What are Ovarian Cysts?
Ovarian cysts are small sacs which fill with fluid, and sometimes other tissue, found in or around ovaries. These cysts form as part of a woman’s menstrual cycle and are in general, not a cause for concern.
There are two ovaries situated on either side of the womb and an egg is released every month during ovulation. This is when an ovarian cyst can form, but they usually go away of their own accord without need for treatment. (1)
To understand ovarian cysts better we will detail the different types of cysts and how they form.
Functional cysts are the most common and are generally benign (not cancerous) they are:
The ovary contains small sacs or follicles which have unfertilized eggs growing inside them. At the time of ovulation a mature egg will normally be released from the follicle.
There are occasions when this might not happen and the follicle doesn’t break to release the egg. The follicle will then continue to grow and form a fluid filled cyst. (2)
These cysts are generally two to three centimeters in diameter but can be as large as eight centimeters. They usually resolve themselves and go away in up to a couple of months. (3)
Corpus Luteum Cysts
Corpus luteum controls hormones which help the ovaries prepare a mature egg ready for release the following month. It’s an endocrine gland inside the ovary that helps regulate a woman’s monthly cycle and early pregnancy.
The corpus luteum forms after the follicle sac containing the egg breaks open. The egg is released and the sac shrinks to make cells which contain progesterone and estrogen, two reproductive hormones.
If the sac reseals itself following release of the egg fluid can build up inside it and form a cyst. These cysts generally disappear after a few weeks but can be as large as ten centimeters. There is also the possibility they may bleed or that they can cause the ovary to twist and be painful. (4,5)
Non functional cysts that form on the ovaries which are also usually benign (not cancerous) include:
Endometriosis is a condition where tissue normally found inside the womb (endometrial tissue) is found in areas outside the womb. This tissue can form cysts on the ovaries. (6)
Dermoids or Teratoma
This type of cyst is made up of different kinds of tissues like skin and hair. These cysts can be present from birth or can develop in adolescence. (7)
This fluid filled cyst develops on the outside of the ovary and can grow very large, although this is rare. (8)
Polycystic Ovary Syndrome (PCOS)
The literal meaning of polycystic is “having many cysts”. This condition generally develops as a result of a hormone imbalance and can cause many fluid filled sacs to form within the ovaries.
PCOS is a common cause of infertility resulting from not ovulating (releasing a mature egg) each month. This condition often only comes to light when a woman has difficulty getting pregnant (9)
Other factors that play a part in the formation of ovarian cysts include the following:
Functional cysts form during the menstrual cycle and usually dissipate by themselves. Hormonal issues or medication taken to assist ovulation can be the cause of these cysts. (10)
An ovarian cyst can develop early on in a pregnancy however, it will normally disappear by about the 16th week of gestation. (11)
Severe Pelvic Infections
Pelvic infections can cause scar tissue on the ovaries which can lead to the formation of cysts. (12)
These are any type of malignant cysts found in or on the ovary, they are rare and referred to as ovarian cancer. Women over the age of 50 years are more likely to have this type of cyst. (13)
We have already learnt that most ovarian cysts go away by themselves and you may not even know they were ever there. However, there are some common symptoms that can be felt. These include: abdominal pain on the side where the cyst is, swelling, bloating and abdominal pressure.
There are also occasions when the cyst may rupture and cause a sudden sharp pain. A large cyst may be capable of twisting the ovary which will cause pain as well as vomiting and nausea.
Some of the less common symptoms are pain when menstruating or having sex. You can experience abnormal vaginal bleeding and your periods may be heavier, lighter or irregular.
Bladder or bowel issues can be another factor, for example: frequent urination or not being able to completely empty your bowels. You may also feel your abdomen is bloated or swollen and you might not be able to eat as much.
Experiencing a dull ache or a sudden, sharp and severe pain in the pelvis are also reason for concern. You might also feel a similar pain in your lower back or thighs, or have tender breasts and unexpected weight gain. (14,15)
Ovarian cysts can be detected during a pelvic examination when the doctor feels a swelling from the cyst on the ovary.
This being the case you will likely be required to undergo further tests. These include:
During this procedure an probe is put into your vagina which transmits sound waves. It is able to examine your reproductive organs and bladder.
The sound waves transmit the picture, a sonogram, to a computer to evaluate the condition of your ovaries.
Providing ovarian cysts are identified, it will tell the doctor the location, size, shape and type, for example fluid filled or solid.
A wait and watch approach can be taken after identification of a cyst with an ultrasound. This entails a further scan after a few weeks to determine any changes to the cyst. (16,17)
The cause of the symptoms experienced could be due to pregnancy, so a test will be done to negate this factor.
Hormone Level Tests
These tests are done to ascertain whether you might have any hormone related issues.
There are some chemicals in your blood which can indicate ovarian cancer, namely cancer-antigen 125 (CA-125). A high level of this chemical can indicate the presence of cancer but this is not conclusive. (18)
A doctor or gynecologist will take into account the results of all tests before diagnosis.
What are ovarian cysts? Ovarian cysts are small sacs which fill with fluid, and sometimes other tissue, found inside the ovary. These cysts form as part of a woman’s menstrual cycle and in most cases are not a cause for concern.
What causes ovarian cysts? These cysts can be caused by follicles or sacs which contain eggs not breaking open or resealing after releasing the egg. There are other factors that can play a part, which include endometriosis, hormones, pregnancy and ovarian cancer.
How do doctors test for ovarian cysts? After an initial pelvic examination an ultrasound scan can be done and/or blood, hormone and pregnancy tests.
When should you go to the doctors with ovarian cysts? You should see your doctor if you have any unusual pelvic pain or abnormal vaginal bleeding. If you have been diagnosed with ovarian cysts there are times when certain symptoms can indicate a medical emergency. These include severe, sudden, abdominal pain, vomiting and fever, feeling faint, dizzy and weak or breathing rapidly. It is possible the cyst may have ruptured. (19)
Can you prevent ovarian cysts? Functional ovarian cysts are a part of ovulation and therefore if you are premenopausal they cannot be prevented. It is possible for your doctor in some instances to prescribe birth control pills to regulate ovulation and reduce the chances of more cysts occurring. (20)
What can relieve ovarian cysts? You can get over the counter pain medications to relieve any pain associated with cysts. Speak to your pharmacist who can advise you.
Will I need surgery for ovarian cysts? Whilst most ovarian cysts go away on their own there are circumstances when a surgical option can be considered. This is generally the favoured choice for women post menopause. If you are still ovulating it would depend on whether your cyst persists after quite a few menstrual cycles. It would also be looked at if your cyst increases in size, looks abnormal on a scan or causes pain.
Will ovarian cysts affect my fertility? In general the answer is no, however endometriosis and polycystic ovaries can make it harder to get pregnant. In fact 40 percent of women with polycystic ovaries will be infertile due to not releasing an egg at the time of ovulation. (21)
Ovarian cysts are small sacs which fill with fluid and sometimes other tissue, found in or around ovaries. These cysts generally go away on their own and are not a cause for concern.
There are occasions when the cysts can grow and be persistent therefore requiring medical intervention. A doctor will usually require tests like ultrasound, blood or hormone tests to confirm the presence of ovarian cysts.
There are surgical interventions which can be carried out to deal with cysts that don’t disappear of their own volition. Thankfully, it is also rare for these cysts to become cancerous, however it should never be completely dismissed.