Ovarian Cyst Surgery After Menopause
Menopause is the physiological cessation of menstrual cycles associated with advancing age in women. The process occurs as the ovaries stop producing estrogen, causing the reproductive system to gradually shut down. Benign ovarian cysts can still occur after menopause, but due to the lack of hormones being produced, the majority of cysts will not be functional.
Ovarian cysts are not uncommon in post-menopausal women. In this group, 10% of cysts will be functional (indicating that the woman may not have completely undergone menopause) and the remaining 90% of cysts will be either benign or malignant. The incidence of ovarian cancer increases with age after menopause, with almost 60% of ovarian cysts tending to be malignant in women aged more than 80 years.
Whilst an ovarian cyst prior to menopause will often disappear on its own, post-menopausal ovarian cysts typically do not resolve themselves. Ovarian cysts are typically monitored for several months and, if after this time the cyst has not cleared up, a decision about further treatment will need to be discussed with your doctor. Pre-menopausal women may be treated with hormones to encourage resolution of an ovarian cyst, however after menopause this cannot happen. Doctors typically surmise that a cyst that develops on the ovaries after menopause is unrelated to usual menstrual function.
If you think you have an ovarian cyst, see your doctor. They will need to determine the shape and size of any cyst to understand whether it is a simple, fluid-filled cyst, or whether it is a complex cyst, consisting of fluid and solid particles. This will be done by pelvic ultrasound, a non-invasive, pain-free procedure. With knowledge of the location, size and shape of the cyst, the doctor can then recommend further treatment. It is likely that you will need a blood test, which can determine whether or not the ovarian cyst is benign or malignant. Whether malignant or benign, and depending on your age and the level of pain you are experiencing, your doctor will most likely recommend that you have surgery to remove your ovarian cyst.
Having your doctor recommend removing your ovarian cyst does not necessarily mean that the cyst is cancerous, however after menopause an ovarian cyst is more likely to become cancerous. Women who develop cysts when they are aged between 50 and 70 years have a much higher risk of developing ovarian cancer. If your cyst is cancerous, your chance of survival is substantially greater if the disease is detected early.
If your doctor wishes only to remove the ovarian cyst, you will most likely be able to have laparoscopic surgery, which is a relatively minor surgery with a good recovery time. In post-menopausal women with an ovarian cyst, doctors may wish to remove your ovaries, as well as the cyst, regardless of whether or not your cyst is cancerous. This surgery can be done by laparoscopy, but may need to be performed using a more traditional open-abdomen procedure. Talk with your doctor about what option is best for you.
The good part about having your ovaries as well as your cyst removed is that ovarian cancer will no longer be a risk for you. Since ovarian cysts can reoccur and since ovarian cancer can be difficult to detect, many post-menopausal women are happy to have their ovaries removed as part of the surgical procedure to remove their cyst. Patients should speak to their doctor to achieve a solution that best suits them and their lifestyle.