Ovarian Cysts

Many women will suffer from ovarian cysts during their childbearing years. While they can certainly be painful, ovarian cysts are fairly common, often benign and will not usually lead to infertility. However, the development of certain types cysts have been linked to some cancers, so it’s best to see your doctor if you’re experiencing the symptoms of ovarian cysts.

Types of Ovarian Cysts


There are a number of different cysts that can affect a woman.

Functional Cysts - Each month, prior to ovulation, a woman’s ovaries will develop the eggs destined for release inside small fluid-filled sacs called functional cysts. When the egg is ready for release, the sac breaks, releasing the egg and allowing the cyst to be re-absorbed by the body. Unfortunately, sometimes the sac does not break on schedule, instead continuing to grow into what is called a follicular cyst. Usually this type of cyst will go away on it’s own within one to three months.

Corpus Luteum - Similar to follicular cysts, these cysts form if a sac that has released its egg does not dissolve, allowing fluid to build up inside of it. This type of cyst can grow up to almost four inches and may twist the ovary, causing pain or bleeding. The good news is that this type of cyst will typically go away on its own after a week or two. If you are taking ovulation-inducing drugs, such as Clomid or Serophene, this can increase the risk of developing a corpus luteum cyst. This type of cyst is rarely associated with cancer.

Cystadenomas - These cysts grow on the outer surface of the ovary. Like a blister, they are often filled with a thick gel or a watery fluid. These cysts can become large and painful.

Endometriomas - These cysts develop in women who have endometriosis, a condition which causes tissue from the lining of the uterus to grow outside of the uterus. The tissue may attach to the ovary and form a cyst. These cysts can cause pain during menstruation and sexual intercourse.

Polycystic Ovaries - Also known as Polycystic Ovary Syndrome, or PCOS. This occurs when the ovary doesn't make the hormones required for an egg to mature. The cysts start out as functional cysts, but none of the eggs inside ever develop enough to be released and ovulation does not occur. When this happens, the body stops producing progesterone, causing the menstrual cycle to become irregular or stop entirely. These cysts also produce male hormones, which continue to prevent ovulation as well as a host of other symptoms.

Dermoid cysts - Also considered to be a benign tumor, this usually benign growth uses cells and genetic information from the ovary to grow tissue such as teeth, hair and bones. Dermoid cysts can cause the ovary to twist, causing pain. There is a risk of rupture if these cysts are not caught early enough.

Ovarian Cyst Symptoms


Not all women with ovarian cysts will exhibit any symptoms. If symptoms are exhibited, these are the most common:
  • A feeling of pressure, fullness, or pain in the abdomen
  • Sudden weight gain
  • Painful sexual intercourse
  • Infrequent menstrual periods, no menstrual periods, and/or irregular bleeding
  • A dull ache in the lower back and thighs
  • Painful menstrual periods and abnormal bleeding
  • Nausea or vomiting
  • Problems passing urine completely
  • Tender breasts

Diagnosis


A doctor usually finds ovarian cysts during a routine pelvic examination, when she will be able to feel the swelling on your ovaries. Once the cyst has been felt, the next step is usually to perform an ultrasound, which allows the doctor see the size, shape and location of the cyst. Other tests, such as hormones tests, pregnancy tests and tests to check for cancer, may also be performed.

Treatment


Once found, a non-cancerous cyst is usually left for a period of three months to determine if the cyst has changed in size. If the cyst does not go away after several months, the treatment options are:
  • Surgery: If the cyst has not gone away, has grown larger, looks strange on the ultrasound, causes pain, or if you’re postmenopausal, your doctor might want to remove it. The two main surgical procedures are:
    • Laparoscopy - Usually performed if the cyst looks small and benign on the ultrasound. Under general anesthesia, a very small incision is made above or below the navel, and a small instrument, a laparoscope, that acts like a telescope is inserted into the abdomen. If the cyst is as it looked on the ultrasound – small and benign – it will be removed.
    • Laparotomy - If the cyst is large and looks suspicious, the doctor may perform a laparotomy. This procedure uses a bigger incision in the stomach. While you are still under general anesthesia, the doctor will have the cyst tested to find out if it is cancerous. If it is, the doctor may need to remove the ovary and any tissues that may be affected, such as the uterus or lymph nodes.
  • Birth Control Pills - In women with persistent, benign ovarian cysts, who are not attempting to conceive, birth control pills are often prescribed in order to stop ovulation. If ovulation does not occur, there is a lower chance that cysts will form.

Prevention


Unfortunately, there is no sure way to prevent ovarian cysts. Some women do find relief with oral contraceptive use (as mentioned above). If you suspect that you have ovarian cysts, see your doctor to determine if ovarian cysts are the cause of your symptoms.

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