One woman described how she'd had two miscarriages already. The first one was at 21 weeks, the second was at eight weeks. And she found out during her second pregnancy that she had a dermoid cyst on her right ovary. And she writes in that we consulted a doctor that said it wasn't the cause of my miscarriage, and can I still try getting pregnant? It was almost a year passed since I had my second miscarriage, and I'm trying to get pregnant, but what I just observed with myself now is I can't get pregnant as easily now like before, any advice?
First of all, the first advice is she had two miscarriages, miscarriages are extremely common. Twenty percent of all pregnancies miscarry before 12 weeks, it's nature's way of ridding vaginetic products. The miscarriage at 21 weeks was rather unusual. I'm assuming that this was something that was looked into, and probably was not a cause of anything that would repeat itself. The dermoid cyst on her right ovary, well if she knows she had a dermoid cyst on the right ovary, that must have been removed.
We were probably given part of the information because no doctor's going to leave a dermoid cyst. As far as her so-called - her concerns about infertility since that dermoid cyst, pregnancy is not as easy as one thinks. Pregnancy - the average couple who have intercourse the average number of times, which is 2.5 times per week will conceive 90 percent of the time in one year, in two years 95 percent. But you still have ten percent that are not going to conceive in one year. So one year of lack of conception is not an infertility concern in my mind. So my advice is just continue trying, don't worry about the cyst, and hopefully pregnancy number three will be absolutely normal.
Let's see, there was something else here. Oh, there is an increasing number of women - since we mentioned some drugs, we should mention Tamoxifen. Tamoxifen is an anti-breast cancer drug, the most commonly used. Women are often on it five years, very effective. The good news is Tamoxifen works, being an anti-estrogen effect on the breast, it stops the estrogen receptors.
Because breast tumors many times have - they like estrogen. So this particular anti-cancer drug works by blocking estrogen. But it has some good news too, it has a positive estrogen effect on bone and on the heart. And we know that estrogen can be good for bone growth, that's why many women are given estrogens after menopause. And it can be good on bone growth and prevent heart disease. The one problem with women on this particular drug though is that it causes in some cases a slight increase in uterus cancers, because it has the positive estrogen effect on the uterus.
And it can in some cases increase any cysts that are there. But to my knowledge there is no evidence that it can cause ovary cancers. So we have some effects from this powerful anti-breast cancer drug that are positive, no ovary bad effects except it can cause an increased size in the cysts. And these would be managed like any other cysts.
I think one thing here is - one woman writes in and she says is surgery a must for a cyst measuring 20 centimeters? 20 centimeters is huge. Greater than 10 centimeters is huge. The answer is unequivocally 20-centimeter cyst is in risk of torsion, it should be operated upon, no questions asked. And we don't know the age of this woman, but the odds are most likely in her favor because it's a cyst. And the other one here is -
I have one question I think is very good. Is a hysterectomy the best option for an ovary cyst on a 68-year-old woman, any other options? I'm going to answer that because I'm from the school of thought that says if you're going in for a hysterectomy in the menopausal years, I believe those ovaries should come out. Now this is Doctor Christopher Freville's philosophy, many colleagues agree with me, some do not. But the ovary has very little function after menopause. At menopause it doesn't have any except it can serve as a place for bad tumors and bad cysts to grow.
So if for some reason one has to have a hysterectomy at the menopausal time in life, my strong recommendation would be discussed with your doctor should the ovaries come out. Because unfortunately, ovary cancers, which are not really the topic of this discussion, often don't show up and have symptoms until they're somewhat progressed. That's something I wanted to throw in there.