Women who develop cysts in the ovary after they have gone through menopause are in a different category than pre-menopausal women. There are a couple of reasons for this. The first has do do with age related risk for ovarian cancer. The older a woman is, the higher the chance of getting ovarian cancer. For this reason alone, post-menopausal women that have cysts are more likely to have cancer than a pre-menopausal woman with an identical cyst. Even in older women, however, most ovarian cysts are benign and not cancerous. The other reason is that by definition the ovaries in a post-menopausal woman are no longer making eggs. Cyst production can be a normal part of ovaries during egg formation. Since post-menopausal women are not producing eggs, cyst formation is not a normal part of the ovarian function.
In a post-menopausal woman with a suspected ovarian cyst, an ultrasound of the pelvis is generally the best study. The ultrasound can be very accurate in identifying ovarian cysts. The ultrasound can also give very useful information regarding the size and quality of the cyst. CT scans are poor at looking at ovaries because the bones of the pelvis tend to get in the way of the images. Occasionally MRI can add information, but usually ultrasound remains the best imaging modality. If a cyst is present in a post-menapausal woman, tumor markers such as CEA and CA-125 are often checked. If positive, they can help guide treatment.
The treatment for an ovarian cyst in a post-menopausal woman is almost always surgery. If the cyst is thought to be most likely benign, removing the ovary through the laparoscope is often the treatment of choice. This surgery is done through a small incision in the belly button and two small incisions in the lower abdomen. Women usually go home the same day and recovery is about a week. If the cyst is suspicious for cancer a larger surgery may be needed.