Ovarian Cysts in Postmenopausal Women
Ovarian cysts are common in postmenopausal women and about 17 percent of the postmenopausal women can have ovarian cysts. But its occurrence in postmenopausal women is lower as compared to its occurrence in the premenopausal women. These ovarian cysts are examined through ultrasound monitoring techniques. The ovarian cysts may be then discovered either with the help of ultrasound techniques or screening.
The postmenopausal women can’t ovulate and because of this, the occurrence of functional cyst is not possible. Therefore when such cysts are found in postmenopausal women the possibility of such cysts to be benign or malignant tumors is more. Such tumors may require a surgery.
Finding of the pelvic mass or ovarian cysts was considered to be an indication of surgery before the availability of ultrasound. But now with the help of ultrasound techniques, large number of ovarian cysts are discovered and the decreased risk in the growth of these ovarian cysts imply that all of them don’t require surgery.
The ovarian cysts in postmenopausal women are generally reviewed by using CA125 and Transvaginal grey scale sonography. The tests like serum CA125 measurement and ultrasound need to be done in order to check whether the ovarian cysts are malignant or dangerous. Observation of ovarian cysts in postmenopausal women using transvaginal ultrasound gives a far better and detail outlook of the cysts compared to the transabdominal method. However, reviewing of the larger cysts may require the use of transabdominal method. The other imaging method like magnetic resonance imaging (MRI) was considered to be superior to ultrasound in diagnosing the ovarian cysts, but it was unable to distinguish between malignant and benign disease.
When the ovarian cysts are simple, unilateral, unilocular and less than 5 cm in diameter they have low risk of malignancy. Such ovarian cysts can be managed conventionally by following an ultrasound scan for about 2 to 3 months in the presence of a normal serum CA125 levels. Since fifty percent of such ovarian cysts resolve by themselves they don’t require surgery. But for the ovarian cysts more than 5cm in diameter, a surgery may be required.
The surgical methods for the treatment of ovarian cysts in postmenopausal women involve laparoscopy, laparotomy and aspiration of cyst. Laparoscopy and laparotomy are recommended for postmenopausal women, aspiration however is not recommended for treatment of ovarian cysts in postmenopausal women. Since aspiration may increase the risk of ovarian cyst rupture and with the malignant cyst, ovarian cyst rupture during surgery may have an adverse impact on disease free survival.
But recent studies show that most of the ovarian cysts in postmenopausal women are smaller than 50 mm in diameter, benign and therefore can be managed conservatively by regular monitoring of serum CA 125 level and cyst size.