All Women's Care is a well-recognized and reputed healthcare center serving women’s health in and around the Los Angeles area. The experienced doctors and staff have focused their medical practice in treating women’s reproductive health issues and helped women who suffered from reproductive disorders,including cysts and fibroids. The expert gynecologists and OB-GYNs are well-versed with the latest developments in the ovarian cyst and fibroid diagnosis and treatment. We discuss all the available methods of treatment and let you choose from the options that best suit your needs and lifestyle.
Cysts and Fibroids: An Overview
Many women experience growth of cysts and fibroids in their reproductive system at some point in their life, generally during the childbearing years. Sometimes women may have had them and never known it, as they usually disappear on their own without causing any serious discomfort. However, in some cases, women may experience hormonal fluctuations that can result in pain, abdominal bloating, or irregular periods. These growths in the female reproductive system may also be treated as reproductive disorders as they can interfere with a woman’s fertility. Both these reproductive disorders may have similar symptoms, but the causes, treatment, and potential complications are different. The only way to medically diagnose the different types of growths is through a regular examination of the potential symptoms by your doctor. Let’s understand the two types of growths—cysts and fibroids—in some detail below.
What are Ovarian Cysts?
An ovarian cyst, or cyst, is a small fluid-filled pocket or sac that forms during ovulation. This closed, sac-like structure that grows within or on the surface of an ovary contains a liquid or semi-solid substance.
Ovarian cysts are common in females with regular periods. Also reported as ovarian masses, cysts are often found incidentally in women with no symptoms. In most cases, the presence of a cyst is harmless; cysts are completely normal, and there is nothing to be concerned about. It is usually the size and location that determine whether the presence of a cyst can cause a ‘problem.' For example, if a cyst is located near other anatomical structures, either the uterine wall or abdomen, it is likely to rupture more easily. A ruptured cyst can be a serious issue if it results in severe pain and accompanied by vomiting, bleeding, and sometimes fever. In more complicated cases, which are rare, a ruptured cyst can cause internal bleeding and demand surgical intervention.
Ovarian cysts are mostly benign and present little or mild discomfort; however, if left untreated, they can grow in size, leading to a range of serious complications. There is even the possibility of cancer, although it's rare.
Symptoms of Ovarian Cysts
While most ovarian cysts are small and go away on their own without causing serious problems, a large cyst may show symptoms and may need emergency attention. You might experience a sharp or dull pain in the lower abdomen on the side of the cyst and may come and go.Common symptoms may also include abnormal bleeding, unexplained bloating, swelling, and pressure. Other symptoms, which may be less common, include pelvic pain, pain during intercourse, breast tenderness, difficulty in bowel movements, abnormal vaginal bleeding, unexplained weight gain, frequent urination, dull ache in thighs or lower back, indigestion, painful menstrual period, and a few others. It is important to get in touch with your doctor as you experience any of the mentioned symptoms.
Larger ovarian cysts are at a higher risk of rupture, or torsion, where the cyst actually causes the ovary to twist the tissues causing severe shooting or stabbing pains. If you experience sudden, severe pain, it could be due to a ruptured cyst. This is one of the biggest dangers associated with cysts as a cyst rupture can release their contents into other body cavities, creating a possibility of blood poisoning or other infections. You may experience nausea and vomiting if a cyst causes the twisting of an ovary. Medical attention by a doctor must be pursued on an immediate basis in such cases.
Types of Ovarian Cysts
Cysts can appear on one or both ovaries, and there can be several types of cysts.
Functional cysts are the most common type of ovarian cysts and do not generally require special treatment as they are a part of your regular menstrual cycle and often come and go on their own.
Follicular cysts: A follicle, a tiny fluid sac that contains the female eggs inside the ovary breaks open and releases the egg during ovulation. Sometimes, the follicle doesn’t open and continues to fill with fluid inside the ovary, causing what is called a follicular cyst. Such functional cysts often disappear in one to three months.
Corpus luteum cysts: After the egg has been released, the empty follicle sac reduces into a mass of cells, which is called corpus luteum. These types of cysts develop when the empty follicle sac doesn’t shrink but seals up and swells with fluid inside.Corpus luteum cysts normally go away in a few weeks but can be painful and cause bleeding. Certain medicines prescribed to trigger ovulation can increase the risk of forming this kind of cysts.
Non-functional ovarian cysts, also known as complex ovarian cysts, are generally less common and not related to the normal function of a woman’s menstrual cycle.
Endometriomas: Ovarian cysts caused by endometriosis; these benign cysts are also known as "chocolate cysts." These cysts occur as a result of a condition where the uterine lining grows outside the uterus (womb) and attaches to the ovaries.
Dermoid cysts: (cystic teratomas). These ovarian cysts are generally benign and are formed from stem cells. Also called teratomas, these pathological cysts contain tissues such as skin, hair follicles, sweat glands, teeth, as well as bone, fat, and thyroid tissue. Dermoids do not generally cause symptoms.
Cystadenomas cysts: Common among women above 40 years, these benign ovarian cysts are thick, fluid-like (a watery or a mucous material) sacs that develop in or the surface of the ovary. Such cysts develop from the outer lining tissue of the ovaries and grow inside the ovary. Sometimes, cystadenomas can grow quite large but are rarely cancerous.
Polycystic ovarian syndrome (PCOS): Some women produce a lot of small cysts on their ovaries—this condition is called PCOS and is known to be a common cause of infertility in females.
Generally, ovarian cysts are benign and rarely malignant. Malignant cysts are rare in younger women as compared to older women. Ovarian masses that develop after menopause might be malignant (cancerous) and are at a higher risk of ovarian cancer, although, it is rare. This is one of the important reasons why regular checkups with your gynecologist are so stressed.
Diagnosis: How are Ovarian Cysts Found?
Little is known about the exact cause of most ovarian cysts and what stimulates their growth in women. While there is no way to prevent ovarian cysts, they are often identified during a pelvic (female) exam. Through a pelvic exam, your doctor or gynecologist can feel for swelling of a cyst on the ovary and diagnose any changes in your ovaries at an early stage. Your doctor can diagnose ovarian cysts with a pelvic ultrasound test that allows the doctor to see the shape, location, size, and mass (fluid, solid, or mix of two) of the cyst. A transvaginal ultrasound involves inserting a probe into the vagina to examine the uterus and ovaries.
Ultrasound is often followed by certain blood tests to check if the cyst present in or on the ovary is malignant. Tests for the assessment of hormone levels may be done to check hormonal fluctuations if any. A pregnancy test is also performed to exclude the possibility of pregnancy since ovarian cysts are common during pregnancy.
Every woman should keep track of any changes in her menstrual cycle, as well as any unusual symptoms, particularly those that continue for more than a few months in a row. Never hesitate about talking to your doctor about any bothering changes in your monthly cycle.
Treatment of Ovarian Cysts
While functional ovarian cysts can often resolve without treatment, watchful waiting is often recommended. This involves repeated examination one to three months after the cyst detection. It is highly likely that ovarian cysts—especially fluid-filled cysts—disappear or cause no further change; in such cases, no treatment may be required.
With pelvic ultrasounds, doctors or gynecologists can monitor the growth and development of the cyst.
If the pelvic pain is high, pain relievers, such as ibuprofen, can be used. Although they don't help dissolve the ovarian cyst, they likely to provide relief from the cyst symptoms. Ovarian cysts can also be treated through birth control pills that suppress ovulation, resulting in a lesser risk of new cysts formation.
In the case of a ruptured ovarian cyst, pain medications can be prescribed to reduce the uncomfortable symptoms in place of surgical intervention in most cases.
If a cyst is determined to be non-functional, it may require some type of surgical removal—either the cyst or the ovary. Cysts can be removed laparoscopically while keeping the ovaries and other pelvic organs intact by a procedure that is called cystectomy. In more severe instances when one or both ovaries may need to be removed surgically, a procedure called oophorectomy is carried out. Surgery may also be an option for ruptured ovarian cysts if the patient has suffered from internal bleeding or has a possibility of cancer. Surgical removal is more recommended for postmenopausal women as there is a higher risk of ovarian cancer for older women.
What are Uterine Fibroids?
Uterine fibroids, or simply fibroids, are basically muscular tumors. In a fibroid tumor, parts of the muscle simply start to grow abnormally in or on the wall of the uterus (womb) on their own. Such muscular tumors are exceedingly common in women of reproductive age (30-40 years old) but can be diagnosed in women of any age. They can develop in any portion of the uterus—in the cavity, in the muscle, or on the exterior surface. Some fibroids can be attached to the uterus on a stalk. They usually shrink in size after menopause as the estrogen levels fall.
Also known asleiomyomas or myomas for short, fibroids are slow-growing, almost always benignand generally harmless.Like ovarian cysts, many women who might have fibroids,are never aware of it, because they do not show symptoms or cause pain. Only in some cases, they may physically block a passageway or put pressure on a nearby structure, making them painful.Fibroids are non-cancerous tumors and rarely turn into cancer.
Studies reveal that uterine fibroids are more prevalent in African-American women as compared to women of other racial groups and are likely to show up at younger ages in African-American women.Experts are still to figure out the reason behind it.
Types of Uterine Fibroids
There are four types of uterine fibroids depending on location in or on the uterus.
Intramuralfibroids. These are the most common type of fibroid. They grow within the muscular wall of the uterus.
Submucosal fibroids. These fibroids are located inside the uterine cavity below the inner uterus lining. The rarest type of fibroid, they grow just below the thin layer of tissue found in the uterus, called submucosa.
Subserosal fibroids. These fibroids grow on the outside of the uterus. They can grow larger, causing pain due to their size or pressure put on adjacent anatomical structures.
Pedunculated fibroids. These fibroids grow on stalks or stems of tissue known as a pedicle (like a mushroom and may grow out inside the cavity of the uterus or outside the surface of the uterus.
Symptoms of Uterine Fibroids
In the majority of cases, fibroids are asymptomatic and often found during a routine exam or ultrasound. However, sometimes fibroids become quite large in size and cause various symptoms that can vary based on the size, location, and number of fibroids. The abnormal growth of fibroids can vary from size as small as an apple seed to as large as a melon. Large uterine fibroids can affect the size and shape of the uterus, which may cause pain and lead to other complications during pregnancy and delivery.
Some of the common symptoms of fibroids may include heavy bleeding or painful periods; pressure, pain, or fullness in lower stomach; bloating; constipation; pain during sexual intercourse; enlarged abdomen or uterus, sometimes making a woman look pregnant; backache or leg pain; frequent need to urinate or difficulty emptying the bladder; infertility and pregnancy complications.
While regular periods typically last for four to five days, fibroids can cause the periods to last for more than seven days, and often with heavy bleeding that may require you to change sanitary pads very frequently. Abnormal bleeding can occur due to any type of fibroid, but women who have submucous fibroids are more expected to face abnormal bleeding. Fibroids can also cause severe cramps during your menstrual periods.
Other possible symptoms of fibroids in women may include problems in labor, pregnancy, fertility problems as well as repeated miscarriages. Larger fibroids may also result in weight gain and swelling in the lower abdomen.
Uterine Fibroids: Causes and Risk Factors
A woman's body has many complexities, and medical science is still to figure out the precise cause of fibroids. It is not clear why they form, grow, or shrink; however, based on research and clinical studies, the potential causes of uterine fibroids are associated with:
Hormones. Ovaries of the female reproductive system produce estrogen and progesterone hormones, and the growth of fibroids has been linked to change in both these female hormones. Studies reveal that women who had their periods at a younger age are more susceptible to developing fibroids.
Pregnancy. Also, fibroids are seen to grow in size (swell) during pregnancy when hormone levels (estrogen and progesterone) are high and shrink when the production of hormones goes down (during menopause), or an anti-hormone medication is taken.
Genetic Changes. The development of uterine fibroids depends on certain genetic factors too. If you have a close relative or a family member (mother or sister) who have had a history of fibroids, you are at an increased risk of developing fibroids as well.
Food Habits. Another factor that may increase the risk of fibroids, based on scientific evidence, is the high consumption of alcohol, red meat, and caffeine. If you are overweight, you can be at a higher risk of fibroids. On the contrary, a high intake of fresh fruits and vegetables might help you reduce the chances of fibroids development.
How to Diagnose Uterine Fibroids?
Since uterine fibroids do not show up any noticeable symptoms or cause pain, so your doctor or gynecologist may incidentally detect fibroids during a regular pelvic examination. A pelvic exam is recommended on a routine basis (at least once a year) to check the health of a woman’s uterus, vagina, and ovaries.Sometimes, during a routine pelvic exam, your gynecologist can feel the fibroid with their fingers as a lump or mass on the uterus. Your gynecologist may help you understand the size of your fibroids by comparing their size relative to the size of your uterus that would be if you were pregnant, or sometimes, even by comparing to fruit sizes, such as nuts, a grape, an orange, or a walnut.
Tests, such as an ultrasound, can visualize the inside of the uterus and show information about the size and location of fibroids as well as to detect other abnormalities.Other by imaging tests, including MRI or CT scans, may also play a role in the diagnosis of uterine fibroids and ensure a more accurate diagnosis.
A laparoscopy may also be performed where the gynecologist examines the outside of the uterus and its surrounding structures on a monitor during the procedure. A biopsy can be taken from the outer layer of the womb if required.
The treatment generally depends on the severity of the experienced symptoms as well as a woman’s age.With the ongoing study on uterine fibroids, little evidence is available on how to prevent them from occuring. However, certain lifestyles and food habits can reduce your chances.
If the pain caused by fibroids is dull and/or mildly cramping, over-the-counter (OTC) medications like Ibuprofen or Naprosyn or certain types of birth control medications, as well as over-the-counter treatments like warm baths and heat therapy, can help ease your discomfort. If the pain continues, or there is a sharp spurt of pain suddenly, it deserves a doctor’s attention right away.
In some cases, the surgical invention may be required for fibroids removal as severe fibroids may not respond to more conservative treatment options. Following surgical procedures may be considered based on a patient’s case:
- Endometrial ablation
- Uterine fibroid embolization (UFE)
- MRI-guided percutaneous laser ablation
- MRI-guided focused ultrasound surgery
It is important to note that all surgical procedures do not intervene with a woman's ability to get pregnant because not all surgical treatments require full removal of the uterus or hysterectomy. In order to know the best treatment options available to treat your fibroids, you must get in touch with an experienced OB-GYN.
Find an OB-GYN Specializing in Cysts and Fibroids Near Me
If you or a loved one has been diagnosed with cysts or fibroids, you must seek medical attention from a women’s healthcare center like All Women's Care. The experienced and well-reputed doctors at All Women's Care provide treatment for various gynecological conditions, including reproductive disorders and fertility treatments. We have a history of successful treatment of reproductive disorders like fibroids and ovarian cysts that can interfere with a woman’s fertility.Be assured of getting all the answers from your doctor and absolute satisfaction with the treatment offered to you. Call us at 213-250-9461 to schedule an appointment with one of our experienced Los Angeles OB-GYN to know about the best treatment for your gynecological condition. We promise to stand by you in your journey to motherhood and good health!