Ovarian Cysts

What are ovarian cysts?

The ovaries are part of the female reproductive system. They are located in the lower abdomen on both sides of the uterus. Women have two ovaries that produce eggs as well as the hormones estrogen and progesterone.

Sometimes, a fluid-filled sac called a cyst can develop in one of the ovaries. Many women develop at least one cyst in their lifetime. In most cases, cysts are painless and cause no symptoms.

Types of ovarian cysts

There are various types of ovarian cysts such as dermoid cysts and endometrioma cysts. However, functional cysts are the most common type. Two types of functional cysts include follicle and corpus luteum cysts.

Follicle cyst

During a woman’s menstrual cycle, an egg grows in a sac called a follicle. This sac is located inside the ovaries. In most cases, this follicle or sac opens and an egg is released. However, if the follicle does not open, the fluid inside the follicle may form a cyst in the ovary.

Corpus luteum cysts

Follicular sacs typically dissolve after releasing an egg. However, if the sac does not dissolve and the follicle seals open, additional fluid may develop within the sac, and this fluid buildup causes a corpus luteum cyst.

Other types of ovarian cysts:

  • dermoid cysts: sac-like growths on the ovaries that may contain hair, fat, and other tissue
  • cystadenomas: noncancerous growths that can develop on the outer surface of the ovaries
  • endometriomas: tissues that normally grow inside the uterus can develop outside the uterus and attach to the ovaries, resulting in a cyst.

Some women develop a condition called polycystic ovary syndrome. This means that the ovaries contain many small cysts. It can cause enlargement of the ovaries. If left untreated, polycystic ovaries can cause infertility.

Symptoms of an ovarian cyst

Most of the time, ovarian cysts do not cause any symptoms. However, symptoms may occur as the cyst grows. Symptoms may include:

  • abdominal bloating or swelling
  • painful bowel movements
  • pelvic pain before or during the menstrual cycle
  • painful relationship
  • pain in the lower back or thigh
  • breast tenderness
  • nausea and vomiting

Serious symptoms of an ovarian cyst that requires immediate medical attention include:

  • severe or sharp pelvic pain
  • fire
  • paleness or dizziness
  • rapid breathing

These symptoms may indicate a ruptured cyst or an ovarian torsion. Both complications can have serious consequences if not treated early.

Ovarian cyst complications

Most ovarian cysts are benign and go away naturally on their own without treatment. These cysts cause few symptoms. But in a rare case, your doctor may detect a cancerous cystic ovarian mass during a routine exam.

Ovarian torsion is another rare complication of ovarian cysts. This is when a large cyst causes an ovary to bend or move from its original position. If the blood supply to the ovary is cut off and left untreated, it can cause damage to the ovarian tissue or death. Although rare, ovarian torsion accounts for about 3 percent of emergency gynecological surgeries.

Also, rare ruptured cysts can cause severe pain and internal bleeding. This complication increases your risk of infection and can be life-threatening if left untreated.

Diagnosing an ovarian cyst

Your doctor may detect an ovarian cyst during a routine pelvic exam. They may notice swelling in one of your ovaries and order an ultrasound test to confirm the presence of a cyst. An ultrasound test (ultrasonography) is an imaging test that uses high-frequency sound waves to produce an image of your internal organs. Ultrasound tests help determine the size, location, shape, and composition (solid or fluid-filled) of a cyst.

Imaging tools used to diagnose ovarian cysts include:

  • CT scan: a body imaging device used to create cross-sectional images of internal organs
  • MRI: a test that uses magnetic fields to produce in-depth images of internal organs
  • ultrasound device: an imaging device used to visualize the ovaries

Because most cysts go away after a few weeks or months, your doctor may not recommend an immediate treatment plan. Instead, they may repeat the ultrasound test in a few weeks or months to check your condition.

If your condition does not change or the cyst increases in size, your doctor will order additional tests to identify other causes of your symptoms.

These include:

  • pregnancy test to make sure you are not pregnant
  • hormone level testing to check for hormone-related problems, such as too much estrogen or progesterone
  • CA-125 blood test for ovarian cancer screening

Treatment for an ovarian cyst

Your doctor may recommend treatment to shrink or remove the cyst if it doesn’t go away on its own or when it gets bigger.

birth control pills

If you have recurrent ovarian cysts, your doctor may prescribe oral contraceptives to stop ovulation and prevent the development of new cysts. Oral contraceptives may also reduce your risk of ovarian cancer. Postmenopausal women have a higher risk of ovarian cancer.

laparoscopy

If your cyst is small and is due to an imaging test to rule out cancer, your doctor may perform a laparoscopy to surgically remove the cyst. The procedure involves your doctor making a small incision near the navel and then placing a small instrument on your abdomen to remove the cyst.

laparotomy

If you have a large cyst, your doctor may surgically remove the cyst through a large incision in your abdomen. If they do a biopsy right away and find that the cyst is cancerous, they may perform a hysterectomy to remove your ovaries and uterus.

Ovarian cyst prevention

Ovarian cysts cannot be prevented. However, routine gynecological examinations can detect ovarian cysts early. Benign ovarian cysts are not cancerous. However, ovarian cancer symptoms can mimic those of an ovarian cyst. Therefore, it is important to visit your doctor and get the correct diagnosis. Alert your doctor to symptoms that may indicate a problem, such as:

  • changes in the menstrual cycle
  • ongoing pelvic pain
  • loss of appetite
  • unexplained weight loss
  • abdominal fullness

What is the long-term outlook?

The outlook for premenopausal women with ovarian cysts is good. Most cysts disappear within a few months. However, recurrent ovarian cysts can occur in premenopausal women and women with hormone imbalances.

If left untreated, some cysts can reduce fertility. This is common in endometriomas and polycystic ovary syndrome. To improve fertility, your doctor may remove or shrink the cyst. Functional cysts, cystadenomas, and dermoid cysts do not affect fertility.

Although some doctors take a “wait and see” approach with ovarian cysts, your doctor may recommend surgery to remove and examine any cysts or growths that develop on the ovaries after menopause. This is because the risk of developing a cancerous cyst or ovarian cancer increases after menopause. However, ovarian cysts do not increase the risk of ovarian cancer. Some doctors remove the cyst if it is larger than 5 centimeters in diameter.

S:

What are the effects of ovarian cysts on pregnancy? How does it affect someone who is pregnant and trying to get pregnant?

A:

Some ovarian cysts are associated with decreased fertility, while others are not. Endometriomas and cysts from polycystic ovary syndrome can reduce a woman’s ability to conceive. However, functional cysts, dermoid cysts, and cystadenomas are not associated with difficulty conceiving unless they are extensive. If your doctor discovers an ovarian cyst while you’re pregnant, treatment may depend on the type or size of the cyst. Most cysts are benign and do not require surgical intervention. However, surgery may be needed if the cyst is suspected of cancer, or if the cyst ruptures or folds (known as torsion) or is very large.

Read the article in Spanish

Resources:

Mayo Clinic Staff. (2014). Ovarian cysts.

Office of Women’s Health. (2014). ovarian cysts [Bilgi sayfası].

Ovarian torsion. (2015).

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