Uterine fibroids and ovarian cysts are two common conditions affecting women. Largely asymptomatic and usually only detected during routine abdominal or pelvic ultrasounds, not many are aware of what these are, how they are similar or different, and how diagnosis and treatment are done.

Here are some questions and answers about these growths to help you be better informed when it comes to this aspect of women’s health.

How common are fibroids and cysts? Can they occur simultaneously?

Fibroids are non-cancerous growths that develop in the muscle of the uterus and are often found in women during their reproductive years.

Ovarian cysts, meanwhile, are sacs containing mostly fluid, or occasionally tissues or blood. They grow within the ovaries or on the surface.

Unlike fibroids that are benign, cysts can be benign or malignant (cancerous). Consultants will use an ultrasound and CA125 tumour-marker test to differentiate a benign cyst from a malignant one.

Ovarian malignancies peak in women between age 60 and 65. Still, most cysts remain benign, according to Dr Wong Yen Shi, consultant obstetrician and gynaecologist at a medical centre in Kuala Lumpur.

“Many cysts regress on their own within months, and harmless ones such as follicular or corpus luteal cysts grow and regress with a woman’s menstrual cycle,” she said.

Cysts and fibroids can occur concurrently. As the conditions vary from patient to patient, management and monitoring depends on the sizes and respective symptoms.

What causes them, and what are their symptoms?

While the exact causes of fibroids remain unknown, Wong notes that hormones, genetics and growth factors are thought to factor into these occurrences.

“Like fibroids, cysts occur naturally. Conditions such as pregnancy, pelvic infections, endometriosis, and a history of ovarian cysts can increase the likelihood of developing ovarian cysts,” she said.

Wong added that fibroids and cysts may also present with similar symptoms; for instance, irregular or painful periods, compressive symptoms such as frequent urination or constipation, abdominal distension or bloating, back pain, unexplained weight gain, or even painful intercourse.

“Fibroids are more likely to present with heavy menstrual bleeding compared with cysts. In cases of ovarian malignancies, feeling full quickly when eating, and loss of weight and appetite are the accompanying symptoms.”

Can fibroids and cysts affect fertility?

Most women with fibroids and cysts have no problems getting pregnant, according to consultant obstetrician, gynaecologist and fertility specialist Farah Leong Rahman.

That said, these conditions may cause the fallopian tubes to be blocked, or make the environment less conducive for embryo implantation.

“This is especially so with fibroids that are located in the lining of the womb, the treatment of which depends on the symptoms. Surgery is only indicated if it can improve the chances of pregnancy.”

Will a fibroid or cyst affect the development of the child, or the mother’s health?

The biggest risk of having fibroids during pregnancy is early delivery. “In some cases, it can cause severe pain where fibroids outgrow their blood supply,” Farah added.

“If the fibroid is large it could cause malposition of the baby, where the baby’s head does not turn downwards even at term.”

Cysts during pregnancy generally do not cause any harm unless they are big enough to cause torsion or rupture.

At the end of the day, women with fibroids or cysts are advised to seek advice from their doctor before embarking on their pregnancy journey.

How are fibroids and cysts treated?

Individualised treatment is key: smaller cysts usually do not require treatment and are monitored for growth, while larger cysts may require removal laparoscopically or via open surgery.

“Surgery remains the permanent solution for treatment of fibroids,” Wong said. “For women who no longer desire conception or are in the post-menopausal stage, a hysterectomy could be considered.”

And for those who do not require surgical intervention, it’s important for medical relief to be provided for symptoms such as heavy menstrual bleeding and painful periods, she added.

What can you do to prevent or manage them?

While fibroids and cysts are not passed down from one generation to the other, they can still run in families. Farah recommends regular gynaecology checkups as their growth may not cause any problems and could go unnoticed.