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What Is Advisable Treatment For Cyst In Ovary And Is Ovary Removal Safe To Bring Down Estrogen Levels?

Posted on Thu, 2 Jan 2014

Question: My wife is scheduled for a hysterectomy this coming Tuesday, December 17th, After our preop appointment with her OBGYN my wife has decided to keep one ovary. The dr. said that my wife had one ovary with a small cyst and other was fine. The reason my wife wants to remove the one ovary is because her body over produces estrogen and feels if she gets one removed her estrogen levels might balance out so she won't have anymore breast tenderness, etc. I told her I think if the dr, can remove the cyst she should keep both ovaries for hormonal balance, etc. Her dr would not give us an answer either way of which would be best.. Please help.

Answered by Dr. Mahesh Koregol (4 hours later)

Brief Answer: Keep both ovaries Detailed Answer: Hi You are right. It is better to keep both ovaries. Idea behind keeping ovaries is to prevent menopause like symptoms due to estrogen deficiency. Only one ovary is enough for this function. But no harm in keeping both ovaries. But ovary has a cyst. Hence your doctor might have felt need to remove it. Anyway retain both ovaries. Its fine. Regards Dr. Mahesh Koregol

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mahesh Koregol (58 minutes later)

The Dr. said it was up to my wife. My wife as I explained wants to have one of her ovaries removed. She feels having one ovary will improve her over production of estrogen therefore relieving some systoms of breast tenderness, etc. I think if the Dr. can remove the cyst without affecting the function of the ovary she should keep both. Can you be more specific for reasons she should keep that ovary if the cyst can be removed? Are you a OBGYN? Please repond ASAP as we have to make a decision by tomorrow. Thanks again. Bob

Answered by Dr. Mahesh Koregol (40 minutes later)

Brief Answer: Yes Detailed Answer: Hi, I am an OBGYN. This is a common dilemma faced by many women while undergoing hysterectomy. 1) Basic reason why doctor advices to remove ovary is to prevent any future chances of cancer in the ovary. Hence ovaries are removed while hysterectomy to be on safer side. 2) Recent development in OBGYN field stated that estrogen deficiency caused by removing ovaries ( as ovaries produce estrogen) is bad for bones and heart, Breast tenderness etc. Hence recommendation was to keep ovaries in women who are not menopausal and keep estrogen supply intact. 3) But doctor has seen a cyst which most of times is normal but there is very insignificant and slight chances of cancer which can be tested by removing the cyst while performing hysterectomy and sent for testing. Test will clearly say if there are chances of cancer. This provided no history of breast or ovary cancer in her family. If there is history, it is better to remove both ovaries. 4) But majority of cysts in this age group are simple and not cancerous. Hence I suggest get the cyst removed and keep the ovaries intact. Some doctor like yours feel one ovary is enough to be left behind as it takes care of estrogen production needed for body. 5) It is better to have both ovaries left behind as there will be adequate amount of estrogen and will meet body requirements. 6) Hence my final advice is having both ovaries left behind rather than one. Its more beneficial. Ask the doctor to remove cyst and send it for testing leaving behind both ovaries. I hope your doubts are cleared now. Let me know if confusions still exist. Regards, Dr. Mahesh Koregol

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mahesh Koregol (11 minutes later)

Her body is over producing estrogen at this time. Will taking one ovary out help this or not. I feel it won't but I am not a dr. Please let me know. I also want to know what the chances are of her getting ovarian cancer? Her family has no history of ovarian cancer. I have read there is a 3 % chance or am I way off? Thank you.

Answered by Dr. Mahesh Koregol (13 minutes later)

Brief Answer: No Detailed Answer: Hi, Her body cannot produce excess estrogen at this age. It is wrong. Estrogen production will be definitely less associated with age. Hence no need to take out one ovary just assuming estrogen is in excess. If there is no history in family, the risk would be around 1 percent even less which anybody can get and not to worry about it.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mahesh Koregol (13 minutes later)

My wife feels by removing one ovary it will help with PMS symptoms -breast tenderness, bloating, weight gain, feeling tired/fatiqued, sex drive, and overall well being. I think but again I am not a dr that by removing the one ovary it will not make a difference therefore she should keep her ovaries if cyst can be removed and ovaries are disease free. Please comment. I appreciate you answering my questions. I know we cannot go back once an ovary is removed so i want us to make the right decision. Thank you again for your help with this matter.

Answered by Dr. Mahesh Koregol (15 minutes later)

Brief Answer: wrong Detailed Answer: She is wrong in thinking these are PMS symptoms. These are because she is nearing menopause and estrogen is decreasing. If you get ovaries removed these symptoms will increase rather decrease. Let her keep ovaries

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mahesh Koregol (19 minutes later)

My wifes blood work says it is above normal and has been for the past 3 years. We tried bioidentical hormone replacement and tried to get estrogen levels normal with arimadex, etc but did not work. It made things worse. I don't no if having high estrogen is whats causing her to have continues PMS symptoms. She is very frustrated and wants to feel better. I am trying to seek out information for her so she can make an educated decision. Again she has been suffering from severe endometriosis her whole life. The Dr says she may also have andonmyosis but won't know for sure until the she can send her uterus out for biopsy. I have just shared your information with my wife. Once I shared with my wife you were a man she stated that she figured you would say what you said in your comments since you have never suffered from severe PMS. She has a women OBGYN. I told her it didn't matter whether you were a woman or a man OBGYN it doesn't change the facts. Is there anyway you can help me get a OBGYN women's perpective on this as well? Please respond. Again I thank you for all your help with this matter.

Answered by Dr. Mahesh Koregol (9 minutes later)

Brief Answer: repost Detailed Answer: Hi In this age group of women especially if they have a cyst it secretes estrogen and shows high values on day 2 itself on blood tests. Best way yo supress estrogen and see if symptoms subside. Estrogen can be suppressed with medicines. You can ask for injections about same and see if estrogen suppression helps reduce her symptoms. I dont think there is difference between male or female OBGYN. I respect her wishes if she wants to consult a female OBGYN. Please close this thread of discussion and write a review. Then repost your query specifically requesting for a female OBGYN to answer your query. All the best

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar