Fibroids vs Cysts

Understanding your reproductive system is vital to maintaining its health, and to educate yourself on reproductive health conditions. Many women struggle to differentiate uterine fibroids and ovarian cysts, which may delay necessary treatment.

About uterine fibroids

Uterine fibroids are non-cancerous growths made of smooth muscle tissue found in or around the uterus (womb). Their shape and size vary; some fibroids are less than 1 cm in diameter, but others can be 15 cm or more. Other names for these growths are myomas, uterine myomas, and leiomyomas.

Symptoms of uterine fibroids

Many women do not experience symptoms immediately after developing fibroids, so they may not be aware they even have them. However, those who do have symptoms may experience:

• Heavy or painful bleeding during periods
• Bleeding between periods
• Abdominal (stomach) pain
• Feelings of fullness
• Lower back pain
• Pelvis pain
• Frequent need to urinate
• Pain or discomfort during sexual intercourse

In extreme cases, fibroids can cause pregnancy complications and infertility.

Risk factors of developing uterine fibroids

There are no clear causes for uterine fibroids, but evidence suggests that oestrogen plays a role. Fibroids tend to develop during a woman's reproductive years, when oestrogen levels peak, and then shrink after menopause. Other factors include being between the ages of 30 to 50 and being overweight.

Diagnosis of uterine fibroids

Since most women with fibroids do not experience symptoms, they are often diagnosed incidentally during routine visits to their gynaecologist.

If your doctor or general practitioner (GP) suspects you have fibroids, they will refer you for a pelvic or abdominal ultrasound scan. Depending on the location of the fibroids, your doctor may diagnose you with:

• Intramural fibroids grow within the muscular wall of your uterus.
• Subserosal fibroids grow on the outer wall of your uterus and can become very large.
• Submucosal fibroids grow underneath the inner lining of your uterus.
• Pedunculated fibroids that are subserosal or submucosal fibroids that are attached to your uterus with stem-like tissue.

Treatment options for uterine fibroids

If the uterine fibroids are not causing symptoms, treatment may usually not be required as they often naturally shrink after menopause.

However, if you are experiencing symptoms, your doctor may formulate a treatment plan based on your age, overall health, severity of the symptoms, size and location of the fibroids, and plans for pregnancy (if any).

Usually, doctors prescribe medications to manage symptoms. Other treatment options include:

1. Myomectomy, a surgery to remove fibroids without affecting fertility, but there is a chance that the fibroids may grow back, meaning further surgery is required.
2. Hysterectomy, a surgical procedure that removes the uterus entirely. It is only recommended for women with large fibroids, severe symptoms, and no desire to have children.
3. Magnetic Resonance Imaging (MRI) guided procedures that use guided ultrasound waves to remove fibroids.
4. Uterine artery embolisation (UAE), a procedure that injects a special solution through a tube in the leg. The solution will cut off blood flow to the fibroids, causing them to shrink. Women with plans to have children are also encouraged to consult their doctor before undergoing this procedure.

About ovarian cysts

Cysts are sacs of fluid that form within your body. Ovarian cysts refer specifically to cysts that form on one or both of your ovaries. Most ovarian cysts are non-cancerous, but a medical examination is required to rule out ovarian cancer.

Symptoms of ovarian cysts

Like fibroids, ovarian cysts are common and usually do not show symptoms. However, if they are abnormally large, rupture or block blood flow to the ovaries, you may experience:

• Abdominal (stomach) pain
• Irregular periods or lighter periods
• Feelings of fullness
• Frequent need to urinate
• Pain or discomfort during sexual intercourse

Another common symptom is pelvic pain. However, if the pain is sharp and sudden, it is recommended to seek medical attention immediately.

Risk factors of developing ovarian cysts

In some cases, ovarian cysts stem from an underlying condition, like endometriosis or polycystic ovary syndrome (PCOS). Others form due to abnormal cell growth and pose a risk of developing into ovarian cancer, especially for post-menopausal women (women who have already gone through menopause). These kinds of cysts are called pathological cysts.

The vast majority of cysts, however, occur naturally during menstruation. When an ovary’s follicle either fails to release an egg or discharge its fluid and shrink after the egg’s release, the follicle swells to become a functional cyst.

Diagnosis of ovarian cysts

Since most ovarian cysts do not cause symptoms, they are usually discovered during routine pelvic examinations. Once that happens, further tests are needed to confirm the diagnosis.

During the transvaginal ultrasound procedure, sound waves are used to images of the ovaries on a special monitor, allowing the doctor to detect the cyst more accurately. Although the ultrasound can reveal the cyst’s size, it cannot determine whether it is benign or malignant.

If a cyst is suspected to be cancerous, blood tests are performed to look for high levels of chemicals. However, having high levels of chemicals can also be caused by underlying conditions, so they do not necessarily mean your cyst is cancerous.

Treatment options for ovarian cysts

The first step of ovarian cyst treatment is the monitoring stage. This is when doctors refer you for a follow-up ultrasound scan after a few weeks or months to see whether the cyst has disappeared or grown. If you are post-menopausal, you may undergo ultrasound scans and blood tests every four months for an entire year.

For most ovarian cysts, medical treatment may not be required as they will usually disappear on their own. If a cyst causes symptoms, is abnormally large, or a doctor suspects it is malignant, you will need to undergo one of the following surgeries:

1. Laparoscopy: A tube-shaped microscope with a light, called a laparoscope, will be inserted into your abdomen before your surgeon removes the cyst with minor cuts in your skin. Most patients undergoing laparoscopy can be discharged on the same day or the next day.
2. Laparotomy: This procedure is adopted for larger or cancerous ovarian cysts. The surgeon will make a larger cut on your abdomen to completely remove the cyst while avoiding removal of the ovaries unless absolutely necessary.

FAQs on ovarian cysts and uterine fibroids

1. Can a fibroid be mistaken for a cyst?
   Yes, but only if you are trying to diagnose yourself. A medical professional can tell the difference immediately after a pelvic exam or an ultrasound scan.
2. Which is more dangerous, a cyst or a fibroid?
   Although most ovarian cysts are harmless, some can be cancerous and require surgical removal. On the other hand, the fibroids themselves are not cancerous, and while it is possible for cancerous cells to grow within fibroids, that occurrence is extremely rare.
3. Can a woman have ovarian cysts and fibroids together?
   Yes. Ovarian cysts and fibroids develop in different places within the female reproductive system, so it’s possible for a woman to develop both at the same time.
4. Do fibroids and cysts need to be removed?
   Usually, no. Most fibroids and cysts do not cause symptoms and are completely harmless. However, if you are experiencing symptoms, please seek help from a medical professional.
5. Can fibroids go away on their own?
   Usually, yes. If your fibroids are not causing symptoms, they will usually shrink over time, especially after menopause.
6. What happens if you leave fibroids untreated?
   Untreated fibroids (especially large ones) may affect your chances of conceiving a child or carrying it to term. In rare cases, they may also cause anaemia, or if the fibroid is pedunculated, it may twist and cause abdominal pain.

Make an appointment at Gleneagles Hospitals

Learning to differentiate between ovarian cysts vs uterine fibroids is essential to maintaining your reproductive health. While they appear similar to a layman, they grow in separate areas within the female reproductive system and have certain differentiating symptoms. A medical examination is the best way to accurately diagnose each.

Get in touch with us to book an appointment today if you want to know more about uterine fibroids and ovarian cysts, or find out more about our Obstetrics and Gynaecology Services at your nearest Gleneagles Hospital. The caring and multidisciplinary team of healthcare professionals are available for consultation and to provide the best care.