Ovarian cysts are fluid-filled sacs or pockets within or on the surface of an ovary. The ovaries are two bilateral organs — each about the size and shape of an almond — located on each side of your uterus. Eggs (ova) develop and mature in the ovaries and are released in monthly cycles during your childbearing years. Many women have ovarian cysts at some time during their lives. Most ovarian cysts present little or no discomfort and are harmless. The majority of ovarian cysts disappear without treatment within a few months. However, ovarian cysts — especially those that have ruptured — sometimes produce serious symptoms. The best way to protect your health is to know the symptoms and types of ovarian cysts that may signal a more significant problem, and to schedule regular pelvic examinations.
Complications of Ovarian Cysts
A large ovarian cyst can cause abdominal discomfort. If a large cyst presses on your bladder, you may feel the need to urinate more frequently because bladder capacity is reduced. Some women develop less common types of cysts that may not produce symptoms, but that your doctor may find during a pelvic examination. Cystic ovarian masses that develop after menopause may be cancerous (malignant). These factors make regular pelvic examinations important.
The following types of cysts are much less common than functional cysts:
Causes of Ovarian Cysts
Your ovaries normally grow cyst-like structures called follicles each month. Follicles produce the hormones estrogen and progesterone and release an egg when you ovulate. Sometimes a normal monthly follicle just keeps growing. When that happens, it becomes known as a functional cyst. This means it started during the normal function of your menstrual cycle. There are two types of functional cysts:
A follicular cyst begins when the LH surge doesn't occur. The result is a follicle that doesn't rupture or release its egg. Instead it grows and turns into a cyst. Follicular cysts are usually harmless, rarely cause pain and often disappear on their own within two or three menstrual cycles.
Although this cyst usually disappears on its own in a few weeks, it can grow to almost 4 inches in diameter and has the potential to bleed into itself or cause the ovary to twist, cutting off its blood supply and causing pelvic or abdominal pain. If it fills with blood, the cyst may rupture, causing internal bleeding and sudden, sharp pain. The fertility drug clomiphene citrate (Clomid, Serophene), which is used to induce ovulation, increases the risk of a corpus luteum cyst developing after ovulation. These cysts don't prevent or threaten a resulting pregnancy.
Signs & Symptoms of Ovarian Cysts
You can't depend on symptoms alone to tell you if you have an ovarian cyst. In fact, you'll likely have no symptoms at all. Or if you do, the symptoms may be similar to those of other conditions, such as endometriosis, pelvic inflammatory disease, ectopic pregnancy or ovarian cancer. Even appendicitis and diverticulitis can produce signs and symptoms that mimic a ruptured ovarian cyst. Still, it's important to be watchful of any symptoms or changes in your body and to know which symptoms are serious. If you have an ovarian cyst, you may experience one or more of the following signs and symptoms:
Diagnosis of Ovarian Cysts
A cyst on your ovary may be found during a pelvic exam. If a cyst is suspected, doctors often advise further testing to determine its type and whether you need treatment.
Typically, doctors address several questions to determine a diagnosis and to aid in management decisions:
To identify the type of cyst, your doctor may perform the following procedures:
Treatments of Ovarian Cysts
Treatment depends on your age, the type and size of your cyst, and your symptoms. Your doctor may suggest:
Watchful waiting, including regular monitoring with ultrasound, is also a common treatment option recommended for postmenopausal women if a cyst is filled with fluid and is less than 2 centimeters in diameter.
Some cysts can be removed without removing the ovary in a procedure known as a cystectomy. Your doctor may also suggest removing the affected ovary and leaving the other intact in a procedure known as oophorectomy. Both procedures may allow you to maintain your fertility if you're still in your childbearing years. Leaving at least one ovary intact also has the benefit of maintaining a source of estrogen production. If a cystic mass is cancerous, however, your doctor will advise a hysterectomy to remove both ovaries and your uterus. After menopause, the risk of a newly found cystic ovarian mass being cancerous increases. As a result, doctors more commonly recommend surgery when a cystic mass develops on the ovaries after menopause.
Prevention of Ovarian Cysts
Although there's no definite way to prevent the growth of ovarian cysts, regular pelvic examinations are a way to help ensure that changes in your ovaries are diagnosed as early as possible. In addition, be alert to changes in your monthly cycle, including symptoms that may accompany menstruation that aren't typical for you or that persists over more than a few cycles. Be sure to talk with your doctor about any concerns relating to menstruation.
When to seek Medical Advice
Seek immediate medical attention if you have:
These signs and symptoms — or those of shock, such as cold, clammy skin, rapid breathing, and lightheadedness or weakness — indicate an emergency and mean that you need to see a doctor right away.