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Dr Jessie Phoon, a consultant from the Department of Reproductive Medicine at KK Women’s and Children’s Hospital joined I Love Children at Waterway Point on 16 July for its Know Your FERTILITY WELLNESS campaign roadshow. 

Here are Dr Phoon’s answers to questions on Cysts and Fibroids.

1) What is the difference between cysts and fibroids?

Generally, fibroids are solid tumours which are not cancerous. They are often found in the womb. Cysts, on the other hand, are sac-like structures that contain liquid. They occur more often in the ovaries; some are benign while others might be cancerous.

 

2) How can a woman determine if she has cysts or fibroids?

Cysts cause women to experience pain or discomfort in the stomach. They may also make your stomach grow bigger. On the other hand, fibroids can result in heavy, prolonged menstrual cycles. 

 

3) Do cysts and fibroids lead to infertility?

Generally, 60% to 70% of cysts and fibroids do not cause infertility. What matters are the size, location and type of cyst or fibroid. If the fibroid is growing within the womb lining, then yes, it might affect chances of pregnancy. However, if it is outside the womb lining, then it should not.

 

4) What are the chances of me getting fibroids or cysts?

Fibroids are very common and can start growing at any age. Women need to monitor any fibroid that might be growing so that it does not get so large that it affects their lifestyle and decreases chances of fertility. 

Likewise, the chances of women getting cysts are equally high. Again, monitor if the cysts are affecting lifestyle and fertility chances. 

 

5) How would I know if my cysts are dangerous without a test?

There is no way to tell if a cyst is dangerous or not from the symptoms. Please seek advice from an obstetrician and gynaecologist as soon as possible.

 

6) What if my cysts or fibroids are discovered during a pregnancy and grows bigger? Must I remove them? Will either one affect the baby’s development?

There are a number of women who develop cysts or fibroids during a pregnancy. Since fibroids are non-cancerous, doctors will just monitor the situation during a pregnancy. 

This is because fibroids grow in the womb and there should be minimal disruption to the womb that supports a pregnancy. Fibroids are usually managed after a pregnancy.

It is very common for water cysts to develop during a pregnancy. Again, such cysts just contain water, so there is no cause for concern. 

However, if the cyst does grow too big, there is a risk of it rupturing and irritating the stomach. In this case, doctors will advise surgery about 14-16 weeks into a pregnancy. 

 

7) I completed my menstruation cycle within a day. What happened?

Generally, the flow or length of a menstruation cycle does not matter. It is the regularity of the menstruation cycle that is of more importance. Hence, there is no need for concern if menstruation occurs every month.

 

8) I have a history of endometriosis and had two surgeries in my ovaries. How can I avoid a reoccurrence? 

There is no way to avoid endometriosis until menopause. It is also good to note that you should have surgeries for endometriosis or endometriotic cysts only once in your life. Whenever possible, plan for a pregnancy before a surgery is scheduled.  

 

9) Can we remove cysts using medication?

This is generally not possible. However, some types of cysts do resolve with contraception pills. Please consult an obstetrician and gynaecologist for further advice.

 

10) Is it recommended for women who have a history of endometrial cysts to have yearly check-ups?

It is recommended for women with endometrial cysts to have regular check-ups. Determine with a doctor how often these check-ups should be.

 

11) I experience very heavy and painful menstrual flows. Do I have cysts or fibroids?

Fibroids cause heavy but painless menstrual flows. Cysts, depending on their nature and size, can cause pain but not heavy menstrual flows. 

Heavy and painful menstrual flows that happen suddenly could be a sign of endometriosis. To obtain a diagnosis, consult a doctor immediately.

 

12)  Can pap smears help detect cysts and fibroids?

Doctors perform pap smears to extract cells from the cervix – the outermost organ of the vagina to check for cervical cancer. 

To detect cysts and fibroids during a pap smear, the doctor must perform a further internal examination to feel your womb and ovaries. Even then, the doctor will only be able to feel cysts and fibroids that are large. A scan is required for cysts and fibroids which are smaller in size.

 

13) What happens if I leave a fibroid untreated?

This depends on the rate of growth and location of the fibroid. 

If it is in the womb cavity, it can cause heavy and prolonged menstruation. If it grows too big quickly, then it will cause pain and problems with bowel movement. Please consult an obstetrician and gynaecologist for a further assessment. 

 

I Love Children would like to thank Dr Jessie Phoon, a consultant from the Department of Reproductive Medicine at KK Women’s and Children’s Hospital, for supporting the ILC Know Your FERTILITY WELLNESS campaign.

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