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3.5 Minute

10-10-2024 Team Medicover woman-and-child

Written by Medicover Team and Medically Reviewed by Dr Tanuja Priyadarsini V, Gynecologist

Ovarian Cysts After Menopause: Signs, Causes & Care

Ovarian cysts are fluid-filled sacs that form on or inside the ovaries. They are quite common, especially during the childbearing years, and often form as a part of the normal menstrual cycle. Most ovarian cysts are harmless (benign) and go away on their own without treatment.

This article delves into the causes, symptoms, and management of ovarian cysts after menopause, providing a comprehensive understanding of this condition.

About Postmenopausal Cysts

Ovarian cysts can also develop after menopause, which is known as postmenopausal ovarian cysts. While these are less common, they require closer monitoring because the risk of complications or malignancy (cancer) slightly increases with age. Most postmenopausal cysts are still benign, but timely diagnosis and regular follow-ups are important.

Before diving into the specific causes of ovarian cysts after menopause, it's essential to understand what ovarian cysts are and how they form. Ovarian cysts can be classified into several types, including functional cysts, dermoid cysts, cystadenomas, and endometriomas.

Types of Ovarian Cysts

Functional Cysts: These are the most common type of ovarian cysts and usually occur during the menstrual cycle. They include follicular cysts and corpus luteum cysts.
Dermoid Cysts: Also known as teratomas, these cysts can contain tissues such as hair, skin, or teeth.
Cystadenomas: These are benign tumours that develop from ovarian tissue and can be filled with a watery or mucous substance.
Endometriomas: These cysts form due to endometriosis, where endometrial tissue grows outside the uterus.

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Symptoms of Ovarian Cysts After Menopause

Ovarian cysts may be asymptomatic, especially when they are small. However, larger cysts or those causing complications can present with various symptoms:

Abdominal Pain: Persistent or intermittent pain in the lower abdomen or pelvis.
Bloating: A feeling of fullness or bloating in the abdomen.
Changes in Bowel Movements: Altered bowel habits, such as constipation or diarrhoea.
Frequent Urination: Increased urgency or frequency of urination due to pressure on the bladder.
Irregular Bleeding: Postmenopausal bleeding or spotting, which requires immediate medical attention.

Causes of Ovarian Cysts After Menopause

While ovarian cysts are less common after menopause, they can still develop. The following are some potential causes:

Hormonal Imbalance

Hormonal fluctuations are a primary cause of ovarian cysts in premenopausal women. Although hormone levels stabilize after menopause, some women may still experience hormonal imbalances. These imbalances can lead to the development of cysts.

Hormone Replacement Therapy (HRT)

Hormone replacement therapy, often used to manage menopausal symptoms, can increase the risk of ovarian cyst formation. Estrogen and progesterone, the hormones used in HRT, can stimulate the ovaries and potentially lead to cyst development

Benign Tumors

Cystadenomas and dermoid cysts, which are benign tumours, can develop in postmenopausal women. While not cancerous, these cysts can grow large and cause discomfort or other complications.

Malignancy

Although rare, ovarian cysts in postmenopausal women can be cancerous. Ovarian cancer often presents as a cystic mass, and the risk increases with age. It's crucial to monitor any cysts for changes in size, shape, or symptoms and seek medical evaluation if needed.

Diagnosis and Evaluation

Diagnosing ovarian cysts after menopause involves a combination of physical examination, imaging studies, and laboratory tests.

Physical Examination

A pelvic exam can help detect abnormalities in the ovaries. However, small cysts may not be palpable.

Imaging Studies

Ultrasound: Transvaginal ultrasound is the most common imaging modality used to evaluate ovarian cysts. It provides detailed images of the ovaries and helps determine the cyst's size, shape, and composition.
CT Scan or MRI: These imaging techniques may be used for further evaluation if the ultrasound findings are inconclusive or if malignancy is suspected.

Laboratory Tests

CA-125 Blood Test: This test measures the level of CA-125, a protein often elevated in ovarian cancer. However, elevated CA-125 levels can also be seen in benign conditions, so it is not definitive for diagnosing cancer.
Hormone Levels: Blood tests to evaluate hormone levels can help determine if hormonal imbalances are contributing to cyst formation.

Management and Treatment of Ovarian Cysts After Menopause

Treatment for postmenopausal ovarian cysts depends on the size, type, symptoms, and whether the cyst appears suspicious on imaging tests.

Watchful Waiting (Monitoring)

If the cyst is small, simple (fluid-filled), and not causing symptoms, your doctor may recommend regular monitoring with ultrasound and blood tests (like CA-125) to watch for any changes.
This is common for benign-appearing cysts under 5 cm.

Medications

Hormonal medications, such as birth control pills, are generally not used in postmenopausal women. However, in some cases, hormone replacement therapy may be adjusted or discontinued if it is contributing to cyst formation.

Surgical Intervention

Surgery may be necessary if the cyst is large, symptomatic, or suspected to be malignant. The type of surgery depends on various factors:

Laparoscopy: A minimally invasive procedure where small incisions are made, and a laparoscope is used to remove the cyst.
Laparotomy: A more extensive surgical procedure involving a larger incision, typically used for larger or potentially malignant cysts.

Post-Surgical Care

After surgical removal of an ovarian cyst, post-surgical care involves monitoring for complications, managing pain, and ensuring proper wound healing. Follow-up visits and imaging studies are essential to ensure the cyst does not recur and to monitor for any new developments.

Risk Factors of Postmenopausal Ovarian Cysts

Although ovarian cysts are less common after menopause, certain factors can increase the risk of developing ovarian cysts during menopause:

Age: Advancing age, especially after menopause, is a risk factor as the chances of abnormal or complex cysts increase.
Hormone Replacement Therapy (HRT): Taking estrogen-containing medications after menopause may contribute to the formation of ovarian cysts during menopause.
Family History of Ovarian or Breast Cancer: A family history of ovarian, breast, or colon cancer may increase the risk of cysts, some of which may be cancerous.
Personal History of Ovarian Cysts: Women who had functional ovarian cysts during their reproductive years may still be at risk after menopause.
Obesity: Higher body weight can affect hormone balance and increase the risk of certain ovarian changes.
Genetic Conditions: Inherited conditions like BRCA1 or BRCA2 mutations raise the risk of ovarian and breast cancer, along with abnormal cyst development.
Pelvic Infections or Inflammation: Chronic infections may lead to the formation of cysts or adhesions around the ovaries.

Prevention and Monitoring

While it may not be possible to prevent all ovarian cysts, certain measures can help reduce the risk and promote early detection:

Regular Check-ups: Annual gynaecological exams can help detect ovarian cysts early.
Healthy Lifestyle: Maintaining a healthy diet, regular exercise, and managing stress can contribute to overall well-being and hormonal balance.
Awareness of Symptoms: Being aware of the symptoms of ovarian cysts and seeking medical attention if they occur can lead to early diagnosis and treatment.

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Conclusion

Ovarian cysts after menopause can be a cause for concern, but understanding their causes, symptoms, and management options can help alleviate anxiety. Regular medical check-ups, awareness of symptoms, and timely medical intervention are crucial in managing ovarian cysts and ensuring optimal health.

Frequently Asked Questions

Yes, ovarian cysts can still occur after menopause, although they are less common than in younger women.

Ovarian cysts after menopause can form due to hormonal changes or underlying conditions. While most are benign, they need evaluation to rule out cancer risks.

Yes, ovarian cysts at age 60 are possible, though they are less common after menopause. At this age, doctors usually recommend regular monitoring because the risk of complications or malignancy may be slightly higher.

Birth control pills are often used to prevent new cysts. Pain relievers help manage symptoms. Treatment depends on the cyst's size, type, and whether you're postmenopausal.

The CA-125 blood test is commonly done to check for cancer risk, especially in postmenopausal women. It's usually combined with ultrasound imaging for diagnosis.

Seek medical advice if you experience severe pain, bloating, or unusual menstrual symptoms.