In a normal menstrual cycle, an egg cell develops in one follicle of either ovary. It matures and is released to be fertilized, leaving a cyst in its wake, later to be resolved naturally.
But in some women, a cyst may become troublesome, producing pain, menstrual irregularities and sometimes, infertility.
Ovarian cysts are actually quite common, particularly among women of childbearing years. What are ovarian cysts? And what can you do if you’ve been diagnosed with them?
The Role of Cysts in the Menstrual Cycle
Each month, some time after the start of the menstrual cycle (cycle day 1), a single follicle begins to develop the egg cell it contains. (Occasionally, more than one egg is released, with the potential of twins or multiples birth if fertilization occurs.)
This egg matures until it’s ready to be released from the follicle. This release (also called a “rupture” or “eruption”) is ovulation, usually occurring between cycle days 10 and 14.
At this time, a cyst called the corpus luteum (white body) develops at the site where the egg was released. The corpus luteum begins to produce progesterone, which is necessary in order to sustain the beginning of a pregnancy should the egg be fertilized. It also produces the hormones estradiol and inhibin A.
This cyst is temporary. If a pregnancy occurs, the corpus luteum will continue to produce these hormones until the activity of the placenta is sufficient to sustain the pregnancy, at about nine weeks. The corpus luteum will then gradually stop producing hormones and will be reabsorbed into the body.
If a pregnancy doesn’t occur, the corpus luteum stops working one to two days before the start of the next menstrual period. It is then reabsorbed into the body.
When Things Go Wrong
Occasionally, however, this cycle doesn’t proceed the way it should. A number of issues can occur to stimulate abnormal ovarian cysts, including the following:
- The corpus luteum continues to collect fluid and doesn’t get reabsorbed by the body. It may stay the same size or it might grow much larger over time.
- A single follicle attempts to mature its egg, but rupture (the release of the egg) doesn’t occur, leaving a hard or fluid-filled cyst at the site.
- Multiple follicles are active during a single menstrual cycle but do not erupt (release eggs), producing the “string of pearls” appearance common in Polycystic Ovarian Syndrome (PCOS).
- A cyst develops somewhere on the ovary of its own accord.
Is it Cancer?
Only a small percentage of ovarian cysts are cancerous. However, because of the possibility that the cyst contains abnormal cells, you should always see your doctor if you suspect ovarian cysts.
Is it PCOS?
Not every ovarian cyst, even when accompanied by other similar cysts, is Polycystic Ovarian Syndrome. PCOS comes with its own set of symptoms (including overgrowth of facial hair, weight gain and dark areas on the skin) and is most likely to be caused by a hormone imbalance and/or lack of ovulation during multiple cycles over a period of months or years.
Most single or even multiple ovarian cysts are not PCOS, but some are. If you suspect PCOS, see your doctor.
Causes of Ovarian Cysts
Ovarian cysts may occur for a number of reasons, including the following:
- Not ovulating during a given menstrual cycle (no release of the egg). When the egg does not mature and/or does not erupt from the follicle, progesterone is not produced from the site. This causes a hormonal imbalance during the second half, or luteal phase, of the menstrual cycle, which can exacerbate the problem.
- Hypothyroidism. An underactive thyroid does not produce its own hormones, which are closely linked with reproductive hormones, in a sufficient amount. This can result in a hormonal imbalance that encourages the growth of ovarian cysts.
- Early onset of menstruation (before age 11) has been linked to ovarian cysts later in life.
- Irregular menstrual cycles may contribute to the development of ovarian cysts. For example, the body may attempt to mature and release an egg unsuccessfully several times during a single cycle, leaving unruptured cysts behind.
- Increased upper body fat or too much fat in the body overall has been linked to ovarian cysts. This may be because estrogen is both stored in fat and ultimately produced by fat, creating a hormonal imbalance.
- Certain drugs can contribute to the development of ovarian cysts, including Clomid (Clomiphene) or Tamoxifen.
Symptoms of Ovarian Cysts
Some ovarian cysts produce no symptoms at all. Other times, a woman may experience one or more of the following symptoms:
- lower abdominal pain/feeling of “fullness” or pressure on the lower abdomen
- irregular menstrual cycles
- pain during intercourse
- a dull ache in the legs and back of the thighs
- “breakthrough” bleeding: spotting or bleeding when not menstruating
- weight gain
- breast tenderness
Medical Protocol for Ovarian Cysts
There are two typically recommended procedures for treating ovarian cysts: birth control pills, or surgical removal of the cyst.
Birth control pills prevent the process of ovulation by flooding the body with large doses of synthetic hormones. Sometimes, this “rest” from ovulation over a period of months can reset the body’s hormonal system.
Surgery is generally only indicated if the cyst is very large or if it is suspected of containing abnormal cells, if it is producing severe symptoms or if cancer has been diagnosed. In rare cases, a complete removal of the ovary may be indicated.
If Polycystic Ovarian Syndrome has been diagnosed, a hormonal protocol will most likely be administered, as well as recommendations for a change in lifestyle (including diet, exercise and the avoidance of certain foods, particularly estrogenic – or estrogen-mimicking – foods).
Natural Remedies for Ovarian Cysts
If cancer or other abnormal growth has been ruled out, you may want to investigate natural ovarian cyst treatment on your own. If you’re working with a doctor or reproductive endocrinologist, let him or her know the protocol you’re attempting before you start.
Natural progesterone has been highly touted as a remedy for ovarian cysts and for balancing the cycle in general. In the case that the body is not producing enough progesterone, or when ovulation isn’t occurring regularly, the body will remain estrogen dominant for too much of the cycle.
Normally, estrogen is dominant pre-ovulation; progesterone is dominant post-ovulation.
Purchase a cream over-the-counter or online that contains Progesterone USP and follow the instructions exactly. (Ask your doctor.)
DO NOT purchase a soy-based progesterone cream, as soy is a phytoestrogen and may only make the initial problem worse.
Remove Phytoestrogens From Your Diet
Remove phytoestrogens and environmental estrogens from your life as much as possible. Don’t eat soy or soy products and eat only organic, hormone-free meat and dairy, and/or limit your intake of meat and dairy as much as possible.
Limit your use of plastics, as these often contain estrogen-mimicking chemicals. That means, no more drinking “bottled water” from plastic containers (which, in my opinion, is one of the worst environmental catastrophes of our time anyway. But I digress …)
- Try diindolylmethane (DIM). DIM is said to aid in the breakdown of estrogen, allowing progesterone to dominate when it should. DIM is available over-the-counter and is also found in cruciferous vegetables, such as broccoli and cauliflower.
- Try fertility enzyme therapy to help eliminate excess/unneeded hormones from the body.
- Consider herbs that are said to aid in reducing ovarian cysts. These include wild yam root, yarrow, Vitex (chaste berry) and maca root.
- Change your lifestyle. Losing weight, exercising more and eating healthfully, with plenty of non-estrogenic vegetables, can help tremendously.
(All these remedies are found in a step-by-step guide on ending your ovarian cysts.)
Remember: ovarian cysts are a real medical condition. Always consult your doctor before beginning a new protocol that may influence your hormones. Meanwhile, know that help is available – you don’t have to suffer with ovarian cysts forever.