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Ovarian Cysts and Fibroids: Your Questions Answered

November 9, 2011 cancer, OBGYN, women's health 9 Comments

What is the difference between fibroids and cysts? What to do if you have them? How they can be treated/prevented? How will this affect your spouse and your sex life? Should you increase or decrease hormones? Should you get surgery? What are the risks? Will this affect your ability to get pregnant?

Women always come into the office confused stating that their primary doctor or an emergency room doctor told them they have cysts in their uterus or possibly in their ovaries.  Here, we help to clarify the two different conditions.

Ovarian Cysts

Ovarian cysts are very common in reproductive age women.  Most of them are called functional or physiologic cysts that are a result of our monthly ovulation.  Each month when you begin your period a hormone is released from the pituitary gland that stimulates the follicles in your ovary to grow and produce estrogen.  One cyst will become the dominant follicle and stop the other follicles from growing.  This follicle will rupture at ovulation and release the egg which makes its way to the fallopian tube.  The remaining follicle can fill up with fluid or blood and form an ovarian cyst.  This type of cyst has a very specific appearance on ultrasound.  These functional cysts will usually resolve on their own after one or two menstrual cycles.  They do not require surgery, just monitoring with ultrasound and occasionally anti-inflammatory medication such as Tylenol or Motrin for pain.

Other types of ovarian cysts can represent tumors of the ovary.  Some are benign and others are malignant. Benign examples include endometriomas or dermoids.  Malignant tumors include germ cell tumors or epithelial ovarian cancers.   Each type of ovarian cyst has a specific appearance on ultrasound.  Your gynecologist can get a pretty good idea of what type of tumor it is based on its ultrasound appearance.  Also certain blood tests can be done to tell if the cyst may be malignant.

If a cyst does have the characteristics of non-functional cysts usually some type of surgical removal is required either of the cyst or of the ovary. They are tumors and we do not yet know what stimulates tumor growth in people. Once this is discovered we would be able to eliminate cancer. Functional ovarian cysts on the other hand can often be prevented by the use of birth control pills which suppress ovulation.  We do not find cysts in the uterus, however, fibroids which are smooth muscle tumors, form in the uterus.


Fibroids are very common, over 50% of women will have a fibroid at some point.  They are almost always benign.  They can be in any portion of the uterus, in the cavity of the uterus, in the muscle of the uterus or on the exterior surface of the uterus.  They can also be attached to the uterus on a stalk.  Many times fibroids are asymptomatic and are diagnosed on a pelvic ultrasound or during a routine pelvic exam.  If they are small and a woman doesn’t have abnormal pain or bleeding the fibroid can be observed and followed for growth or symptoms by the gynecologist.

Symptoms from the fibroid include: heavy menstrual cycles, passing large clots during menses, pelvic pressure or pain, severe cramping with menses, urgency to urinate or difficulty having bowel movements, lower back pain.   Women may also have pain with intercourse if the fibroid is located in a specific portion of the uterus.  Your partner may also feel the fibroids if they are coming into the back portion of the vagina.   If the fibroids are located in the cavity of the uterus where a pregnancy would implant, fibroids can cause infertility and miscarriage.  Also if the fibroids are near the opening of the fallopian tubes into the uterus this can cause infertility as well.   Pain with intercourse, recurrent miscarriage, infertility or any of the above mentioned symptoms would indicate the need for treatment for fibroids.

The following treatments are available for fibroids:  surgical removal of the fibroids which is called a myomectomy or removal of the uterus which is called a hysterectomy.  Other options include removing the fibroid transvaginally with use of a camera and operating system called a hysteroscope if the fibroid is small and is in the cavity of the uterus.  If a woman isn’t planning on having more children an interventional radiographic procedure called uterine artery embolization is another means to reduce the size and bleeding from fibroids.

Fibroids typically grow in response to the release of estrogen from our ovaries.  Situations that increase our hormone levels will stimulate fibroid growth such as pregnancy.  Situations that decrease our hormones will cause fibroids to shrink which is what typically occurs after menopause.  Some women will be treated with birth control pills to attempt to control the excess bleeding from the fibroids if the patient does not want surgical intervention.

The gynecologist should monitor the growth of the fibroids while on hormones to insure that they are not getting too big.  Also there are drugs available that will temporarily induce a menopausal hormonal state to help stop bleeding from fibroids and to help them shrink.  Unfortunately, this drug can only be used for short durations because it can induce osteoporosis or weak bones.  It is typically given to help reduce fibroid size or help build up a woman’s blood count for surgery.

Treatment for fibroids depends on many factors such as size, degree and severity of symptoms and age of the woman.  Each case is different so the management is something to be determined by the patient’s desires and her gynecologist recommendations.

Unfortunately, ovarian tumors and fibroids cannot be prevented with medication, dietary changes or herbs. We recommend women discuss treatment and prevention with their doctors and always advocate for healthy living overall to reduce risks for every kind of health ailment and disease.

About the Author -

We are Dr. Yvonne Bohn, Dr. Allison Hill, and Dr. Alane Park, and we recently celebrated the 10th anniversary of our OB/GYN practice in Los Angeles. The three of us have personally welcomed more than 15,000 babies into the world. We are the featured doctors in the popular TV series “Deliver Me” (now on Discovery Fit and Health, formerly on OWN: The Oprah Winfrey Network) and we have a new series "Mommy Docs" in development for public television. We know the pregnancy and birthing process intimately…from both sides. We’re doctors — but we’re also moms who have been through all the stages of pregnancy with six kids of our own. In addition to obstetric care we also provide guidance and treatment for various women’s health concerns including: Contraceptive Health, Breast Cancer Screening, STD Screening, Menopausal Care, Infertility and Preventive health. Have a question? Email us at


  1. So happy to see you are back on the air! I feared you had tired of the show and decided not to continue. You bring so much information about pregnancies to your viewer and seeing the joy of receiving new family members is so heartwarming! Thank you and your patients for sharing this with us!

  2. I have a ovarian cycst on my left side and might have one on my right side the hurt and yes you can bleed from them if you don’t go see you doctor or nearest hostpital you can bleed to death I have to live with the cycst for now

  3. Katriza on said:

    I have an ovarian cyst on the left side and a fibroid in the uterine incidentally.. Fibroids are uterine muscle which cause more pain and cramping with periods..

  4. Cassandra Middleton on said:

    I am 50 years old and I know I have 7 cyst on my ovaries. My cycles last for 3 weeks before stopping some times longer. I have been to the doctors and it seems that no body care. Every time I make a bowel movement I bleed more and mt bowels hurt and i can feel the bowels moving, sex hurts to were i have stopped having sex with my husband. I cramp in my lower back that hurts all the time I am getting weak I can tell but I keep going on . Question is the normal? Because it seems like nobody cares. My mother had to have here ovaries removed at the age of 60 she was breeding like me and never menopause.

    • Interesting… I haven’t been to a doctor for this yet (have only gone once in the past 11 years!), but ever since I started my period I’ve bled *heavily* with incredibly severe cramps. I wondered why no one else had such problems with their periods as me (+painful sex to the point of avoiding or rushing), but I thought it must be normal, so I didn’t find out until age 27 that my condition was so abnormal. I’m applying for SSI for something probably unrelated, but they’re sending me for a test concerning anemia, which has lead me to read about cysts & fibroids. I have prolapsed pelvic organs, and thought that was the main reason for my troubles going to the bathroom, but now I’m hoping I can get tests to finally uncover my menstrual difficulties as well and figure out what’s really going on.

      I do not believe these are not treatable, unpreventable, or even that cancer is incurable. There are many different medical systems to consider when the one you’re currently working with is giving you no answers or no help. I wish they would all be willing to work together! I’m finding amazing help from Traditional Chinese Medicine – something I once thought to be meaningless, but took a second look at after finding handwritten notes from my grandmother in an alternative medicine book about it. I first cured “incurable” surgery-induced tinnitus through acupressure alone, in two days, and have been hooked since. For my menstrual problems, I’m now looking to qigong – which there are many different types of due to different teachers, but there are so many cases of people being cured or helped incredibly with their cancer and countless other ailments, I am very intrigued, and even before really starting it, I recommend others to look into this. I’m sure there is a type that is perfect for these conditions.

      I intend to do everything I can to keep my body intact and normalize my hormones SAFELY. The best relief I’ve ever had from my presumed cysts or fibroids was from drinking kombucha before period – I believe it helped flush excess estrogen or something, but I can’t make it for now and there are still missing pieces in my “puzzle”. Posture, deep breathing, diet, gentle exercise, positive thinking… there are so many ways that one can improve their life, their body… Don’t give up, I won’t.

  5. I have an ovarian cyst on the Left side and and 3 small Fibroids are in the uterine my doctor give me a danocrine 200 mg capsules for 6 month . again will re-test Ultrasound and bloods test . please tell me did it remove only medicine ?

  6. Hi ther… yup!… I got that same problem! I had fibroid in my uterus, cyst in my right ovarian! My symptoms was un explain so muchs pleeding 7-12day, extremely tired, lower back pain, hardly walk most times, nausea throw up, hand fett chilling went pain Hit me! Been black out without im knew what going b for (some one found me on floor, Seeing 6 OB , 4CT. 5 -6 ultrasound. I had madical card. Dr say they not goingto cover for my surgery! I havd comeup with money then they will give me surgery! .. im dieing! Suffering with pain none DR! Seen care. Is suck!..

  7. I’m had ovarian cysts since I was 14 when I first started getting my period. My periods have progressively got worse with symptoms changin drastically in the last 3 months. I’ve been on birth control since we first discovered the cysts in an attempt to drive them away. I used to have an annual ultrasound to keep an eye on them but have stopped in the past year. I am now 20. My period has reached the absolute max of symptoms I can handle. The past 5 periods have been hell. I have nausea and a lack of desire to eat. Lower back pain, tender breasts, hands and feet that swell on and off the whole 7 to 9 days of having a period. My cramping has reached a very high intensity, my last period to the point that I considered going to the ER. I have had two periods a month the past 2 cycles. This triggered concern for me as I have been regular for as long as I can remember. So I went in for a visit. His answe was rathe disappointing. I was told that one of two things could be causing this sudden change. One the herbal detox I had done thrown my hormones out of whack which would explain my double periods or the second reason being my recent change pills had set my body off again. His explanation after that was to keep an eye on any changes and for now we would wait and see if another month of my new pill would sort itself out. I’m concerned and feel as though he is maybe not exploring all possibilities. With the history of cysts I figured I would get sent for another ultrasound just to check but he didn’t. Should I be concerned or am I over reacting? My periods are now affecting what I can and cannot do during my one week of the month. Can someone please help shed light on this?

  8. Jessica on said:

    This article is very helpful. I was diagnosed yesterday with what we believe is a 6cm dermoid cyst on my left ovary. Since I’m nearly 18 weeks pregnant, surgery isn’t an option at this point; we can only monitor the cyst to see if it’s growing. A few years ago I had a fibroid on the outside of my uterus (right side), and I’ve been wondering the difference. Thanks for this information!

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