January 15, 2017 Liza Colimon, MD Of the many things we have in common as women, Ovarian cysts are at the top of the list. If you speak to a friend or a family member, chances are at some point in their lifetime they have been diagnosed with an ovarian cyst. If you have an ovarian cyst... don't panic! Cysts on the ovaries are extremely common. The key to minimizing your anxiety level is to talk to your gynecologist and become educated about the type of cyst you have and develop a follow up plan. A cyst on the ovary is a fluid filled space within the ovary which usually results from ovulation. Most cysts resolve on their own by breaking or being re-absorbed by your body. Occasionally they can cause bloating, discomfort, pain, and may grow large. Here are five myths about ovarian cysts we need to discuss... 1. Ovarian cysts need to be surgically removed. Not all ovarian cysts require surgical removal. Most ovarian cysts are small, appear to be non-cancerous, and resolve on their own. If you are experiencing pain that is not improving, if the cyst continues to grow larger, or if you are experiencing fever or signs of infection in combination with lower pelvic discomfort this may indicate you need surgery. Other types of cysts such as dermoid cysts, endometriomas, or cysts that have an abnormal appearance need to be removed surgically. Make sure you are informed about they type of cyst you have, it's size, and craft a follow up plan with your gynecologist that you are comfortable with. 2. Ovarian cysts cause infertility. Infertility, or the inability to conceive a pregnancy, is usually diagnosed after a couple has been unable to get pregnant after a 12 month period. Causes may be due to a partner's abnormal semen analysis up to 40% of the time. If you are not ovulating (having irregular periods is a sign), have a history of fallopian tube surgery, pituitary or thyroid problems or have had a history of Chlamydia, pelvic inflammatory disease, or an ectopic pregnancy you may be at risk for infertility. Most ovarian cysts do not cause infertility. Cysts that become infected and cause a pelvic infection may cause scarring in the fallopian tubes which could cause infertility. However this is rare. Ovarian cysts that contain endometriosis may be associated with infertility. Monitoring a normal appearing ovarian cyst until it resolves will not cause infertility. 3. Ovarian cysts are cancerous. Many women believe ovarian cysts will grow into ovarian cancer. However, the vast majority of ovarian cysts will not grow into ovarian cancer nor are cancerous at the time of diagnosis. Some ovarian cysts may contain cancer and this can only be diagnosed after surgery. There are signs on pelvic ultrasound which will help your gynecologist decide if cancer is a concern or if immediate surgery is recommended. Every case is different. Comparing stories with girlfriends may be helpful but remember... Your body, Your cyst, and Your story is unique. Be prepared to bring your concerns and questions to your visit with your gynecologist. 4. A CA-125 level will definitively diagnose ovarian cancer. A CA-125 is a tumor marker that may be elevated only half of the time when a certain type of ovarian cancer is present. This blood test is often used to help decide to perform surgery immediately or wait for the cyst to resolve in women who are menopausal. We may perform this test in pre-menopausal women as well but it is not often recommended. An elevated, or abnormal, CA-125 level does not mean you have ovarian cancer. It can be elevated in many situations including in women with endometriosis. 5. Birth Control Pills are not helpful. Birth control pills can prevent your ovaries from ovulation 50% of the time. If you have recurrent ovarian cysts it is important to consider taking birth control pills to suppress the development of cysts on your ovaries. This is also very important to consider if you have had prior ovarian surgery for an ovarian cyst or if you form cysts on a regular basis.