The Posh Syndrome

It's hard to imagine Posh Spice got a cyst scare as she strikes a cucumber cool pose here. The condition is on the rise as more and more women hit the fast lane and take to stress as a way of life. The problem hasn't spared even Nicole Kidman or closer home Sapna Bhavnani, author and celebrity hairdresser. If you're a woman, irrespective of whether or not you're in your child-bearing years, you could be at risk of an ovarian cyst. Dr Kiran Coelho, Head of the Department of Obstetrics and Gynaecology at Lilavati Hospital and Research Center, runs you through different types of cysts and the symptoms to watch out for.

What are cysts?
Ovarian cysts are essentially closed fluid-filled sacs that develop on one or both ovaries. A sac or follicle forms on the surface of a woman's ovary during ovulation. This sac holds a maturing egg and dissolves away when the egg is released during the monthly menstrual cycle. Sometimes, however, the egg is not released and the sac gets enlarged and a cyst develops.

But, if you've just been diagnosed with an ovarian cyst, don't press the panic button and assume that all cysts are malignant and life-threatening. In most cases, ovarian cysts are completely benign.

Symptoms
One may be a cyst carrier and manifest no symptoms whatsoever. However, in most cases, the woman will suffer from irregular periods. In some cases, women may experience discomfort in the abdominal area with a bloated feeling and may even land up putting on weight around this area, which most women assume is simply a paunch and as a result go on a strict diet.

Cysts may often be accompanied by problems such as frequent stomach upsets. In rare cases, a cyst goes undetected till torsion occurs (where the cyst ends up twisting) or where a cyst bursts; there is usually sharp and often unbearable pain, which may be accompanied by vomiting – medical emergencies which warrant surgery.

How are they detected?
If you're experiencing any of the above symptoms and would like to rule out the possibility of a cyst, it is important to get an ultrasound done. A mineral oil gel is smeared on the abdomen and the probe of the ultrasound machine is moved over the skin of the abdomen area. With the help of high frequency sound waves, the doctor can get a view of your insides.

Types of cysts
While cysts form solely due to hormonal imbalance, there are can be several types of cyst formations. A few common cysts are described as follows:

Follicular cyst A follicular cyst forms when the follicle (sac) grows larger than normal and does not rupture to release the egg. The result is often a delayed period which is what prompts women to seek medical aid. The good news is, a follicular cyst usually dissolves away without any treatment. However, in some cases the doctor may prescribe oral medication and keep the patient under simple observation over a few days or months.

Polycystic Ovarian Syndrome (PCOS) This syndrome plagues Victoria Beckham aka Posh Spice as well as one out of every five women worldwide. In PCOS, a hormonal imbalance results in the egg ripening partially, yet it doesn't rupture. And this process is repeated over several months. As a result, multiple (poly) unruptured follicles are formed within the ovary.

The disease is characterised by symptoms that every woman dreads – acne, hirsutism (excess hair growth), tendency towards weight gain, etc. However, not all women with PCOS exhibit these symptoms. No surgery is required for PCOS. The woman is merely expected to get regular ultrasound and in some cases is also advised to go on birth control pills, which help regulate the hormones.. Contrary to what many women continue to believe, oral birth control pills will not make conception difficult when you decide to go off the pill. Nor will it lead to any hormonal imbalances.

Endometriosis This condition has earned a strange nick name – Chocolate cyst! This type of cyst is created when the lining of the uterus is also present in the ovaries and therefore during menstruation, bleeding occurs on the outside and is also accompanied with internal bleeding. Over time, this internal bleeding turns brown and chocolate coloured.

If the cyst is detected after it has fully formed, the only treatment option available is a surgery known as Laparoscopy. A key-hole surgery, here the cyst is drained away by making only two to three tiny incisions that leave barely-there scars low in the abdomen. For few women, the pain caused by the cyst during menstruation is excruciating. In most cases, however, the pain is managed with medication (and many other lucky women may experience no pain at all).

Dermoid Cysts This type of cyst is semi-solid. It contains bodily fluid, as well as the various layers of the body such as skin, teeth and hair. Most often benign, the only treatment option for a dermoid cyst is a laparoscopic surgery.
 
While cysts are less likely to form in women who have reached menopause, the chances of malignancy are higher in this group. Hence, women in this age group are advised to undergo certain cancer marker tests (CA 125).  

How often should one visit a gynaecologist?
Sexually active women need to visit a gynaecologist and get a routine check-up, which includes an ultrasound, clinical exam and pap-smear, at least once every year. Sexually inactive women are usually advised only an annual ultrasound.