Should I remove a simple cyst -4cm

[esteeny]

I have an ovarian cyst about 4cm in size on left ovary.  I am 52 and have been menopausal for a few years.  Had the cyst for more than 5 years and has gone from 2cm to 4cm over that time.

I have regular sonograms with doppler to monitor and doctor says its a simple cyst - no immediate danger but suggests to take out ovaries & tubes to remove cyst because that is the only way to be sure that there is nothing else there.  Blood work always came out fine.  Doctor says ovaries at my age have no function.

Question -
1-  should I take ovaries out (as doctors advice at my age)?
2- remove only left ovary?
3 - Watch and see and continue to monitor with regular sonogram screening?

  What is the side effect since I am in menapause.  Also I went to a herbalist that said surgery can make you feel 20 years older is this true??? Doctor keeps saying that ovaries at my age have no function - but I read that there is residual estrogen and removal  can affect your bones & heart.

Please advice pros & cons of having surgery. I am very confused & undecided by it all!!

ps.  herbalist also suggested 2 products that claim to shrink cyst - do you know anything about them
Maitake D fraction & Female Hormonal Balance (vitex)??

Thanks in advance,

[Annekathryn Goodman, M.D.]

Hi There,

here has been debate about the postmenopausal ovarian function. By hormone measurement, the ovary no longer makes estrogen or progesterone. However, it seems to make male hormones. Over time with aging these levels fall as well. I have pasted one study below looking at hormone changes and their consequence after removing both ovaries after the menopause. In general , while male hormone levels fell, most women did not notice. I have to say, that has been my personal experience as well. About 10-20% of women will notice a change in their sex drive. Most women, however will not. some women will get hot flashes again for a short time.


As far as your cyst, it is probably a benign tumor and is slowly growing over the years. You should consider removing the ovary with the cyst on it. then you are done worrying about it. As far as the other ovary - if you have a family history of breast, ovarian, or colon cancer, you should strongly consider removing the normal ovary. otherwise, leave it alone.
I am not familiar with the herbs that you mention
best wishes

Gynecol Oncol. 1991 Jan;40(1):42-5.


Reproductive hormone levels in gynecologic oncology patients undergoing surgical castration after spontaneous menopause.

Hughes CL, Wall LL, Creasman WT.

Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina 27710.

The endocrine function of the ovary after menopause is perhaps less well understood than at any other time in the female life cycle. To evaluate the hormonal function of the ovary further at this stage of life, reproductive hormone levels were measured in 11 postmenopausal women admitted to the gynecologic oncology service for pelvic surgery which would involve bilateral oophorectomy. Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels, along with estradiol, testosterone, dehydroepiandrosterone sulfate (DHEA-S), and androstenedione levels, were measured preoperatively, on Postoperative Days 1 and 4, and at 6 weeks following surgery. Testosterone and androstenedione levels fell by half in these patients, whereas estradiol levels were unaffected. LH and FSH showed a fall in the immediate postoperative period, with a subsequent return to baseline levels by 6 weeks after surgery. DHEA-S levels were unaffected by surgery. There are no discernible differences in subjective menopausal symptoms postoperatively in postmenopausal women undergoing bilateral oophorectomy compared to their preoperative state. The data show that the long-held but inadequately proven thesis that postmenopausal oophorectomy dramatically reduces androgen levels is in fact true. This is further evidence that the postmenopausal ovary is an important source of potent and potentially aromatizable androgens.

[akg]

one ovary removed does not affect hormone levels
yes - laparoscopy
2 weeks recovery time
best wishes

[esteeny]

By how much would the effect of one ovary be on my hormonal levels.  Meaning with removal of just one ovary how will I feel afterwards (re- hormones)?

Any effect on my bones? Heart? (or is this only a worry before being menopausal)?

Also what is involved in a laparoscopic removal?  Recovery time?