Ovarian Cysts

What are ovarian cysts?

Ovarian cysts are fluid-filled sacs in or on an ovary. The two ovaries are part of the female reproductive system. They produce eggs and the female hormones estrogen and progesterone.

How do they occur?

Ovarian cysts are common. Some cysts are normal, functional cysts, and some are abnormal.

The most common types of functional cysts are follicular cysts and corpus luteum cysts:

• A follicular cyst forms when an egg starts to develop for release at ovulation. The cyst gets bigger and fills with fluid as it gets close to the time for release of the egg.
• A corpus luteum cyst occurs after an egg has been released. The corpus luteum makes the hormone progesterone, which is needed for pregnancy if the egg is fertilized. If pregnancy does not occur, the corpus luteum usually breaks down. However, occasionally it swells with fluid or blood and stays on the surface of the ovary as a cyst.

Functional cysts usually do not happen after menopause.

Abnormal cysts result from abnormal cell growth. Sometimes abnormal cysts are caused by cancer, but 95% of cysts of the ovaries are not cancerous. The most common abnormal cysts are dermoid cysts. These cysts are similar to skin tissue. They are filled with fatty material and sometimes bits of bone, hair, nerve tissue, and cartilage.

You have a higher risk for getting an ovarian cyst if:

• You have pelvic inflammatory disease (PID).
• You have endometriosis.
• You have bulimia.
• You are taking fertility drugs.

What are the symptoms?

Ovarian cysts often cause no symptoms at all. Symptoms that might be caused by a cyst include:

• weight gain
• abdominal pain or indigestion
• pelvic pain during sex
• changes in menstrual periods such as heavy periods, painful periods, or no periods
• a firm, painless swelling in the lower belly
• a feeling of pressure or fullness in the belly or pelvis
• a change in bowel or bladder habits
• a feeling of pressure on the rectum or bladder
• an increase in facial and body hair
• acne

If the cyst becomes twisted, it can cause severe abdominal pain, nausea, and vomiting.

It is important for cysts to be found, checked, and possibly treated. If they do not go away, sometimes they rupture (burst). A ruptured cyst can be very painful and sometimes dangerous. It could lead to bleeding inside the belly and an emergency operation.

How are they diagnosed?

Your healthcare provider may find a cyst during a routine pelvic exam. Sometimes the mass that a provider might feel during an exam is something other than a cyst. For example, it might be a growth on another organ, or it might just be stool in the rectum.

You may have an ultrasound scan to check for an ovarian cyst. Ultrasound can also be used to measure the size of a cyst. Computed tomography (CT) and magnetic resonance imaging (MRI) are other scans that might be done.

In some cases, you may have a laparoscopy to check for or examine a cyst. For this procedure your provider uses a thin flexible tube and tiny camera inserted through tiny cuts in your abdomen to look at your ovaries.

A sample of fluid may be removed from a cyst for lab tests.

How are they treated?

Functional ovarian cysts usually go away without treatment. Functional cysts that don't go away can sometimes be drained with a needle through the abdomen or vagina, using ultrasound to guide the needle into the cyst. Abnormally large cysts (5 centimeters or larger) that don't go away after 3 menstrual cycles may be treated with hormone medicine or they may be removed with surgery. Twisted cysts need to be treated with surgery right away before they damage the ovary.

If a cyst ruptures, sometimes it may be treated with pain medicine until the body absorbs the fluid from the cyst. If a ruptured cyst is bleeding, you may need surgery to stop the bleeding.

An abnormal cyst that is not cancerous may be removed without removing an ovary. The procedure for removing just the cyst is called a cystectomy. If an ovary is removed as well as the cyst, the procedure is called an oophorectomy. You can usually still get pregnant if just a cyst or just one ovary is removed. However, if a cyst is cancerous, both ovaries and the uterus may need to be removed. In this case, you will no longer be able to get pregnant.

Persistent cysts in menopausal women must be evaluated thoroughly and removed because they might be cancerous.

How long will the effects last?

Functional cysts usually go away on their own within 2 or 3 menstrual cycles. However, it is important for you to have regular checkups so that if you have a cyst and there is any chance of the cyst rupturing, the cyst can be treated before it ruptures. If a cyst gets very large, it needs to be removed because otherwise it might destroy the ovary.

How can I help take care of myself?

You should have regular pelvic exams when you become sexually active or by the age of 21, whichever happens first. Have the exams as often as your healthcare provider recommends. Routine exams will help ensure that changes in your ovaries are diagnosed as early as possible.

Follow your healthcare provider’s recommendations if you are diagnosed with a cyst.

How can I help prevent ovarian cysts?

There is no definite way to prevent the growth of ovarian cysts. You should have a physical exam, including a pelvic exam and Pap test, every year or as often as your healthcare provider recommends. Doing this will help ensure that changes in your ovaries are diagnosed as early as possible.

If you tend to have ovarian cysts often, your provider may recommend that you take birth control pills to help stop the cysts from coming back. Your provider may also recommend more frequent exams.