The “Ovarian Cyst” in the Postmenopausal Woman

All postmenopausal women who present with an adnexal mass, should have a transvaginal ultrasound and CA 125 level measurements.  Any elevation of CA 125 levels in this age group is highly suggestive of malignancy.  Most pelvic masses in postmenopausal women will require surgical intervention.  Exceptions to this are women who are found to have simple cysts, even up to 10 cm in diameter, on ultrasound.  These type of ovarian cysts are usually benign and may be followed with serial ultrasounds, without surgical exploration.

All postmenopausal women with a mass should have a breast and digital rectal exam as well as mammography because the ovary is a common site for metastases from breast, colorectal, uterine and gastric cancers. 

There is no definite way to prevent the growth of ovarian cysts. You should have a physical exam, including a pelvic exam and Pap test, every year or as often as your health care provider recommends. Doing this will help ensure that changes in your ovaries are diagnosed as early as possible.