Ovarian cysts happen when fluid accumulates within a membrane inside the ovary. The size of ovarian cysts can vary and cysts smaller than 10 centimeters across often do not require treatment.
A cyst is a closed sac-like structure. A membrane separates it from surrounding tissue. It is a pocket of fluid, similar to a blister. It contains either liquid, gaseous, or semi-solid material. The outer or capsular portion of a cyst is called the cyst wall.
It is different from an abscess because an abscess contains pus, but a cyst does not.
Often, ovarian cysts are small and harmless, do not produce symptoms, and go away on their own. However, sometimes they
Cysts occur
Most cysts are symptomless, and doctors only find them when carrying out checks for other reasons.
If symptoms occur, they
Symptoms of an ovarian cyst may
- changes in menstruation
- unusual vaginal bleeding
- pelvic pain
- a dull ache in the lower back and thighs
- pain just before menstruation begins or ends.
- pain in the pelvic area or abdomen during sex
- pain when passing a stool
- pressure on the bowels or frequent bowel movements
- problems emptying the bladder fully or frequent urination
- unexpected weight gain
- breast tenderness
- feeling full after eating less than usual
- abdominal bloating or swelling
Complications
An ovarian cyst often causes no problems, but sometimes it can lead to complications.
- Torsion is when the stem of an ovary becomes twisted, which can happen if a cyst is growing on it. It can block the blood supply to the cyst and cause severe pain in the lower abdomen.
- A ruptured ovarian cyst is a burst cyst. Symptoms include severe pain in the lower abdomen and possibly bleeding.
- Some cysts are cancerous or later develop into ovarian cancer.
A person should seek immediate medical help if they
- pain with fever
- nausea and vomiting
- faintness, weakness, or dizziness
- sudden, severe, abdominal pain
- rapid breathing
- unexpected and heavy bleeding
There are two main categories of ovarian cysts.
Functional ovarian cysts are the most common type. They occur with the menstrual cycle and are benign, which means they are not cancerous.
Pathological cysts grow in the ovaries and are not related to the menstrual cycle. They may be harmless or cancerous (malignant).
The
- Follicle cysts: These develop when a follicle does not open to release an egg during menstruation. They are the most common type of cyst, often produce no symptoms, and usually disappear in 1–3 months.
- Corpus luteum cysts: These form if the sac that released the egg does not shrink in the usual way but fills with fluid. They usually disappear within weeks but can grow to almost 4 inches across. They can also twist the ovary, causing pain and bleeding.
- Endometriomas: This results from endometriosis, when endometrial-like tissue develops outside the womb. It can cause pain during menstruation and sex.
- Dermoid cysts: These
usually develop from cells that are present from birth. They can occur anywhere, including the ovaries. - Cystadenomas: These are cysts that fill with a watery fluid.
- Polycystic ovary syndrome: This involves the development of many small cells. It can result in pain and fertility problems and has links with other health conditions.
- Ovarian cancer: This involves cancerous cysts. These cysts are rare, but a doctor will usually follow up any type of cyst in case it is cancerous.
Ovarian cysts can also be simple or complex. A simple cyst contains fluid, while a complex cyst contains blood or a hard substance.
Learn more about the differences between simple and complex ovarian cysts here.
There are
- Hormonal factors and drugs that help people ovulate can lead to follicle and corpus luteum cysts, also known as functional cysts.
- Having endometriosis increases the risk of developing endometriomas.
- In pregnancy, the corpus luteum cyst releases progesterone to maintain the pregnancy. The placenta takes over this function and usually the corpus luteum cyst regresses. If it remains as it is or gets larger, a surgeon may need to remove it.
- Infections that affect the ovaries and fallopian tubes can result in the formation of cysts.
Treatment will depend on:
- whether or not the person has undergone menopause
- the size and appearance of the cyst
- if there are any symptoms
- the person’s
age
If a cyst is less than
The Office on Women’s Health notes that
A person may need surgery if the cyst:
- causes pain
- is large or appears to be growing
- looks unusual on a scan
- lasts for several menstrual cycles
In keyhole (laparoscopic) surgery, the surgeon uses tools to remove the cyst through a small incision. In most cases, the person can go home the same day. This type of surgery does not usually affect fertility, and recovery times are fast.
Laparotomy can be more suitable if a cyst is large or may be cancerous. The surgeon makes a longer cut across the top of the pubic hairline. After removing the cyst, they will send it to the lab for testing. A person may need to spend time in the hospital. If tests show the tissue is cancerous, further surgery may be necessary.
There is no way to prevent ovarian cyst growth in most cases, although one
Regular pelvic examinations will allow for monitoring and early treatment, if necessary. This may help prevent complications.
Most ovarian cysts present no signs or symptoms, so they often remain undiagnosed. Sometimes, screening for an unrelated pelvic condition may show that a cyst is present.
If a person approaches a doctor with symptoms, the doctor will:
- ask about symptoms
- ask about the person’s medical history
- carry out tests to assess the shape and size of the cyst, and whether it contains a solid or liquid
Diagnostic tests may
- an ultrasound scan
- a blood test
- a pregnancy test
- an MRI or CT scan, in some cases
Ovarian cysts are common and often cause no symptoms and resolve without treatment. However, some cysts can become large, rupture, or cause twisting in the ovaries, resulting in pain and possibly bleeding. Some become cancerous over time.
Anyone who experiences severe abdominal pain and bleeding should seek urgent medical help as this can indicate an ovarian cyst that needs treatment.