Ovarian Cysts: The Post-Menopausal Reasons, Menaces And Answers

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.

In the laparoscopic management of ovarian cysts in post-menopausal women, the recommendation is often for oophorectomy instead of cystectomy. Frequently the error is made in choosing ovarian cyst fluid for a cytological assessment in an effort to identify cyst malignancy. The precision factor is only 25 percent in this case and there is also the risk of the cyst disintegrating. It is the high threat malignancy index that shows all ovarian cysts in post-menopausal women, which are suspected of being malignant. If a laparoscopy indicates suspicious clinical findings, then a full laparotomy and other staging procedures are to be employed. These must be done by a surgeon qualified for this as part of a multidisciplinary team working at a certified cancer center. Therefore one may deduce that aspiration has no real role to play in the post-menopausal management of asymptomatic ovarian cysts. Nevertheless, in conjunction with laparotomy and laparoscopy it might be a step in the preliminary surgical management. The extended midline incision should comprise biopsies from areas and adhesions under suspicion, the cytology in the form of ascites or washings, BSO, TAH and infra-colic omentectomy and laparotomy that is well documented. If the cyst is malignant this may have grave further effects on the probability of the patient surviving.

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.

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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