Post Menopausal Ovarian Cysts: Reasons, Menaces And Answers
Posted Mar 25 2010 5:13pm
Even though ovarian cysts after the menopause are less common, instances do crop up and may cause difficulties. Post-menopausal women with an ovarian cyst that is not suitable for conservative management may have to have an oophorectomy. This operation is done to take out the ovary within a bag so as not to have the cyst break open in the peritoneal cavity.
Post-menopausal women are recommended to take a sonographical CA125 test using transvaginal grayscale. Magnetic resonance imaging (MRI), computed tomography (CT), and Doppler scans are not as good for the detection of post-menopausal cysts. Transvaginal ultrasound is the best way to understand the situation of ovarian cysts because it gives enhanced detail and more sensitivity. Larger cysts nevertheless should be examined transabdominally.
After menopause, ovarian cysts are contracted by about 17 percent of women. No optimal management solution for cysts exists. Many cysts will be reabsorbed by themselves without major difficulty. Malignancy and ovarian cysts do not appear to have much correlation, but ovarian cancer is showing a disturbing rise in older women. Survival is statistically unlikely, if the cancer spreads beyond the ovary. To be completely sure it is necessary to do a full laparotomy and staging procedure, even though it is well to be suspicious of the possible malignancy of all ovarian cysts in women after the menopause.
From a sample of 226 women recent research on post-menopausal ovarian cysts suggests that ovarian cysts that are smaller than 50mm in diameter are benign and can be treated with safe management involving regular monitoring of the cyst size and the CA 125 levels.
There are two main questions concerning ovarian cysts for women after menopause: what is the best management; and where the treatment should take place. A gynecologist generalist should be able to manage low-risk cases, but intermediate-risk cases should be referred to a cancer unit and those women who represent high-risk cases should go to a cancer center.
Management changes should be revised accordingly when used with an index to determine malignancy risk. Measurement of CA 125 which is used in more than four out of every five studies is a typical test here. Usually a cutoff of 30 u/ml is used with test specificity of 75 percent and sensitivity of 81 percent. Using ultrasound has demonstrated 73 percent specificity and 89 percent sensitivity. To usefully evaluate ovarian cysts, Doppler sonography with color flow has also proven its worth. It is less effective in the evaluation of a tumor as benign or malignant to examine the cytological fluid from an ovarian cyst. In this case the sensitivity is only around 25 percent and the danger is greater that the cyst will break open.
The recommendation for women after the menopause when laparoscopic management of ovarian cysts is done is frequently not for cystectomy but in fact for oophorectomy. Trying to use ovarian cyst fluid for a cytological assessment is a common error when trying to evaluate system malignancy. The accuracy factor is only 25 percent with an increased risk of cyst rupture. The higher risk malignancy index indicates all ovarian cysts suspected of malignancy in post-menopausal women.
If laparoscopy indicates suspicious clinical evidence, then a full laparotomy and subsequent staging procedures are to be employed. A certified surgeon within a cancer center team that is multidisciplinary is required. For this reason, it may be said that aspiration does not have a role to play after menopause for asymptomatic ovarian cysts management. Notwithstanding, it might still form a part of the pre-surgical management together with laparoscopy and laparotomy.
The incision under extension of the midline should include the cytology in the form of ascite washings, laparotomy that is well documented, and biopsies from adhesion and areas that are suspect. It should also include infra-colic omentectomy as well as BSO and TAH. In the case of a malignant cyst, this may have grave repercussions on the probability of survival of the patient.
Post-menopausal ovarian cysts in common with many other chronic health ailments have no simple cause. For this reason, classical medicine that only focuses on a specific symptom will not be successful in remedying ovarian cysts. Several factors will in fact trigger the formation of an ovarian cyst. Some of these factors are directly responsible for ovarian cysts forming, and others act indirectly to play a secondary part to worsen existing cysts. Although classical medicine may be of use in handling a primary cause, these indirect factors will stay around and be the root of further complications.
A holistic program is the only way to free yourself from a complaint of post-menopausal ovarian cysts. Because multiple factors are at the root of ovarian cysts, the treatment needs to integrate multiple dimensions. This is the only way for getting to the real, underlying problems and removing cysts forever.
Mary Parker is an author of the best-selling e-book, “Ovarian Cysts No More- The Secrets Of Curing Ovarian Cysts Holistically”. To Learn More About Her Unique 3-Step Holistic Ovarian Cysts Cure System Visit: . For further information visit: