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I'm 35 years old and have always had normal pap smears. The other day I went to my doctor for my annual pelvic exam. When my doctor was done she informed me that she had found a couple of cysts while performing my pelvic exam. My question is should I be worried about cancer and what kind of treatment is there for cyst? Also for the last couple of months I have been experiencing very bad dizziness; can this be related in any way to what my doctor found?
— Concerned About Cysts
I’m very glad you've asked this question, as sometimes we receive a diagnosis or results from our physicians and we don't quite know what to make of it. However, I am unsure of your specific diagnosis, as cysts can appear in many different places in the female reproductive organs, so I will discuss some different types of common female reproductive organ cysts. Hopefully this will provide you some information on your particular problem. If you still have unanswered questions regarding your particular diagnosis, I urge you to contact your physician who diagnosed the cysts for further discussion.
To learn more about this health topic, keep reading.
There are three common types of cysts that can be found on a routine pelvic exam: cervical cysts, uterine cysts (more commonly known as fibroids), and ovarian cysts. Cervical cysts, also known as Nabothian cysts, can be seen by your physician when your pelvic exam and pap smear are done. Uterine fibroids and ovarian cysts are more likely to be felt or palpated by your physician during your pelvic exam.
Cervical cysts are mucous-filled lumps that form on the cervix and are rarely cancerous. They form when normal epithelial tissue on the outer part of the cervix grows over the mucous-secreting glandular tissue of the inner part of the cervix. Cervical mucous is then trapped and forms cysts. Typically, these cysts do not cause any symptoms and don’t require treatment unless they grow large enough to cause pain. In those cases, treatment may include removal or drainage of the cyst. In a rare case where the cervical cyst has an unusual appearance or is accompanied by signs and symptoms of cervical cancer (abnormal vaginal bleeding/discharge, pain during intercourse or pelvic pain), your physician may perform a special pelvic exam called colposcopy. This pelvic exam is almost identical to the one you receive when a pap smear is performed, but the physician will use a special magnifying instrument to visualize the cervix. If the cyst appears abnormal during the colposcopy, your physician may perform a biopsy to determine if the lesion is cancerous.
Uterine fibroids are noncancerous growths of the uterus that develop from the smooth muscular tissue of the uterus. They are less commonly referred to as uterine cysts as they do not typically resemble a cyst-like structure. As many as one in five women may develop fibroids, and development is more common during the childbearing years. They typically affect women over age 30 and are more common in African-Americans than Caucasians. Often, women do not experience any symptoms from fibroids. If symptoms occur, the most common ones are abdominal fullness, bleeding between periods, increase in urinary frequency, heavy or prolonged menstrual bleeding, pain during intercourse, constipation, and pelvic cramping or pain with periods. A pelvic examination by your physician may show an irregularly shaped, lumpy, or enlarged uterus. Diagnosis may be confirmed with ultrasound or MRI. Generally speaking, fibroids are not associated with an increased risk of cancer, however, depending on your signs and symptoms, your physician may want to perform a biopsy to rule out cancer. There are many options for treatment depending on the size and symptoms of your fibroids. If you were diagnosed with uterine fibroids, you should discuss your treatment options with your physician.
Ovarian cysts are fluid-filled sacs that form in or on the ovaries. The most common type of ovarian cyst is a functional cyst, and these often form during the menstrual cycle. Other types of ovarian cysts include endometriosis, cystadenomas, dermoid cysts, or polycystic ovaries. These types of ovarian cysts are much less common than functional cysts. Many women have ovarian cysts at some point in their lives, and a majority of functional cysts disappear without treatment. Typically, physicians address several factors of the cyst to determine a diagnosis: shape, size, and composition (fluid, solid, or mixed). To identify the type of cyst, your physician may perform the following procedures: pregnancy test, pelvic ultrasound, laparoscopy (abdominal surgery performed with special cameras to determine the type of cyst and possibly remove it), and blood tests to determine if a specific ovarian cancer marker called CA-125 is elevated. Typically, cystic ovarian masses that occur after menopause may be cancerous, however, your physician will be able to determine based on diagnostic testing whether a cyst is cancerous. Treatment options will depend on what type of ovarian cyst is diagnosed by your physician but may include watchful waiting, birth control pills, or surgery.
To answer your question about the dizziness you've been having for the past few months and whether it is related to your cysts, I honestly cannot determine that based on the fact I do not know what type of cyst you have. However, dizziness can come from many different medical problems, and I urge you to not only discuss the dizziness with your health care provider, but you should also discuss your diagnosis of cysts (in terms of treatment and prognosis) with your physician. Based on what type of cysts you have, your physician will be able to determine your treatment options and prognosis, as well as determine if your dizziness is related to the cysts or if further evaluation and testing are needed to determine the cause of your dizziness.
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