What’s the Difference between an Ovarian Cyst vs a Follicular Cyst

What’s the Difference between an Ovarian Cyst vs a Follicular Cyst

Many women may have follicular cysts but don’t have PCOS. Do you know how to differentiate between the two? In this artilce, I’d like to discuss how you can.

One of the main difference is in their size:

  • a follicle is 10mm or 2cm or smaller
  • a dominant follicle is 20-30mm or smaller
  • an ovarian cyst is larger than 30mm (3cm) in size

We don’t usually consider surgery unless a cyst is larger than 50-60mm (5-6cm) although that may depend on what the cyst looks like & what symptoms it causes. Ovarian cysts are so common that nearly every woman will have 1 at some stage in her life. Many women will have no problems related to a cyst.

There are 3 main groups of ovarian cysts:

  1. Functional (physiological) cysts. They form when the monthly ovarian cycle doesn’t follow its usual pattern. These form when the dominant follicle & corpus luteum do not behave as they normally would during a particular menstrual cycle. They are called either follicular or corpus luteum cysts.
  2. Follicular cysts form when the follicle does not release an egg but instead continues to swell up with fluid. In the same way, a corpus luteum cyst forms when the corpus luteum does not shrink away but continues to grow in size. Functional cysts are common & usually go away by themselves, but this can take 2 – 3 months. After the cyst goes away, the ovary usually goes back to working normally. From time to time, another functional cyst may occur. Not surprisingly, your period may not come at the right time in a cycle affected by a functional ovarian cyst. Often the period comes later than expected but it can come earlier. However, once the cyst has resolved, the menstrual cycles return to normal. Just remember, they’re common & mostly resolve by themselves without treatment.
  3. Benign (non-cancerous) ovarian cysts are also common.
    1. Dermoid cysts (aka teratomas) are benign ovarian tumors which contain many different body tissues – fat, hair, skin & even teeth. They occur mostly in young women & are even found in children. In women with a dermoid cyst, 10% will have 1 in both ovaries. Dermoid cysts are ‘growths’, but many grow so slowly (1 – 2 mm per year) that surgery is often not recommended unless they reach about 5cm.
    2. Cystadenomas are benign tumors containing clear, water-like fluid or mucus. On ultrasound, they often look just like functional cysts – the difference is that functional cysts usually go away over a few months while cystadenomas keep getting bigger over time. Once a cystadenoma is about 5 – 6 cm in size & has been there for several months (so it’s not likely to be a functional cyst), you & your gynecologist may decide to have it removed, as it may twist the ovary or burst in the future (but not common).

What about Polycystic Ovaries?

PCO means ‘many cysts on the ovary’ but the ‘cysts’ that are seen in this condition are not true cysts – instead PCO actually means having lots of small follicles (2 – 9mm). This is often normal for young women and is not usually Polycystic Ovary Syndrome (PCOS), particularly if they have regular periods and no abnormal facial or body hair or have insulin resistance. However, if a woman only has a period every few months and/or she also has a problem with facial/body hair, acne, and blood sugar imbalances, she may have PCOS. In PCOS, the hormones don’t follow the normal menstrual cycle & has many small ovarian follicles. These are not true ovarian cysts and generally don’t require surgery.

What should I do if think I have an ovarian cyst?

If your symptoms are mild then you should see your GP, who will ask you about your symptoms and examine you. It may be possible for your doctor to feel a cyst by checking your abdomen or by vaginal examination. Your GP will most likely request:

  1. A pap smear if it’s due.
  2. A pregnancy test if there is a possibility you may be pregnant. A pregnancy in the wrong place (the tube, rather than the uterus) can give symptoms just like an ovarian cyst. This type of pregnancy is called an ectopic pregnancy. [see our Fact Sheet on Ectopic Pregnancy]
  3. A pelvic ultrasound– either through the tummy wall or else through the vagina (called a transvaginal US). A scan through the vagina is close to the ovaries and gives much clearer pictures than a scan through the tummy. A vaginal scan is not uncomfortable, especially since it doesn’t need a full bladder. Ultrasound is excellent at seeing a cyst on the ovary and working out what kind of cyst it is.
  4. Rarely, ovarian cysts can cause particular blood tests to become abnormal. Your doctor will decide if you need these tests.

Management of an Ovarian Cyst

If you have an ovarian cyst, managing it will depend on what type of cyst it is, how big it is, and what problems you are experiencing.  Functional cysts can be watched for a few months as they will usually go away on their own. You & your gynecologist may decide to have the cyst removed if it doesn’t go away on its own after 3 months, if it’s causing significant pain/pressure symptoms, if it’s quite big (more than 6cm) or if it’s a type of cyst that doesn’t go away by itself (like a dermoid).

What about taking the oral contraceptive pill?

Taking the pill won’t treat a cyst if it’s already there & it may go away by itself. It’s more like a band-aid to a long-term issue and the pill will block androgen production too. This isn’t a good thing because women need healthy testosterone production for bone health, libido, stamina and mood enhancement. Long-term affects to imbalanced hormone production in the future is also a risk, as well as blood clot formation. In the end remember that the pill only masks the root cause of the hormonal imbalances that are occurring in PCOS. Addressing your adrenal health, blood sugar imbalances and making sure your liver detox pathways are working optimally, is a good place to start. Your body is so intelligent. When one area is out of balance, another area is also. So begin by searching for the reason the cyst formation happened in the first place, will help your body be free to work and maintain its health naturally.  I’m here to help you discover where it all started.

What you need to know about insulin

What you need to know about insulin

Hello Everyone and welcome to my Podcast, Regenerate You!

Insulin is one of the most misunderstood hormones in your body. There are some diet plans that say to keep it as low as possible and others that say you need more of it. If you’re trying to lose weight, balance your cholesterol, or even achieve healthy thyroid levels; optimum insulin levels are necessary. But what constitutes normal insulin and what is this powerful hormone doing in your body? This is what I’ll be discussing on this episode.

If you’re looking for additional advice, feel free to visit my blog here. You can also stay connected with me on my Facebook page @DrNirvanaHeals or on my Instagram @DrNirvana.

Please remember to subscribe and to please leave me a review as well!


And remember, when you regenerate, there’s a new you every day!

The Link Between Food Intolerance, Hormones and Your Gut Health

The Link Between Food Intolerance, Hormones and Your Gut Health

Welcome to Regenerate You!

If you find yourself struggling with food intolerances of any kind, then it’s most likely causing an imbalance in your hormones as well. And if you’ve been diagnosed with low testosterone, PCOSestrogen dominancethyroid issues, or insulin resistance; then your food sensitivities are making them worse.

In this Podcast, I discuss how they’re linked and where to begin to help heal and regenerate your body from the attack on your immune system.

If you’re looking for additional advice, feel free to visit my blog here. You can also stay connected with me on my Facebook page @DrNirvanaHeals or on my Instagram @DrNirvana.

Please subscribe and share this podcast to spread the health.


And remember, when you regenerate, there’s a new you every day!

Low Glycemic Foods

Low Glycemic Foods

Choosing a low-glycemic diet is a wise decision for good health. Packed with fiber and protein, low-glycemic foods cause a slow, steady digestion, which won’t leave you hungry.

Use Dr. Nirvana’s low-glycemic vegetable list to start your journey to a healthier you: Incorporate as many (a minimum of 3 per day) into your daily diet.

  • Artichokes
  • Artichoke hearts
  • Asparagus
  • Bamboo shoots
  • Bean sprouts
  • Broccoli
  • Brussels sprouts
  • Cauliflower
  • Celery
  • Cucumber
  • Daikon
  • Eggplant
  • Leeks
  • Lentils
  • Beans (green, kidney, garbanzo)
  • Greens (collard, kale, mustard, turnip)
  • Mushrooms
  • Okra
  • Onions
  • Pea pods
  • Peppers
  • Radishes
  • Rutabaga
  • Squash
  • Sugar snap peas
  • Swiss chard
  • Tomato
  • Water chestnuts
  • Watercress
  • Zucchini
  • Cabbage (green, bok choy, Chinese)
  • Salad greens (chicory, endive, escarole, iceberg lettuce, romaine, spinach, arugula, radicchio, watercress)

Dr. Nirvana Lectures on Balancing Hormones to Release Weight

Dr. Nirvana Lectures on Balancing Hormones to Release Weight

When working with patients in my Practice, I hear a lot of similar comments. In particular:

  • I’m eating all the right foods, but I still can’t lose the weight.
  • There’s nothing I can do to lose weight, it’s genetic.
  • I’m just getting old and my metabolism has decreased.
  • These last 10 pounds just won’t go away—I want to give up.
  • There are certain foods I can’t stop eating even though I suspect they’re bad for me.
  • I crave sugar like crazy.
  • Diets that work for others don’t seem to work for me.
  • I lose five pounds, and then I regain seven.
  • I’m tired of and frustrated with weight loss.

Do those statements also resonate with you? If so, you might not know an important secret: the reason you struggle with your weight is that your hormones are out of balance.

As a licensed Naturopathic Doctor, I am uniquely qualified to understand the private suffering that women experience with weight gain and body shame. Although hormones are complex, when out of balance, they make losing weight close to impossible particularly for women. During my lecture, I’ll share which hormones are to blame, how they affect your weight, and at least one simple action you can take to bring each hormone back into balance.

Please join me on May 18th at 2pm, as I help you understand the ins and outs of your complex body, with natural solutions for weight loss.

RSVP by May 17th


Reducing Stress on the Body and Mind

Reducing Stress on the Body and Mind

Reducing Stress on the Body and Mind

While stress is a universal experience, we all experience it, and it’s a normal and even necessary part of life. We also experience varying degrees of stress based on our personality traits and the resources we have available. In spite of these differences, most people experience stress on a daily basis, and many of the stressors are the same for everyone. Stress is any kind of outside factor that our body perceives as a threat to our safety or well-being. Many people think this only refers to emotional stress or trauma, but it also includes physiological stress on the body, such as infection, traumatic injury, or a poor diet. Stress can also include environmental factors like exposure to chemicals and other toxins.

One of the bodily processes that occurs during acute stress is often referred to as “fight or flight.” It is the defense mechanism that kicks in when we are in danger – or think we are. In addition to the adrenals pumping out more hormones, bodily functions that are unnecessary in the moment (such as digestion), are put on hold to preserve energy for the “fight or flight.”

While this can be a very useful and sometimes life-saving response to a threat, problems can begin to occur if stress becomes frequent or chronic. As the adrenal glands become over-worked, they eventually can’t keep up with the body’s demands for the various hormones they’re responsible for.

How Chronic Stress Affects your Health


The adrenal glands produce more than just cortisol. They also produce neurotransmitters such as adrenaline (epinephrine), norepinephrine, and dopamine. Neurotransmitters are chemical messengers (also considered hormones of the brain) that help regulate things like mood, performance, weight, pain perception, and sleep. Depending on the degree to which the adrenals have been affected, the neurotransmitters become unbalanced in various ways.


In addition to neurotransmitters and cortisol, the adrenals also produce small amounts of the hormones estrogen and testosterone. Along with balancing out hormones based on whether a person is male or female, the sex hormones also help keep the negative effects of too much cortisol in check, acting as an antioxidant. But once the adrenals become chronically over-worked, more and more of the precursor materials (used to make sex hormones) get diverted to make cortisol, resulting in a decrease in sex hormones. This results in decreased libido and other symptoms related to hormonal imbalances, such as PMS in women or erectile dysfunction in men.

Blood Sugar Balance

When cortisol is released, another hormone called glucagon is signaled and insulin is then directly suppressed. Glucagon controls glucose storage in the liver so that glucose can be signaled for realease into the blood. Insulin is the hormone that is responsible for regulating the amount of glucose or simple sugars being taken from the bloodstream into the cells.During chronic stress, the cells start to become resistant to insulin, leaving blood glucose levels elevated. This is why insulin resistance is the precursor to type II diabetes. A few symptoms of insulin resistance include inability to lose weight, high cholesterol and triglycerides, brain fog, and elevated blood glucose or insulin levels.


The adrenal glands are part of the HPA-axis and this is where the thyroid comes into play. The adrenals are regulated by the hypothalamus and pituitary glands. When cortisol is released under stress, the hypothalamus and pituitary glands work in a feedback loop with cortisol to slow down their production of hormones all together. Unfortunately, this will inevitably slow down function of the thyroid gland since the hypothalamus and pituitary regulate thyroid hormones as well. Stress can also negatively affect the enzyme that converts inactive thyroid hormone to the active thyroid hormone. There are a few other mechanisms involved in the stress/thyroid dysfunction connection as well. Hypothyroid symptoms such as cold extremities, dry skin, depression, and constipation often indicate lowered adrenal function. Most likely, thyroid treatment will be less effective if the adrenals are not addressed as well.


Stress triggers inflammation. Our body knows that chronic inflammation is damaging, so it compensates by slowing down the immune system in order to keep the inflammation in check. The immune system is also directly suppressed during stress since it is one of those “unnecessary” functions when we’re in “fight or flight” mode. This also affects thyroid health since a suppressed immune system can activate viruses capable of attacking and damaging the thyroid.

As you can see, so many functions in the body are interconnected and related back to adrenal function and the stress response.

How Diet and Lifestyle help Moderate the Effects of Stress

how stress effects the body

Eat Good Mood Foods

Nuts, dairy, leafy greens, citrus fruits, whole grains, black tea, and raw vegetables, which have all been shown to have a positive impact on mood, therefore decrease stress levels. Walnuts are rich in healthy fats, including omega-3 fatty acids, that help nourish your nervous system and calm your mind. Healthy fats like omega-3 fatty acids have anti-inflammatory properties that can help counteract the negative effects of stress hormones.

Heal your Gut

Because stress affects everyone differently, and because you might not be getting all of the nutrients you need from your diet, your stress level might be higher than average because you are depleting your stores of protein, vitamins, and minerals that your gut is unable to absorb. Therefore, healing our gut becomes vitally important in reducing the stress on your body. Consider one that also contains botanical ingredients to help reduce stress-related eating, help maintain normal cortisol levels, aid in weight management, and improve your mood.


There are many breathing techniques that take only a few minutes from your day, but will make a significant impact on reducing the effects of stress. Box breathing is one technique used by Navy SEALs to stay calm and focused. It’s easy: find a comfortable spot to lie down. Inhale for 4 seconds, then hold the air in for 4 seconds. Exhale for 4 seconds and hold your lungs empty for 4 seconds. Continue for 5 minutes or however long it takes you to relax, regroup, and refocus; then repeat as necessary.

If you’re interested in balancing your hormones naturally and relieving the stress on your body and mind, please contact the office to begin.