How dangerous is a cyst?
Dear Dr Mitchell,
How dangerous is a womb cyst? My girlfriend has developed something and is experiencing hard pains and the doctors confirmed that she is having cysts. Will she die if they are not removed? And what causes it?
I will assume that what you really mean is an ovarian cyst since a cyst in the womb or uterus is uncommon. The only situation that causes a cyst in the uterus is a condition called adenomyosis, where similar tissues which line the inside of the uterus are present outside of the lining of the uterus (endometrial cavity). In adenomyosis, this is present in the muscles of the uterus and so there is bleeding into the muscles during the menstrual period since the deposits in the muscles behave just like the tissues in the lining that shed and blocks monthly. This results in the uterus being bigger than usual and can also cause painful and heavy periods. Some women have pain during intercourse because of the adenomyosis. This condition may be associated with difficulty getting pregnant.
It can be controlled by using medication to stop the menstrual period. This includes using the oral contraceptive pill, the contraceptive injection Depo Provera or Mesigyna and other medications that shut down the periods by causing a pseudomenopausal state. In severe cases surgery has to be done to remove the abnormal tissues. The only long-term cure for endometriosis and adenomyosis is removing the ovaries and the uterus or if the menopause sets in with age.
The exact cause of endometriosis is really unknown. If she in fact has ovarian cysts and has pains, then this has to be treated with urgency. Pain associated with an ovarian cyst is usually due to bleeding into the cyst, leakage of fluid from the cyst or torsion of the ovary itself. If ovarian torsion occurs this is an emergency situation since the ovary can lose its blood supply if the situation is not corrected and then the entire ovary has to be removed. Some cysts are simple cysts and do not go on to becoming cancerous.
If the cyst is simple then surgery is not necessary if it is small (less than 5cm) since the use of the low dose contraceptive pill can usually help it to shrink. Your girlfriend will not die. The fact that she is experiencing severe pains is significant, however, and suggests that she should consult her gynaecologist and have the cyst removed.
Ovarian cysts can develop during ovulation and are considered normal. In some cases, however, growth in the ovary can be a sign of ovarian cancer. If the cyst is present in both ovaries, greater than 5cm in diameter, solid in nature and associated with enlarged lymph nodes or fluid in the abdomen, then this is suspicious for cancer and needs urgent surgery. However, most ovarian cysts are not cancerous.
She should consult her gynaecologist who will advise her further.
Best wishes.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver. com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 968-2025. Dr Mitchell cannot provide personal responses.
