Ovarian Cysts

Q: Robert: I have a question concerning ovarian cysts; my wife was recently diagnosed with them. I went to your Healthcentral.com Web site that says something like don’t worry about it; they go away in 60 days –- unless I misunderstood.

Then I found out that my daughter had them for a long time and her doctor gave her some kind of continuing medication to prevent them from growing. How serious is this and what can you tell me?

A: Dr. Dean: It would be wrong if Healthcentral.com advised that all ovarian cysts go away in a certain amount of time; it’s just that they can.

You’ve got to understand something about the ovary. When a female is born, there are about 400,000 eggs in her ovaries that she can potentially use, and the ovaries pump them out, one or two a month, for the rest of her life.

Before an egg is delivered to the fallopian tubes from the ovary, a cyst forms around the egg. The cyst is near the surface of the ovary and it bulges and bulges, and then the cyst ruptures. Inside of the cyst is a little fluid and the fluid kind of flushes out the egg, which rushes out in this little burst of fluid. Finger-like strands on the end of the fallopian tubes kind of gather up the fluid and egg and move it down the tube.

If, for some reason, the egg doesn’t go down the tube and instead, goes out in the abdomen, a woman can get something that’s called an ectopic pregnancy. But you see that the ovary is forming cysts all the time so it’s a very cystic-prone organ in the body and so cysts are very common.

Most of the time, women don’t even know they have a cyst. You wouldn’t know you had a cyst unless the doctor felt it during an internal examination. But even during an internal examination, the physician may miss it because he or she cannot wrap his or her fingers all the way around the ovaries. So, there are still limitations to recognizing a cyst.

So sometimes cysts can form and not rupture. They just get bigger and bigger until they rupture suddenly, releasing a bunch of fluid –- this is outside the realm of normal egg production and fertility.

When cysts become large, we have to remove them. We remove them because if you just drain the fluid out of them they seem to reform again

So bottom line, when it comes to ovarian cysts there are various sizes, various prognoses which are based on whether they go away or get larger. They are usually noncancerous –- that is the first concern when a woman has an enlarged ovary. When the doctor is doing the internal exam, they’ve got their hands and fingers in there and if they feel an enlarged ovary and can’t tell whether it is a cyst or it’s solid.

If it’s solid, you’ve got problems. If it’s a cyst, you can relax a little bit. If it’s solid, they you have a higher likelihood of it being ovarian cancer. You’ve got to follow it up either way and not just take a wait and see attitude on your own –- that’s something you want to do with your doctor.

Dean Edell, M.D.

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