cyst does not disappear on its own or is causing severe pain or bleeding or if the cyst is of a type which requires surgery (Dermoid, Endometrial, Cystadenoma). Surgery can be through laparoscope or conventional (by an incision on the tummy), depending on the size & type of cyst patient profile and expertise of surgeon. Treatment of Polycystic ovaries – This depends upon the requirement of the patient, her symptoms and profile. Weight reduction in an overweight patient constitutes the most important treatment. The other treatments can be hormonal for regularising the periods and for excessive facial hair as well as ovulation induction (aiding in producing an egg) in case of infertility. You will need to stay in touch with your gynaecologist to monitor the ovarian cyst.


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