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Ovarian Cysts After The Menopause: Reasons, Threats And Solutions

by: MaryParker
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Ovarian cysts can still occur after menopause even though this is less frequent than before. Women after menopause with an ovarian cyst that does not respond to conservative management may need to undergo an oophorectomy. In this case the ovaries are removed within a clinical bag so that the system cannot rupture inside the cavity of the peritonea. The recommendation for women after menopause is to take a sonography test for CA 125 using a transvaginal grayscale. Doppler scans, computed tomography (CT) and magnetic resonance imaging (MRI) are all less useful for system detection after menopause. The best solution to understand the situation with ovarian cysts is transvaginal ultrasound because of the increased sensitivity and detail with this method. Nonetheless, transabdominal assessment should be used for larger cysts.

Some seventeen percent of post-menopausal women contract ovarian cysts. There is no optimal solution for cyst management. Most of them will disappear spontaneously without any major impact. Ovarian cysts and malignancy do not seem to be correlated, but there is a concerning rise in ovarian cancer in older women. If the cancer invades beyond the ovary then survival is probably unlikely. Although it may be recommended to suspect all ovarian cysts of malignancy in a woman following the menopause, to be entirely certain means a full laparotomy and staging procedure. Studies done recently on post-menopausal ovarian cysts from a group of 226 women indicates that ovarian cysts that are smaller than 50 mm in diameter are benign and can be handled using safe management using regular examination of the dimensions of the cyst and the concentration of CA125.

For a woman after menopause, ovarian cysts generate two questions, the first concerning the best management and the second concerning where the treatment should take place. A typical test is the measurement of CA125 that is used in more than four out of five cases. A cutoff of 30 u/ml is used typically and the test sensitivity is 81 percent with specificity of 75 percent. The use of ultrasound has been shown to have 89 percent sensitivity and 73 percent specificity. Doppler sonography with color flow has also been demonstrated to usefully assess ovarian cysts. Examining the fluid cytologically from an ovarian cyst is less effective in deciding if a tumor is benign or malignant. The sensitivity is only about 25 percent with a greater danger of breaking open a cyst. When used with an index to measure the risk of malignancy, management changes should be revised accordingly. A general gynecologist will be able to manage women with low risk, but women at an intermediate risk level should be referred to a cancer unit and those with a high risk level should be accompanied to a cancer center.

It is the high-risk malignancy index that indicates all ovarian cysts in women after menopause that are suspected of being malignant. If there are suspicious clinical findings using laparoscopy then a full laparotomy and other staging procedures are to be used. These must be done by a qualified surgeon within a multidisciplinary team in a cancer center that is certified. The extended midline incision should comprise the cytology in the form of ascites or washings, biopsies from areas and adhesions under suspicion, and laparotomy that is well documented, BSO, TAH and infra-colic omentectomy. In the laparoscopic management of ovarian cysts in women after the menopause the recommendation is often for oophorectomy rather than cystectomy. It is a common mistake to select the ovarian cyst fluid for a cytological assessment in an attempt to ascertain cyst malignancy. The accuracy factor is only 25 percent in this instance and there is also the danger of the cyst breaking. If the cyst is malignant this could then have severe repercussions impacting the chances of survival of the individual. Therefore one may conclude that aspiration has no specific part to play in the management of asymptomatic ovarian cysts after the menopause. Nonetheless, together with laparotomy and laparoscopy it might be part of the preliminary surgical management.

A holistic approach is the only way to liberate yourself from a situation of ovarian cysts after the menopause. Ovarian cysts after the menopause like many other chronic health complaints have no unique cause. For this reason, conventional medicine that only targets a specific symptom will not succeed in remedying ovarian cysts. Several factors will in fact provoke the formation of an ovarian cyst. Some of these factors directly trigger the development of ovarian cysts, and others act indirectly to play a secondary role to aggravate existing cysts. Although conventional medicine may be of use in dealing with a primary cause, these indirect factors will linger and provoke further complications. Because multiple factors cause ovarian cysts, the treatment should also be multi-dimensional. This is the only solution for getting to the root of the problem and removing cysts for good.

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About the Author

Mary Parker is a certified nutritionist and author of the #1 best-selling e-book, Ovarian Cysts No More . For Further Information: Post Menopausal Ovarian Cysts   

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