Ovarian Cyst After Menopause

Before menopause, ovarian cysts are more prevalent than after. As long as you still have ovaries you can get an ovarian tumor.

This article will discuss ovarian cysts, their symptoms, and treatment.

Post-menopausal Ovarian Cysts

Ovarian cysts Are fluid-filled sacs which form on or in the ovaries.

The majority are harmless. They’re also more likely to form before menopause, when the ovaries have more activity. The two most common cysts are follicular Cysts, and Corpus Lutum, which are both associated with the menstrual cycle.

After menopause the ovaries stop releasing eggs. The ovaries also stop producing estrogen and progesterone. However, they are not inactive. They can still have cysts, such as:

• Dermoids develop from cells that you have had since birth
• Cystadenomas that grow on the ovary surface

Even though cancerous ovarian tumors are rare, older women are more likely to develop them.

Research found in 2014 that 7 percent of women worldwide develop an ovarian cyst during their lifetime. In the United States post-menopausal woman have an ovarian-cyst incidence of 18% over a period of 15 years.

By the age of 65, it is estimated that 4 percent will be admitted into a hospital due to ovarian cysts.

What symptoms are associated with ovarian cysts after menopause?

The symptoms may be mild at first. Symptoms may increase as the cyst grows.

• A dull ache in your lower back or legs
• Pressure, swelling, and bloating
• Lower abdominal pain
• pain during intercourse
• Bladder or bowel disorders
• Spotting or bleeding
• Weight gain

Other symptoms that may occur before menopause include:

• Spotting or bleeding in between periods
• pain during your period
• Breast tenderness

Cyst rupture or ovarian torsion

The cysts may cause ovarian twisting (ovarian torsion) or rupture. When this happens, symptoms include:

• Sudden acute pain
• Heavy bleeding
• nausea, vomiting
• dizziness, fainting
• Rapid breathing

Seek immediate medical attention

Internal bleeding can result from a ruptured cyst. Seek immediate medical attention if you experience sudden pain, nausea, or fever.

Risk factors and causes of post-menopausal cysts

There are several causes and risk factors that can lead to ovarian cysts.

• Hormonal fluctuations
• Severe pelvic infections which spread to the fallopian tubes and ovaries
• Polycystic Ovary Syndrome (PCOS)
• endometriosis
• hypothyroidism
• cigarette smoking

Women with postmenopausal cysts of the ovary may have a higher risk for ovarian carcinoma.

How is post-menopausal cysts of the ovary diagnosed?

Your doctor will likely start by feeling the pelvis for cysts or other abnormalities.

It is important to rule out other conditions that have similar symptoms. These include:

• Pelvic inflammatory disease
• irritable bowel syndrome (IBS)
• appendicitis
• Diverticulitis

Talk to your doctor about your medical history and any factors that could increase your risk for ovarian cancer.

• Close family members (mothers, sisters, aunts, grandmothers) have all had ovarian carcinoma
• A personal history of breast, uterus or colon cancer, endometrium, or colon cancer
• Testing positive for BRCA1 and BRCA2 mutations or those associated with Lynch Syndrome

Those who are not yet menopausal will usually be ordered to undergo hormone and pregnancy testing.

Image tests

Imaging tests may be recommended if your symptoms and physical examination point to an ovarian cyst. The ultrasound can reveal the exact size, location, and shape of a mass. It can also reveal whether the cyst is filled with liquid (simple cyst), or solid (complex cyst).

Two types of ultrasound are used to examine ovaries and the reproductive system.

• abdominal : The doctor uses the wand to examine the pelvic region.
• transvaginal : A probe of ultrasound is inserted in the vagina for viewing the ovaries.

Other Testing Methods

If you have a solid or partially solid ovarian cyst, further testing may be necessary. This is especially true if your risk for ovarian carcinoma is high.

It is important to determine whether a cyst could be cancerous or benign. A blood test measuring a cancer-antigen protein ( CA-125) can help determine whether a cyst is benign or potentially malignant.

There are several conditions that may cause high CA125 levels in the blood before menopause. A higher than normal level after menopause could indicate ovarian carcinoma.

What is the treatment for ovarian cysts after menopause?

The treatment of cysts is not always necessary, but it’s important to monitor for any changes.

Benign

If your CA-125 is normal and the cyst appears benign, your doctor might decide to wait. This would include:

• Regular physical examinations
• Imaging tests
• Follow-up CA-125 tests to detect any changes

Pain medication can help in the interim.

If:

• It grows too big
• It’s still painful or causing other unpleasant symptoms
• It looks as if it could burst or cause twisting in the ovary
• It does not resolve even after multiple follow-ups
• You’re at a high risk for ovarian cancer

This surgery can often be performed laparoscopically. This surgery involves small incisions. It may be an option if the cyst is not cancerous and small.

Malignant

After menopause, even though most ovarian cysts may be benign, there is a higher risk of ovarian carcinoma. If your CA-125 level is high, then your doctor might recommend surgery. After the cyst is removed, it can then be tested for cancer.

Your doctor may refer to a gynecologic cancer specialist if you have ovarian carcinoma. Treatment for ovarian cancer can include:

• Removal of both ovaries (oophorectomy).
• Total hysterectomy: Removal of the ovaries, tubes and uterus
• Radiation
• Targeted therapies
• supportive care

Takeaway

A cyst on or in the ovary is a sac filled with fluid. The cysts can appear at any point in a woman’s lifetime. Cysts are not only associated with menstruation, but can also appear after menopause.

Ovarian cysts can be benign and asymptomatic. They may also go away by themselves. They can cause pain or other symptoms when they become too large. Ovarian cysts causing pain or other symptoms may be surgically removed.

After menopause, the risk of developing ovarian carcinoma is higher. Do not delay in seeing a doctor about your symptoms.