Ovarian Cysts

Overview

Ovarian cysts are fluid-filled sacs on or within an ovary (part of the female reproductive system), commonly occurring during reproductive years. They can be functional or pathological, often asymptomatic, but may cause pelvic inflammatory disease and menstrual irregularities. Ovarian cyst diagnosis is typically via ultrasound, with treatment ranging from observation to surgery based on the cyst’s characteristics and symptoms. if an ovarian cyst bursts and causes bleeding, you should visit your primary care physician right away.

Types of Benign Ovarian Cysts

There are several types of ovarian cysts, including:

• Functional Ovarian Cysts

Functional cysts, also known as simple cysts. Other cysts, not all ovarian cysts form in response to your menstrual cycle. There are two types of functional cysts, such as:

– Follicular Cysts: In a normal menstrual cycle, an ovary releases an egg each month. The egg grows inside a tiny sac called a follicle. When the eggs mature, the follicles produce the hormone estrogen and break open to release the egg. A follicular cyst forms when a follicle (tiny sac that contains an egg) doesn’t release the egg and continues to grow.

– Corpus Luteum Cysts: Form when the follicle releases the egg but then seals up and fills with fluid or blood.

Different kinds of functional ovarian cysts can form during this cycle. The most common type is ovarian cysts filled with fluid formed during the menstrual cycle.

• Pathological Cysts:

– Dermoid Cyst (Mature Cystic Teratomas): Dermoid cysts form from cells that make eggs. Contain tissues such as hair, skin, or teeth due to embryonic cells.

– Cystadenomas: Develop from cells on the outer surface of the ovary, filled with watery or mucous-like fluid.

– Endometriomas: Ovarian cysts form when endometrial tissue grows within the ovary, often related to endometriosis. These are also called chocolate cysts.

• Polycystic Ovary Syndrome (PCOS)

Polycystic Ovarian Syndrome is characterized by multiple small cysts on the ovaries due to hormonal imbalances, typically causing irregular periods and infertility.

Causes

There are various reasons for ovarian cysts causes, such as: 

• Hormonal Imbalances

Variations in hormone levels can lead to the development of functional cysts, such as follicular cysts and corpus luteum cysts, typically related to the menstrual cycle.

• Endometriosis

This condition causes uterine lining cells to grow outside the uterus, which can form cysts known as endometriomas on the ovaries.

• Pregnancy 

Ovarian cysts can form early in pregnancy to support the pregnancy until the placenta develops. Corpus luteum cysts are normal to see during pregnancy.

• Severe Pelvic Infections

Infections that spread to the ovaries and fallopian tubes can cause cysts.

• Previous Ovarian Cyst History

Women who have had ovarian cysts in the past are more likely to develop them again.

• Polycystic Ovary Syndrome (PCOS)

This condition involves multiple small cysts on the ovaries, resulting from a hormonal imbalance that affects ovulation.

How Does Ovarian Cancer Cause?

Ovarian cancer typically develops when cells in the ovaries undergo genetic mutations that cause abnormal cell growth. Ovarian cancer cysts are solid masses of cancer cells. These mutations can lead to the formation of tumors that may spread to other parts of the body if not detected and treated early. Postmenopausal women with ovarian cysts are at higher risk for ovarian cancer. However, in premenopausal women, other diseases besides cancer can cause a higher risk of CA-125.

How to know if you have ovarian cancer?

To detect ovarian cancer, watch for serious symptoms like persistent abdominal bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, and changes in bowel or urinary habits. Regular pelvic exams, imaging tests like ultrasound or CT scans, and blood tests for ovarian cancer markers can aid in diagnosis if ovarian cancer symptoms persist.

What is Ovarian torsion?

Ovarian torsion is a medical condition where the large ovarian cyst causes an ovary to twist around its supporting tissues, cutting off its blood flow. Ovarian torsion can cause sudden and severe pelvic pain, nausea, and vomiting, and requires emergency medical treatment to prevent damage to the ovary.

Symptoms

Ovarian cyst symptoms include: 

• Pelvic pressure or pain, often on one side
• Abdominal bloating or swelling
• Menstrual irregularities (heavy or irregular periods)
• Pain during intercourse
• Dull ache
• Frequent urination or difficulty emptying the bladder
• Lower back pain
• Nausea or vomiting, especially if a cyst ruptures
• Fever, if there is an infection
• Rapid breathing or dizziness, particularly in cases of rupture or ovarian torsion

Diagnosis

Ovarian cyst diagnosis typically involves:

• Pelvic Exam: A doctor physically examines the pelvic area to detect any abnormalities. However, ovarian cysts are detected during a routine pelvic exam.
• Ultrasound: Uses sound waves to create an image of the ovaries, helping determine the cyst’s size, shape, and whether it is fluid-filled or solid.
• Blood Tests: Measures hormone levels and checks for cancerous cysts like CA-125, particularly if there is concern about ovarian cancer.
• Laparoscopy: A minimally invasive procedure where a small camera is inserted into the abdomen to directly view the ovaries and potentially remove the cyst.

CT or MRI Scans: Advanced imaging tests are used if more detail is needed about the cyst’s nature and structure.

Treatment

Treatment of ovarian cysts depends on the type, size, and symptoms of the cyst, as well as the patient’s age and overall health. Common ovarian cyst treatment options include:

Watchful Waiting

Many cysts, especially functional ones, resolve on their own. Regular monitoring through ultrasounds may be recommended to ensure they disappear without causing problems.

• Medications

Hormonal Contraceptives: To prevent the formation of new cysts in future menstrual cycles, although they do not shrink existing cysts.

• Surgery

Laparoscopy: A minimally invasive surgery for small, benign cysts. A small incision is made, and a camera is used to guide the removal of the cyst.

Laparotomy: A more extensive surgery for larger or potentially cancerous cysts. This involves a larger incision in the abdomen to remove the cyst.

• Pain Management

Over-the-counter pain relievers or prescription medications may be used to manage discomfort associated with ovarian cysts.

• Lifestyle and Home Remedies

   – Applying heat to the lower abdomen

   – Adjusting diet and exercise routines

Regular follow-ups are essential to monitor the condition and adjust ovarian cysts treatment as needed. In cases where a cyst is suspected to be cancerous, referral to a specialist such as a gynecologic oncologist may be necessary.

How to prevent most ovarian cysts?

 Most ovarian cysts cannot be prevented, but maintaining regular gynecological check-ups and managing conditions like polycystic ovary syndrome (PCOS) can help detect and manage cysts early. Most ovarian cysts occur naturally and go away in a few months without needing any treatment.

What does ovarian cyst pain feel like?

Ovarian cyst pain can feel like a sharp or dull ache in the lower abdomen or pelvis. It may be intermittent or constant, depending on the cyst’s size and whether it causes irritation or pressure on surrounding organs.

When To See A Doctor

Visit your primary care physician if you experience severe pelvic pain, persistent abdominal bloating, or irregular menstrual bleeding. Additionally, seek medical attention for new or worsening symptoms like pain during intercourse or difficulty urinating, as these could indicate complications such as a ruptured ovarian cyst or infection. Early evaluation allows for timely diagnosis and appropriate management of ovarian cysts.

Disclaimer

This information is intended for educational purposes only and should not be considered a substitute for professional medical advice. If you have concerns about an ovarian cyst or any other medical condition, please see a doctor for an accurate ovarian cyst diagnosis and personalized ovarian cyst treatment suggestions.