Ovarian Disorders

The primary function of the ovaries is to produce eggs for fertilization each month. They are also responsible for complex hormone production. Disorders of the ovaries are fairly common and can cause symptoms like pain and abnormal bleeding. Some ovarian disorders have no symptoms and can only be detected during pelvic examination.

Ovarian Cysts
Most ovarian cysts are harmless and will disappear on their own. Others, however, can produce serious symptoms or complications. Scheduling regular pelvic examinations is the best way to avoid a serious problem resulting from ovarian cysts.
At some point during your life, you may develop an ovarian cyst. Ovarian cysts are fluid-filled sacs or growths that can form on or within the ovaries. They are most common during childbearing years but can occur at any age. Most ovarian cysts are harmless and will disappear on their own. Others, however, can produce serious symptoms or complications. Rarely, ovarian cysts can be cancerous. Scheduling regular pelvic examinations is the best way to avoid a serious problem resulting from ovarian cysts.

Seek immediate attention if you have these symptoms:

Sudden, severe abdominal pain
Pain with fever and vomiting
Faintness, dizziness or weakness
Rapid breathing
Cold, clammy skin
Increasing size of clothing despite no change in diet and exercise

Types of Ovarian Cysts
Functional cysts are the most common type of ovarian cyst. They develop from tissue that changes during the normal function of ovulation. In the normal reproductive cycle, structures called follicles rupture and release an egg during ovulation. Sometimes this normal rupture does not occur. Instead of being released, the egg grows into a Follicular cyst. This type of ovarian cyst seldom causes pain and generally disappears within a couple of menstrual cycles.

Another type of functional cyst is created when the follicle breaks open and releases the egg but somehow the opening seals itself off and fluid accumulates inside forming a cyst. This type of cyst is called a Corpus Luteum. It usually disappears on it own but has the potential to grow to about 4 inches in diameter and cause pelvic or abdominal pain. You should seek immediate medical attention if you experience severe pain accompanied by fever.

Dermoid cysts are formed from cells that produce human eggs and consequently can contain hair, skin or teeth. They are rarely cancerous and, while generally small, have the potential to grow large and cause painful twisting of the ovary. Dermoids need to be removed, and this can be performed onsite in our surgery center.

Endometriomas may develop in women with endometriosis, a condition in which tissue from the lining of the uterus grows outside of the uterus. Some of this tissue can attach to ovary and form a cyst. It is often painful during intercourse and menstruation. Endometriomas often require surgery for removal.

Cystadenomas develop from ovarian tissue. They are often filled with a watery liquid and are generally benign (non-cancerous). They can become very large and cause pain. Surgery is often required to removed this type of cyst.

Signs and symptoms
Many ovarian cysts have no symptoms and are detected only during a pelvic exam or with imaging studies like ultrasound. While most cysts are benign, some cysts, particularly those that develop after menopause, may be cancerous. OB/Gyn Center urges you to protect your health and schedule regular annual pelvic exams.

Symptoms of ovarian cysts include:

-Pressure, fullness, heaviness or pain in the abdomen
-A dull ache in the lower back and thighs
-Difficulty emptying your bladder fully
-Painful menstrual periods
-Abnormal bleeding
-Pain during intercourse
-Nausea, vomiting or breast tenderness

Diagnosis & treatment
OB/Gyn Center’s physicians are experts in the diagnosis, treatment and, if necessary, surgical removal of ovarian cysts. If an ovarian cyst is either found during a pelvic examination or suspected, we will conduct further tests to identify the type, size, shape and composition of the cyst.

Additional tests may include:

-A pelvic ultrasound, a safe, painless imaging procedure which produces real time images of the internal structures of the pelvis. Ultrasound images are very accurate in confirming the presence of a cyst, identifying its location and determining whether the cyst is fluid filled, solid or a combination of the two.
–Blood tests to assist in identifying the type of cyst.

Treatment of Ovarian Cysts
Treatment plans for ovarian cysts are highly individualized based on each patients unique circumstance and the type of cyst. They may include:

-A wait and see approach if you have no symptoms and an ultrasound confirms the presence of a simple, fluid-filled cyst. We will schedule you for re-examination in one to three months and perform periodic ultrasound exams to monitor any changes in the size of the cyst.
-A prescription for birth control pills to reduce the chance of new cysts developing in future menstrual cycles.
-Minimally invasive laparoscopic surgery if the cyst is large, growing, causing pain or other symptoms. A laparoscope is a slim, lighted instrument inserted through a tiny incision in the abdomen. Your doctor will be able to view the cyst with the scope and remove it, often without removing the ovary.
-Hysterectomy if the cyst is cancerous.
Polycystic Ovarian Syndrome (PCOS)
Polycystic Ovarian Syndrome or PCOS affects 1 in 10 women in America. Though the exact cause of PCOS is unknown, it occurs when the intricate process of a women’s reproductive cycle is disrupted by abnormal hormonal fluctuations. Ovulation is either interrupted entirely or occurs less frequently.
Women with PCOS produce an excess of insulin which in turn contributes to excess androgen production (the male sex hormone) and an abnormally high ratio of other hormones produced by the ovaries. The most common results are irregular or absent menstrual bleeding, excess hair growth and infertility.

Signs and Symptoms
Irregular or no menstrual periods
Unwanted or excessive hair growth
Elevated insulin levels
Obesity, weight gain or difficulty losing weight
Type 2 diabetes
Enlarged ovaries with multiple cysts
Elevated levels of male sex hormones called androgens

Diagnosis and Treatment
OB/Gyn Center’s physicians are experts in the diagnosis and treatment of Polycystic Ovarian Syndrome. Diagnosis will be based on a thorough medical history, physical exam and lab tests, sometimes supplemented by an ultrasound exam onsite at our center.

As always, treatment strategies are carefully tailored to the individual circumstances of each patient but may include:

-Hormones or birth control pills to bring on regular menstrual bleeding
-Medication to slow body hair growth
-Medications to stimulate ovulation for women wishing to become pregnant
-Lifestyle changes like diet and exercise to improve the body’s use of insulin and help relieve symptoms

Women with PCOS are at increased risk for developing serious medical problems. Early diagnosis and treatment may help reduce the risk of:

Heart Disease
High Blood Pressure
High Cholesterol
Endometrial Cancer

Ovarian Cancer
While ovarian cancer can occur at any age, it most often develops after menopause. Ovarian cancer is often mistaken for digestive or bladder disorders because it tends to mimic symptoms of these more common conditions. Women who have constant and worsening abdominal pressure, fullness, swelling or bloating that does not come and go should be evaluated for ovarian cancer.