Most people know someone who've had a dermoid cyst. These are very odd type of cysts. They come from tissue that's developed from early stages of development, when the woman was with a fetus, so these cells have the potential - something like stem cells that you read about; they have the potential to become other types of cells. In dermoid cysts, these cells can develop into all types of tissue. I've seen them, most commonly they form hair. I've seen one that had a row of teeth, if you can believe that. They can have bone - basically anything that looks like - that appear in the human body, they can form. And more importantly is they also accumulate fluid most of the time. So they tend to by cystic and solid, and they're called dermoid cysts. These are almost always benign. Ninety-nine percent of them in all age groups are benign. There's a small percentage that are cancerous, but again, that's rare.



So, we've got endometriomas, dermoid cysts, and I think the next type that's probably gonna be most familiar to women are polycystic ovaries. In fact, a lot of women will say, well the doctor told me I've got cystic ovaries or polycystic ovaries. This is kind of a bad term, but it's stuck around since probably in the 1930's. There was a syndrome by Stein that's called Stein, S-t-e-i-n, Leventhal, L-e-v-e-n-t-h-a-l, Syndrome that was described in the '30s. And it was - it's an array of symptoms that actually accompany these polycystic ovaries. And sometimes the odd thing is the cystic ovaries aren't there. But originally it was reported, and they have certain things such as the women typically do not have - they're not fertile. Many times they don't have regular periods, called anovulatory cycles, no periods. Or they could have very irregular periods.

Typically - probably one of the most typical symptoms is hirsutism, where the women develop a male pattern of hair distribution, and can be over a - usually it's a fairly longer period of time, where you get central hair distribution, facial hair. And certainly every woman that hears this, and she sees that she's got a hair on her skin and chin shouldn't think that she's got Stein-Leventhal syndrome. But the hirsutism is probably one of the number one symptoms that cause a lot of women to go to a doctor or a gynecologist.

She's probably been using various creams. She might even have tried electrolysis, and the hairiness, if you will, gets substantially worse, and she ultimately goes in. So we've got the hirsutism, we've got the irregular cycles associated with infertility. The other major point about this polycystic ovary which Manhatten OB/GYN Christopher Freville refers to along with infertility, is obesity. Many, a large percentage of women are obese, body mass index is, I think it's greater than 30, meaning basically they're overweight, and oftentimes substantially so.

And then you've also got some other symptoms that are not as readily available, but one of the associate symptoms or complexes associated with this that's been more recently looked at is diabetes. That women with this so-called polycystic ovary disease have a difficulty with their insulin not reacting properly, or high insulin levels. And these are treatable, but until they understand the insulin problem by having it diagnosed, they probably don't know they have it.

So you've got this polycystic ovary disease, if you will, which isn't contagious. It again has the - the thing that we're including it in this discussion is because the cysts are there, oftentimes they can't really be felt on exam. They are very small, maybe one or two centimeters.