Ovarian Cysts And Masses In Menopause
Once a woman enters menopause, there is an expectation that the ovaries become inactive. While they do have a lower level of activity, they are still capable of producing cysts. Fortunately, the great majority of these are benign and need no therapy. Dr. David Holtz presents for us what is considered normal and what signs should cause concern. Beverly Vaughn, MD, Medical Coordinator, Menopause and You Program
With the increased use of imaging and the recognition by primary care doctors that ovarian cancers present with subtle symptoms, more ovarian masses are being detected in postmenopausal women. In screening studies, five to 20 percent of women over the age of 50 with no other symptoms will have an ovarian mass detected on ultrasound. However, only a percentage of these will prove to be ovarian cancer after surgery. Thus, it is important for us to try to distinguish ovarian cysts that can be monitored with repeat ultrasound studies from masses that need to be surgically evaluated due to their elevated risk of early ovarian cancer.
Entered The Menopause As A Result Of Her Treatment And Reflects That She Probably Did Have Mood
Women whose menopause started during chemotherapy found it difficult to distinguish between symptoms of the menopause and side effects of the treatment. One woman’s menopause didn’t start until a year after her surgery and several others experienced no symptoms at all. Some women were glad that their periods had finished, but one missed them because her life had revolved around them for so many years.
Younger women whose menopause started as a result of surgery were often offered hormone replacement therapy because the potential health benefits were considered to outweigh the risks. HRT succeeded in preventing or relieving menopausal symptoms in most of the women who took it, but a few experienced unpleasant side effects and changed to a different type of HRT. One stopped taking it because it didn’t seem to be working and two others stopped because they did not want to increase their risk of getting breast cancer.
Most women diagnosed with ovarian cancer will have already been through, or started, the menopause. Older women who had been taking HRT for menopausal symptoms before their diagnosis were often taken off it because it increases the risk of developing breast cancer, and in some the menopausal symptoms returned. A few older women continued to take HRT after their diagnosis because of severe menopausal symptoms or to reduce symptoms of osteoporosis.
Are There Any Risks Related To Hormone Therapy
Like most prescribed medications, there are risks for hormone therapy. Some known health risks include:
- Endometrial cancer .
- Gallstones and gallbladder issues.
Going on hormone therapy is an individualized decision. Discuss all past medical conditions and your family history with your healthcare provider to understand the risks versus benefits of hormone therapy for you.
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Treatment Of Ovarian Cysts After Menopause
Treatment options may involve surgery to remove the cysts or other treatments for health conditions that may be causing them. Surgery, including ovary removal, may be recommended for postmenopausal women with large, non-simple cysts and other risks factors, such as history of ovarian or breast cancer.
How Is Ovarian Cancer Treated
The goal in treating cancer is to remove as much, if not all, cancer from your body as possible. If you have ovarian cancer, this most often involves the removal of your reproductive organs and any organ that has cancer on it, including segments of the intestine and the omentum a fatty material covering the intestines.
Surgical removal of ovarian cancer can be done through a procedure called a laparoscopy or during a laparotomy. A laparotomy is a procedure where the doctor opens the abdomen using a larger incision and is able to remove the ovaries. Other organs where the cancer may have spread can also be removed during this procedure.
Your healthcare provider may recommend chemotherapy either before or after surgery depending upon multiple factors including the extent of your cancer at the time of diagnosis. Chemotherapy are drugs designed to target and kill cancerous cells.
After ovarian cancer has been treated, your healthcare provider will want to regularly see you for observation. You may have routine appointments to check and make sure the cancer hasnt returned over time. During these appointments, your provider may go through any possible symptoms and do an exam. Be mindful of any symptoms you may be having and tell your provider about them. Sometimes, your provider may order imaging tests, typically a CT scan.
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Change In Bladder Function
Typically, when women experience urinary problems, such as pain when urinating or urgency, they frequently think its a urinary tract infection. Often, it is.
But bladder-related issues can also signal a gynecologic or reproductive problem, like ovarian cancer.
Specific urinary symptoms associated with ovarian cancer include the following:
- Feeling pressure or pain in the bladder
- Frequent urination
- Sudden, urgent need to urinate
If these urinary symptoms are new to you and last more than several days, thats a problem, says Ahmed. Talk to your OB/GYN or primary care physician and let them know you are concerned about both bladder problems and issues with your reproductive system.
Can Menopause Be Treated
Menopause is a natural process that your body goes through. In some cases, you may not need any treatment for menopause. When treatment for menopause is discussed, its about treating the symptoms of menopause that disrupt your life. There are many different types of treatments for the symptoms of menopause. The main types of treatment for menopause are:
It is important to talk to your healthcare provider while you are going through menopause to craft a treatment plan that works for you. Every person is different and has unique needs.
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How Do I Know If Changes In My Periods Are Normal Perimenopausal Symptoms Or Something To Be Concerned About
Irregular periods are common and normal during perimenopause . But other conditions can cause abnormalities in menstrual bleeding. If any of the following situations apply to you, see a doctor to rule out other causes.
- Your periods are changing to become very heavy, or accompanied by blood clots.
- Your periods last several days longer than usual.
- You spot or bleed after your period.
- You experience spotting after sex.
- Your periods occur closer together.
Potential causes of abnormal bleeding include hormonal imbalances, hormonal treatments, pregnancy, fibroids, blood-clotting problems or, rarely, cancer.
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Will I Start Menopause If I Have A Hysterectomy
During a hysterectomy, your uterus is removed. You wont have a period after this procedure. However, if you kept your ovaries removal of your ovaries is called an oophorectomy you may not have symptoms of menopause right away. If your ovaries are also removed, you will have symptoms of menopause immediately.
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What Are The Symptoms Of Menopause
Menopause is defined as the time when the ovaries stop making eggs. It is typically confirmed when a person has not had a menstrual period for 12 consecutive months . Menopause will typically occur in the late 40s or early 50s, and the average age for menopause is 51.
Prior to menopause, a person will enter the menopausal transition , which can begin 8 to 10 years before menopause. During this time, the ovaries produce lower levels of the hormones estrogen and progesterone. As a result, the persons menstrual periods start to become irregular before stopping altogether, and certain changes will begin occurring in the body. As this happens, the person may develop menopausal symptoms related to the lower hormone levels.
The most common symptoms of menopause include:
During the period after menopause, which is referred to as postmenopause, menopausal symptoms may begin to ease and become less severe.
Natural Treatment For Postmenopausal Endometriosis
Women looking to naturally treat their endometriosis after menopause should first turn to their nutrition.
Diet has proven to have a significant influence on the risk of pelvic endometriosis. Studies have shown that increased consumption of green vegetables and fresh fruits decreases the risk of endometriosis, while beef and other red meats increase the risk.5
Moreover, dietary fiber and whole grain intake promotes a healthy balance of gut bacteria, which is necessary to properly regulate circulating estrogens and reduce inflammation. Find them in raspberries, pears, green peas, broccoli, lentils, black beans, barley, quinoa, and more.
However, while natural treatments for postmenopausal endometriosis do include dietary changes as an instrumental step toward relief, other alternative options should not be forgotten, like melatonin supplements, which are scientifically proven to reduce endometriosis-related pelvic pain.6
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Ovarian Cyst After Menopause
Can You Get An Ovarian Cyst After Menopause?
Some women may believe that they cannot get an ovarian cyst after menopause. If the issue of a growth in the ovaries even comes up, they wonder if it is possible to develop an ovarian cyst after menopause. The short answer to this question is yes, it is possible to develop this type of cyst once menopause has been experienced. However, it is important to note that while the possibility exists, the potential for postmenopausal women is very different from that of women who have yet to go through menopause.
Ovarian cysts are small sacs that develop in the ovaries these sacs are filled with liquid and have the capability to grow over time. In most cases, the cysts appear, grow for a short period of time, then disappear.
The failure of an egg to not release properly during the menstrual cycle is a common reason for the development of a cyst, but is not the only origin possible.
Females who are old enough to bear children are far more likely to experience a cyst than women who have been through menopause. Still, a significant number of women past their childbearing years can and do develop cysts in the ovaries. Figures related to postmenopausal women in the United States indicate that over 14% of females in that group do develop cysts throughout their lives.
Symptoms Of Endometriosis After Menopause
The list of endometriosis symptoms after menopause can include the following:
- Pelvic pain
- Gastrointestinal problems
- Pain during sexual intercourse
Postmenopausal women should keep in mind that they are also at higher risk of autoimmune disorders – like allergies, asthma, and fibromyalgia – as well as other health conditions, such as chronic fatigue syndrome and hypothyroidism, among others.
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Can Menopause Affect Sleep
Some women may experience trouble sleeping through the night and insomnia during menopause. Insomnia is an inability to fall asleep or stay asleep at night. This can be a normal side effect of menopause itself, or it could be due to another symptom of menopause. Hot flashes are a common culprit of sleepless nights during menopause.
If hot flashes keep you awake at night, try:
- Staying cool at night by wearing loose clothing.
- Keeping your bedroom well-ventilated.
Avoiding certain foods and behaviors that trigger your hot flashes. If spicy food typically sets off a hot flash, avoid eating anything spicy before bed.
Going Through Surgery And Chemo
My doctor told me the tumor had engulfed my left ovary. So during surgery, he removed it along with the tumor, one of my fallopian tubes, and some lymph nodes.
I was lucky: My right ovary was OK. I could keep it and stay out of menopause, which was fabulous. Having my right ovary also meant I still had a possibility of being able to conceive.
After surgery, I had four cycles of chemo, spaced three weeks apart. It was an intense regiment to go through, but necessary to avoid reoccurrence.
Becoming a cancer survivorand a mom.
After the chemo I got CT scansfirst every three months, then every sixto check if the cancer had come back. Then, a year later, in the summer of 2018, I discovered I was pregnant, and stopped the scans because they arent safe for unborn babies.
When youre in your 30s and you only have one ovary, youre holding your breath, hoping you can conceive. We were able to do so on our own, without using any fertility measures. It was the best surprise to my husband and me.
My son, Max, was born on St. Patricks Day, which some people say is lucky. Through all the lows weve been through, its nice to be able to enjoy such a positive piece of life on the other side of my diagnosis.
Life after cancer.
There are highs and lows of being a cancer survivor.
Some days, the treatment feels like something that happened in another lifetime.
Now, after being diagnosed, I feel that this is what Im supposed to be doing: This is the path Im supposed to be on.
The Ovarian Cyst Types:
- Papillary. The tumor of this kind has many papillae, which are predisposed to enlarge in size actively. They are able to penetrate into the walls of neighboring organs.
- Endometrioid. If not to undergo the therapy for endometriosis, that disease ends in the emergence of the endometrioid pathology. Usually, it is filled with a liquid of brown color.
- Mucinous. The formation is able to grow quickly. It is a combination of several mucus-filled entities.
- Serous. This is a single formation that has a round shape with a liquid inside.
- Paraovarial. Often, it has liquid inside and grows to immense sizes.
- Dermoid. Usually, this formation occurs in the womb but is able to grow all life.
Each kind of the tumor on the ovary after the climaxmost often affects only one ovary. With their bilateral presence, a more serious approach to treatment is required, most often this implies the application of the emergency surgical intervention.
When To See A Doctor
The issue of ovary pain after menopause is unpleasant and should be treated quickly to remove the symptoms. Therefore, consult an expert if the pain sensations are severe and have a lasting character. Even if the pain wasnt caused due to the end of menopause, you should define the truth. Perhaps you suffer from some serious disease.
Women should pass a physical exam. Your doctor will also ask a number of questions. These may be:
- Where do you feel the pain?
- When did it start?
- How frequent your pain sensations are?
- Does any physical activity somehow affect your pain?
- What is the degree of pain? .
- Does the pain affect your daily routine and how?
Memorize this list and try to answer it beforehand. Thus, youll save a lot of time and will quickly provide the answers when your doctor will ask them. The diagnostic tests commonly include ultrasound and similar types of imaging.
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Taking Charge: Who Gets Ovarian Cancer
Scientists have found that certain risk factors increase a woman’s chance of developing the most common type of ovarian cancer, epithelial ovarian carcinoma, although in most cases this increased risk is very small. Most ovarian cancer cannot be explained by any known risk factors. More research in this area is needed to help determine why some women develop the disease and others do not.
Women’s Voices For Change
Ovarian cysts in post-menopausal women are now known to be very common and most are not cancerous. However, because the greatest risk factor for ovarian cancer is age, any cysts in a postmenopausal woman should be taken seriously. Before ultrasound was readily available for physicians to use as a tool to evaluate the ovaries, any ovary which a physician was able to palpate on a physical examination in a post menopausal woman was recommended to be removed. After the advent of the use of ultrasound in pelvic imagining, any cysts noted in post-menopausal women were generally removed. Now, after years of widespread use and experience in ultrasound imaging, the criteria for how to manage an ovarian cyst has radically changed, and generally cysts that do not demonstrate well-defined malignant characteristics and do not grow may simply be observed for change.
In one study of 7,700 healthy women, 450 were found to have ovarian cysts, and many of these resolved with time. Ovarian cysts may be detected on physical examination by your healthcare provider, because your physician has performed or ordered a pelvic ultrasound, or they may be found when imaging studies such as a CT scan, MRI, or ultrasound have been performed for another reason. Cysts may be associated with pelvic pressure or pain. When they twist, they may be associated with severe pain.
The take-home message:
- Benign cysts are common in post-menopausal women.
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Symptoms Of Ovarian Cyst After Menopause
At the initial phase of the evolution of the formation on the sex gland in the post-climacteric, it is rarely accompanied by any ovarian cyst symptoms after menopause. Signs of its presence appear in time, meanwhile, the cyst of the ovary enlarges in size.
Symptoms of ovarian cyst:
- the multiplied necessity to urinate
- visual asymmetry of the stomach
- pronounced pain in the lower abdomen during the sexual act
- spotting from the vagina
These ovarian cyst symptoms happen when the pathology is of large dimensions. Many of them are connected with the immense pressure of the tumor on the ovary after the climaxon neighboring organs. It can be expressed by the appearance of varicose veins, disruption of the intestines, etc.
Can Cancer Symptoms Be Mistaken For Menopause
Eleonora Teplinsky, MD, is the head of breast medical oncology at Valley-Mount Sinai Comprehensive Cancer Care in Paramus, New Jersey, and is a clinical assistant professor of medicine at the Icahn School of Medicine at Mount Sinai. She specializes in the treatment of breast and gynecologic cancers. Her research interests focus on the role of exercise and nutrition in cancer and survivorship. She is also a member of the Cancer.Net Editorial Board. You can follow Dr. Teplinsky on . View Dr. Teplinskys disclosures.
People approaching or going through menopause may be concerned that the symptoms theyre experiencing are related to menopause or another medical condition, such as cancer. But can the symptoms of menopause mimic those of certain types of cancer? Or, can menopause and its treatment increase a persons risk of cancer?
Heres what to know about how the symptoms of menopause can be similar to those of cancer and whether menopause impacts cancer risk.
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