Q: I am in need of some guidance. I am a 42-year-old lady that has been having trouble with pelvic pain. I have a history of PCOS and was recently diagnosed with a complex ovarian cyst. I am wondering if it is worth it to have this removed or if I need to have a hysterectomy and be done with it.
Should I be in a hurry to have it removed? Besides the daily pain, I am worried about it twisting and rupturing which my doctor tells me would be an emergency situation. Please give me your thoughts.
I enjoy your column and have learned so much from it. Thank you.
A: PCOS is an acronym for polycystic ovary syndrome, a rather common endocrine system disorder in women of reproductive age. The condition may present with prolonged or infrequent menstrual cycles, acne, obesity, and excessive amounts of hair growth. Most women with PCOS grow numerous cysts on their ovaries that, in turn, lead to hormone imbalances. While the precise cause of PCOS is not completely understood, genetics are believed to be a factor.
Diagnosis begins with a history and examination by a physician who will request laboratory testing to check hormone, thyroid, blood sugar levels, and more. A height and weight will be taken and a blood pressure reading will be done. A pelvic ultrasound will be requested to determine if there are ovarian cysts. While the diagnosis can be made without the ultrasound, the testing will help rule out other disorders.
Key treatment for PCOS includes a healthy diet, exercise such as walking or something slightly more strenuous on a regular basis, and weight control. Following weight control comes medication; the use of birth control pills is important in the treatment of PCOS. A great deal depends on the specific manifestations of PCOS, meaning whether there is treatment required for androgenism or fertility, or treatment of obesity-related problems. Foods that are high in saturated fats should be limited. A diet should consist, in part, of whole grains, fresh fruits and vegetables, nuts, and beans. It has been determined that most women with the condition are overweight and will benefit from losing as little as 10 pounds. The habit of smoking, if appropriate, should be discontinued completely.
Surgery for ovarian cysts has gone out of favor. The risks involved with surgery on an ovary include uncontrollable pain, possible infection, adhesions, and because the bladder may be damaged during the procedure. More physicians, therefore, are using laser removal of large cysts which has less scarring.
