The EngagED Midwife

Silent Signals: Understanding Ovarian Clues


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A stomach that feels “off” can be easy to brush aside—until it shouldn’t be. In this episode, Cara and Missi dig into the quiet warning signs of ovarian disease, separating the everyday from the rare but dangerous ovarian pathology. You’ll learn how to read the body’s cues using the BEAT mnemonic (Bloating, Early satiety, Abdominal/pelvic pain, Trouble with urination or bowels), what ultrasound reports actually mean, and why most ovarian cysts are benign even as we stay alert to red flags.

We walk through the physiology of the menstrual cycle—why ovulation naturally creates a cyst each month—and how that helps explain functional cysts that disappear on their own. Then we shift to the features that raise concern: septations, solid components, irregular borders, and blood flow on Doppler. We talk openly about the limits of CA125, the absence of a reliable screening test, and why surgical biopsy still anchors a definitive diagnosis. 

 We unpack how opportunistic salpingectomy at the time of hysterectomy or permanent sterilization can cut risk, and how combined oral contraceptives lower lifetime risk by suppressing ovulation. We also cover who needs genetic counseling—BRCA1/2, Lynch syndrome, and other familial cancer clues—and how to build smart follow-up plans that balance reassurance with action. Most ovarian findings are benign; the key is knowing when to watch and when to act. If this conversation helps you or a patient put a name to a nagging symptom, it’s done its job. 

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The EngagED MidwifeBy Cara Busenhart and Missi Stec

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