Episode 71: Let’s Talk Ovarian Cysts and Polycystic Ovarian Syndrome: It’s Not Just in Your Ovaries

In this episode, Dr. Lisa and Dr. Toni are talking about the different types of ovarian cysts that perimenopausal women can commonly experience, including PCOS. Did you know that if you have ovarian cysts, it doesn’t mean you have PCOS? Find out what symptoms you need to watch for, what lab testing to consider and natural approaches to effectively managing ovarian cysts.  What types of ovarian cysts can you develop? Functional cysts - related to menstrual cycle, usually harmless, rarely cause pain, resolve within 3 cycles * Follicular cyst - when follicle fails to release egg at ovulation and continues to grow, forming a cyst* Corpus luteum cyst - when follicle releases eggs, corpus luteum continues to grow and accumulates fluid inside, forming a cyst Other cysts: - can become large and shift position of ovary, increasing chance of twisting, or ovarian torsion, which can be painful and cause decrease of blood flow to ovary * Dermoid cysts - also called teratomas, can contain tissue like hair, skin or teeth, because they form embryonic cells, rarely cancerous* Cystadenomas - develop on surface of ovary containing either water or mucus* Endometriomas - develop as a result of uterine endometrial tissue growing outside of uterus and attaching to ovary, related to endometriosis These kinds of ovarian cysts are different than polycystic ovarian syndrome. What is Polycystic Ovarian Syndrome (PCOS)? Endocrine condition that affects other systems as well:  * not only hormones and fertility, but also your skin, cardiovascular system, metabolism, immunity, mental-emotional health and more Risk factors for developing ovarian cysts: Genetics  Inflammation  Hormonal issues * Irregular menstrual cycles* Hormone imbalance* Insulin resistance and increased androgens like circulating testosterone in PCOS* insulin stimulates secretion of testosterone by ovaries, inhibits sex hormone binding globulin from liver, leading to increased circulating testosterone, leading to acne, excess facial and body hair and male pattern baldness in women* Estrogen dominance (for more info, see Episode 21 and Episode 22)* Use of medications like Clomid or Tamoxifen* Hypothyroidism - see Episode 42 for more info Early menstruation (11 yoa and younger) Cigarette smoking BMI above 30 Dysfunctional fat tissue, not inert * Fat cells become enlarged and have less circulation, causing some cells inside fat tissue to die, resulting in inflammation results  How do you know if you have PCOS? You can have at least 2 out of 3 of the following: * presence of micro polycystic ovaries or 12 or more small follicles on ultrasound * signs of high androgens - acne, hirsutism (dark hair on chin, around nipple, upper lip, sternum, lower abdomen), * irregular menses due to chronic ovulation disorder = fewer than 9 periods in a year or any stretch of 3 months without period How do you know if you are not ovulating?