Ovarian cyst assessment in Munich

A cyst is a fluid-filled cavity. Cysts on the ovary are common, especially during the fertile years. Most are functional cysts that develop as part of the cycle. There are also other types: endometriosis cysts, which contain old blood and are also called chocolate cysts because of their dark colour; dermoid cysts, which can contain different kinds of tissue such as fat or hair; and cystadenomas, benign growths of glandular tissue. These types do not usually go away on their own. Whether a cyst is functional can often be judged well on ultrasound, and sometimes only through a follow-up check. Prof. Schulte-Uebbing has given a presentation on benign and malignant diseases of the ovaries and fallopian tubes: “Benign and Malign Adnexa Diseases” (Zilele FMF Oradea, 2013).

Every month, a follicle matures in the ovary. If it does not rupture at ovulation, a follicular cyst can develop. After ovulation the corpus luteum forms; if it fills with fluid or blood, it is called a corpus luteum cyst. Both depend on the hormones of the cycle and usually go away on their own within a few cycles. That is why waiting and monitoring with ultrasound is often the right approach. Hormonal treatment can reduce the formation of new functional cysts but, as far as we currently know, hardly speeds up the disappearance of existing ones. If cysts keep coming back, we look more closely at your cycle and hormonal balance – for example at an imbalance between oestrogen and progesterone.

Certain features on ultrasound are a reason to look more closely: solid areas, septa, a thickened wall, abnormal blood flow, marked growth or a cyst that persists over several check-ups. We also assess cysts after the menopause more carefully, because ovulation no longer takes place then and functional cysts are less common. That does not mean something serious is going on. It means we want to be certain. Further tests can then make sense, such as blood tests, magnetic resonance imaging (MRI) or keyhole surgery in which the cyst is removed and examined in the laboratory (histology). We explain every step and support you along the way.

With PCOS, polycystic ovary syndrome, ultrasound shows many small follicles around the edge of the ovaries. Despite the name, these are not true cysts but follicles that do not mature. An irregular cycle and signs of raised male hormones often go with it. Endometriosis cysts form when tissue similar to the lining of the uterus settles on the ovary. They can cause pain and affect fertility. Endometriosis is one of the main areas of focus of our practice. With both conditions, it is not enough to look at the cyst alone. We look at hormones, cycle, inflammation and life circumstances and advise you holistically. You will find more detail on our pages on PCOS and Endometriosis.

Rarely, an ovary with a larger cyst can twist around its own axis. This ovarian torsion cuts off the blood supply and causes sudden, very severe, usually one-sided pain, often with nausea and vomiting. It must be treated in hospital immediately. A cyst can also rupture. This is often harmless and only hurts briefly; however, if there is bleeding into the abdominal cavity, circulatory problems can occur. If you have sudden severe lower abdominal pain, circulatory problems or fever, please call 112. If pregnancy is possible, an ectopic pregnancy must also be ruled out in cases of severe pain. Outside our consultation hours you can reach the on-call medical service on 116 117.

Cysts are usually a sign of the normal cycle. But if they keep recurring or cycle disorders are added, it is worth looking at the bigger picture. We ask about stress, sleep, weight, diet and environmental burdens, and we look at your hormonal balance, thyroid and possible inflammation. Prof. Schulte-Uebbing has worked for many years on hormonal disorders in women and on environmental substances that act like hormones. Alongside conventional care, we offer natural hormone therapy and acupuncture for cycle and hormonal disorders. These methods do not replace investigation or any necessary surgery. Whether they prevent cysts has not been proven; their aim is to support your cycle and well-being.