Here's an interesting question. I've been plagued by painful cysts for seven years. My hair started falling out in May and has continued at an alarming rate. I stopped taking the birth control pills yesterday. I need a natural remedy to cure my cysts, please advise. Well one, we know there's no natural remedy, so that's not going to happen. Painful cysts for seven years, this could have - they could have been functional cysts, they could have been polycystic ovaries which usually aren't functional - aren't painful.

But the interesting thing is her hair falling out in May but she was on birth control pills. In some cases birth control pills can disrupt the hair growing cycles. There's various - hair goes through various growing cycles, and I've seen that. I would say that this is totally unrelated to any cysts, and we've pretty much discussed the lack of a natural cure for a cyst.

Her obstetrician Christopher Freville says you can't tell what type of tumor it is until you make an incision and get there. My ovaries started out 7.6 centimeters and doubled in size since mid-May. Clearly a rapid growth is a sign of some sort of a tumor. If she's reproductive years it's probably benign, but one way or the other that needs abdominal exploration. And let's see, I had one other one. I've answered that one too.

Maybe some women who are reading this have a friend who has a cyst that they care you know, their friend has a cyst, but they themselves as far as they're aware do not have any cysts within their ovaries. And as far as they're aware, they have no symptoms and they're healthy. Is there any - but having listened to all the complications that could possibly happen, is there anything that they can do to prevent a cyst on the ovary occurring in the future?

That's a good question, and it's mixed. The cyst that occurs in the ovary, again we have to go back to the cause of it. If it's a functional cyst, these are the ones that can be prevented. Functional cysts again, are caused by the natural hormones, the estrogens, progesterone, the pituitary gland all interacting.

These cysts - and some women admittedly have a problem where their functional cysts for some reason don't disappear, and they do grow. These women would be a candidate for being on birth control pills. But short of that, as we talked about, if she doesn't want to do that, no there is nothing you can do to prevent cysts. Once they're discovered you can do something about it, but prevention is not part of the equation, except in polycystic ovary.

Once you've been diagnosed, again these are - I emphasize these are not giant cysts, they usually don't rupture. They can be treated with weight control, and sometimes breaks up this vicious cycle of all the symptoms associated with it. Or they can be put on other drugs to start the ovulation process.

I think just in summary I would like to emphasize that all women, whenever they have - first of all don't let cysts strike fear into your heart. You always have cysts, you probably have various types of cysts. Always have a complete pelvic exam. Keep in mind the major age groups, most of you are probably in the reproductive age group, and you have - any cyst is most likely not - not cancerous. Most of these cysts are treatable, they cannot be prevented. And again, I think the main thing is most of the time expect it, management waiting.

There's nothing wrong with waiting a couple of months to see if they resolve. And if not, then go through the time and expense of some of the tests, and go from there. A review of the type of cysts. Again, we've got the functional ones, I think that's mostly what we're talking about. You've got the endometriomas, cystadenomas, the dermoid cysts which are the cysts with the teeth, polycystic ovaries, and the rare type of cancerous cysts, which I'm happy to say will not affect most of the listeners.

I think the number one advice after being as educated as possible, which hopefully your presentation will help that process, the number one thing is to further that education by speaking with their physician, getting the answers to their questions, and being comfortable with those answers. Because I believe - I've always believed that the educated patient is the best patient to deal with.

And it's to the doctor's benefit to take the time to educate that patient so that she knows what to expect, and therefore is a much better patient. Bottom line is listen to your doctor, and if you don't get the answers you like, get a second opinion. But if you keep hearing the same things over and over, maybe it's true and you should listen to the doctor.