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Ovarian Cysts After The Menopause: Reasons, Threats And Solutions

Jul 16, 2008
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.

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 post-menopausal woman, ovarian cysts spark two questions, the first about the best management and the second on where the treatment should be done. A general gynecologist will be able to handle women with low risk, but for women at an intermediate risk level referral should be made to a cancer unit and if the level of risk is high, they should be accompanied to a cancer center. When used with an index to register the risk of malignancy, the revision of management changes should be done accordingly. A typical test is the check on CA125 that is practiced in over four out of five cases. A cutoff of 30 u/ml is used most often and the test sensitivity is 81 percent with specificity of 75 percent. The use of ultrasound has been registered at 89 percent sensitivity and 73 percent specificity. Doppler sonography with color flow has in addition been found to correctly assess ovarian cysts. Examining the fluid cytologically from an ovarian cyst gives less precise results in order to find out if a tumor is benign or not. The sensitivity is only approximately 25 percent with a greater menace of the cyst rupturing.

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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