It was reported recently in People Magazine that Lena Durham was hospitalized due to a ruptured ovarian cyst.1Unfortunately, her story is all too common. I often say to patients that most health concerns relating to our menstrual cycle – which can range from ovarian cysts, to heavy, difficult or painful periods, to no periods, to fibroids, to fertility issues and all the way to menopause – are not exactly medical conditions that need to be treated with a suppressive therapy such as the birth control pill. Instead, they are signs from your body that your hormones are out of balance. The work that needs to be done is in balancing the hormonal system to alleviate these messages typically referred to as symptoms.
Types of ovarian cysts
Ovarian cysts are fluid filled sacs that develop on the ovaries. In Lena Durham’s case, she developed a type of ovarian cyst called an endometrioma which is secondary to endometriosis.3 In endometriosis, endometrial tissue migrates outside the uterine cavity and attaches to other organs, such as the ovaries. A growth forms which becomes an endometrioma cyst. There are two other common types of ovarian cysts (follicle and corpus luteum cysts) that can form during a normal menstrual cycle and tend to go away on their own.
Follicle cysts. In a normal menstrual cycle, the ovaries release an egg each month. The egg grows inside a tiny sac called a follicle. When the egg matures, the follicle breaks open to release the egg. Follicle cysts form when the follicle doesn’t break open to release the egg. This causes the follicle to continue growing into a cyst. Follicle cysts often have no symptoms and go away in one to three months.2
- Corpus luteum cysts. Once the follicle breaks open and releases the egg, the empty follicle sac shrinks into a mass of cells called the corpus luteum which makes hormones to prepare for the next egg in the menstrual cycle. Corpus luteum cysts form if the sac doesn’t shrink. Instead, the sac reseals itself after the egg is released, and then fluid builds up inside. Most corpus luteum cysts go away after a few weeks.2
Follicle and corpus luteum cysts are referred to as physiological or functional in nature because they form a function in the body.4 In addition to endometriomas, there are three other types of ovarian cysts (dermoid, cystadenoma and polycystic ovarian syndrome) which are considered pathological in nature because they don’t serve a function in the body:
- Dermoids come from cells present from birth and do not usually cause symptoms.
- Cystadenomas are filled with watery fluid and can sometimes grow large.
- Polycystic ovaries. These cysts are caused when eggs mature within the “little balloons” but are not released. The cycle then repeats. The sacs continue to grow and many cysts form. This can result In irregular periods and difficulty getting pregnant if not treated.4
It is important to note that most ovarian cysts are often not malignant and they are a result of menstruation. If you are postmenopausal and experience the symptoms listed below it is important to visit your doctor as postmenopausal women with ovarian cysts are at higher risk for ovarian cancer.2
What you might experience
With ovarian cysts, you do not always experience symptoms because many cysts are small. If the cysts grow to a larger size, you may experience intermittent pain that is sharp or dull in nature in the lower abdomen on the side of the cyst, as well as pressure and bloating.2 Less common symptoms include2:
- Pelvic pain
- Dull ache in the lower back and thighs
- Problems emptying the bladder or bowel completely
- Pain during sex
- Unexplained weight gain
- Pain during your period
- Unusual (not normal) vaginal bleeding
- Breast tenderness
- Needing to urinate more often
In the extreme case of a cyst rupturing, you will experience sudden, severe pain. If a cyst causes twisting of an ovary, you may have pain along with nausea and vomiting.
What you can do about ovarian cysts
If you think you might have ovarian cysts, the first step is to talk to your doctor. If a cyst is found after doing a pelvic exam, your doctor may send you for an ultrasound or hormone level tests. The solution for ovarian cysts from a conventional medical perspective is to manage pain with medication or to prescribe the birth control pill. The National Institute of Health estimates that 5% to 10% of women have surgery to remove an ovarian cyst and this would occur if your cyst:
- Does not go away after several menstrual cycles
- Gets larger
- Looks unusual on the ultrasound
- Causes pain
It is important to understand that there are natural alternatives to taking medication (either pain medication or the birth control pill). It is important to address the underlying causes of hormone imbalances that can lead to ovarian cysts. We have to realize that we need to work with our hormones to do all that we can to avoid surgery. And to truly manage our hormones, we can’t rely on pills. We have to deal with the root causes of food and lifestyle choices that are creating havoc with our hormones. Here are some next steps to take and what you need to be aware of:
- Xenoestrogens from the environment affect the levels of estrogen in our bodies. When estrogen is too high, it can promote the formation of ovarian cysts. Endocrine disruptors may be found in many everyday products – including plastic bottles, metal food cans, detergents, flame retardants, food, toys, cosmetics and pesticides.5 To reduce your exposure to pesticides, start by eating as many of the following foods organic6: apples, peaches, nectarines, strawberries, grapes, celery, spinach, bell peppers, cucumbers, cherry tomatoes, imported snap peas and potatoes (yes, that includes French fries J).
- Our liver is a key organ involved in the break down and elimination of estrogen from our body.7 If our diets are devoid of key nutrients required to break down estrogen, it may build up in our system and stimulate a cyst to grow.8 To support your liver and promote the elimination of estrogen from your body, increase the amount of cruciferous vegetables in your diet (ie broccoli, cauliflower, cabbage and Brussel sprouts), decrease refined sugar and limit coffee and alcohol.
- Your lifestyle affects how your hormones function. It is important to determine whether poor eating habits, lack of sleep, lack of exercise or excessive stress levels may be affecting your hormone balance. Remember that positive change happens in small increments. Pick one area that you can improve on to support your hormonal health.
When your hormonal system is in out of balance, it can cause a domino effect, producing more symptoms, secondary conditions, and even autoimmune issues. Remember to work with your naturopathic doctor to determine what the underlying root causes are for you as an individual.