The treatment of ovarian cysts may be as simple as monitoring the condition, or as complex and invasive as a hysterectomy, if any growth proves to be malignant. The size and type of cyst and the woman’s age influence treatment options. Postmenopausal women are at higher risk of developing ovarian cancer, so they often receive more aggressive treatment.
Functional cysts are common in premenopausal women, and usually shrink and disappear over the course of a few months. Often, such growths don’t require further treatment. After menopause, any ovarian mass is assessed and monitored carefully. Regular ultrasound monitoring may be suggested for older women.
Your physician may order a laparoscopy to help with monitoring. A small incision is made in the pelvic region. A thin tube called a laparoscope is inserted through the incision. This tube can relay pictures of the affected ovary to a monitor, allowing the surgeon to visually evaluate the cyst. If necessary, the laparoscope can be used to gather a sample of tissue for evaluation.
Hormones and Oral Contraceptives
Hormones can be used to shrink or prevent functional cysts. Birth control pills are most often used to regulate hormones. Long-term oral contraceptive use may be used as a preventive measure, and may have an additional benefit: after three years of use, the risk of ovarian cancer is lowered.
Women on birth control pills who experience cyst-like symptoms should seek medical advice. The chances of developing a functional cyst while on oral contraceptives are low, and the symptoms may indicate a different type of growth, or a completely different medical condition.
Surgical treatment for ovarian cysts may involve the removal of the growth, the ovary, or in extreme cases, both ovaries and the uterus. Surgery may be considered under the following circumstances:
-the cyst is exceptionally large
-it does not respond to contraceptive hormones
-the symptoms, including pain, are severe
-its presence causes, or contributes to, infertility
-torsion or bleeding occurs
-evidence suggests the presence of cancer.
One of three surgical techniques is usually employed: the cystectomy, the oophorectomy, or the hysterectomy.
A cystectomy removes the growth, but leaves the ovary intact. If the cyst is benign, and fertility is an issue, a cystectomy is often the preferred treatment.
Large growths may require an oophorectomy, the surgical removal of an entire ovary. Because the woman retains her other ovary she remains fertile. In case of complications, such as a growth that is twisted or bleeds, a salpingo oophorectomy may be performed. This removes both the ovary and the neighboring fallopian tube.
After menopause, the chances of ovarian cancer are greater, and ovarian growths have a greater risk of being malignant. Should a growth prove to be cancerous, the surgeon may recommend a radical hysterectomy, the surgical removal of both ovaries and the uterus.