Description

Ovarian cysts are fluid-filled sacs in the ovary or on its surface. Women have two ovaries. One ovary is located on each side of the uterus.

Each ovary is about the size and shape of an almond. The eggs develop and mature in the ovaries. The eggs are released in monthly cycles during the childbearing years.

Ovarian cysts are common. Most of the time, you have little or no discomfort, and the cysts are harmless. Most cysts disappear without treatment within a couple of months.

But sometimes ovarian cysts can twist or pop open (rupture). This can cause serious symptoms. To protect your health, get regular pelvic exams and know the symptoms that may be a sign of what could be a serious problem.

Symptoms

Most ovarian cysts do not cause symptoms and go away on their own. But a large ovarian cyst can cause:

  • Pelvic pain that may come and go. You may feel a dull ache or a sharp pain in the area below the navel, to one side.
  • Fullness, pressure, or heaviness in the belly (abdomen).
  • The abdominal distension.

When to see a doctor

Seek medical help right away if you have:

  • Sudden, severe abdominal or pelvic pain.
  • Pain with fever or vomiting.
  • Signs of shock. These include cold, clammy skin; rapid breathing; and dizziness or weakness.

Causes

The majority of ovarian cysts are formed as a result of your menstrual cycle. These are called functional cysts. Other types of cysts are much less common.

Functional cysts

The ovaries are small cysts called follicles each month. Follicles produce the hormones estrogen and progesterone, and open up to release an egg when you ovulate.

A monthly follicle continues to grow, it is known as a cyst functional. There are two types of functional cysts:

  • A follicular cyst. About half of their menstrual cycle, an egg bursts from its follicle. Then, the egg travels through the fallopian tubes. A follicular cyst begins when the follicle does not break. Do not release the egg, and continues to grow.
  • Corpus luteum cyst. After a follicle releases its egg, it contracts, and begins the production of estrogen and progesterone. These hormones are necessary for conception. The follicle is now called the corpus luteum. Sometimes, the opening where the egg came from is blocked. The liquid accumulates in the interior of the corpus luteum, resulting in a cyst.

Functional cysts are usually harmless. They rarely cause pain, and often go away by themselves within 2 to 3 menstrual cycles.

Other cysts

There are other types of cysts which are not related to menstrual cycles:

  • Dermoid cyst. Also called a teratoma, this cyst forms of the reproduction of the cells that produce oocytes in the ovary (germ cells). The cyst may contain tissue, such as hair, skin and teeth. This type of cyst is a rare cancer.
  • Cystadenoma. This type of cyst develops from cells in the surface of the ovary. The cyst can be filled with a watery or mucous material. A cystadenoma can grow very large.
  • Endometrioma. Endometriosis is a condition in which cells similar to those lining the interior of the uterus to grow outside the uterus. Some of the tissue can attach to the ovary and form a cyst. This is called an endometrioma.

Dermoid cysts and cystadenomas can become large and move the ovaries out of position. This increases the chance of painful twisting of the ovary, which is called ovarian torsion. Ovarian torsion can reduce or stop the flow of blood to the ovary.

Risk factors

The risk of having an ovarian cyst is more with:

  • Hormonal problems. These include taking a fertility drug that causes ovulation, such as clomiphene or letrozole (Femara).
  • Pregnancy. Sometimes, the follicle that forms when ovulation occurs remains in the ovary during pregnancy. Sometimes it can grow bigger.
  • The Endometriosis. Some of the tissue can attach to your ovary and form a cyst.
  • Severe pelvic infection. If the infection spreads to the ovaries, can cause cysts.
  • Previous ovarian cysts. If you've had an ovarian cyst, is likely to develop more.

Complications

It doesn't happen often, but complications can occur with ovarian cysts. These include:

  • Ovarian torsion. The cysts become large, they can cause the ovary to move. This increases the chance of painful twisting of the ovary (ovarian torsion). If this happens, you might have sudden, severe pelvic pain and nausea and vomiting. Ovarian torsion can also decrease or stop blood flow to the ovaries.
  • Rupture of cysts. A cyst that ruptures (breaks) can cause pain and bleeding in the inside of the pelvis. The greater size of the cyst, the greater the risk of rupture. The vigorous activity that affects the pelvis, such as vaginal sex, it also increases the risk of rupture.

Prevention

There is no way to prevent most of the ovarian cysts. But, regular pelvic exams help to ensure that changes in the ovaries are diagnosed as soon as possible. Be alert to changes in your monthly cycle. Make a note of any unusual symptoms of menstruation, especially those who go for more than a few cycles. Talk with your health care provider about any changes that are of interest to you.

Diagnosis

A cyst on the ovary can be found during a pelvic exam or in an imaging test, such as a pelvic ultrasound. Depending on the size of the cyst and if it is fluid-filled or solid, your doctor will likely recommend tests to determine its type and whether you need treatment.

Possible tests include:

  • Pregnancy test. A positive test might suggest an early pregnancy. Corpus luteum cysts are normal to see during your pregnancy.
  • Pelvic ultrasound. A wandlike device (transducer) sends and receives high-frequency sound waves to create an image of your uterus and ovaries on a video screen (ultrasound). The image is used to confirm that you have a cyst, see their location, and determine if it is solid or filled with fluid.
  • The laparoscopy. A slim, lighted instrument (laparoscope) is inserted into the abdomen through a small cut (incision). Using the laparoscope, your doctor can look at your ovaries and any cyst. If the cyst is found, the treatment is usually performed during the same procedure. This is a surgical procedure that requires anesthesia.
  • Tumor marker tests. The blood levels of a protein called cancer antigen are often elevated in ovarian cancer. If the cyst appears solid and you are at high risk of ovarian cancer, your healthcare provider may order a cancer antigen 125 (CA-125) test or other tests of blood. CA 125 levels can also be elevated in noncancerous conditions, such as endometriosis and pelvic inflammatory disease.

Sometimes, the less common types of cysts develop a health care provider discovered during a pelvic exam. Solid ovarian cysts develop after menopause may be cancerous (malignant). That is why it is important to have regular pelvic exams.

Treatment

The treatment depends on the age and the type and the size of the cyst. It also depends on your symptoms. Your health care provider might suggest:

  • Watchful waiting. In many cases, you can wait and be checked to see if the cyst goes away after a couple of months. This is typically an option — regardless of your age — if you have no symptoms and an ultrasound shows that you have a small fluid-filled cyst. You can have several follow-up pelvic ultrasound to see if the cyst changes in the size or appearance.
  • Of medicine. Hormonal contraceptives, such as birth control pills, it will prevent ovulation. This can prevent you from suffering more ovarian cysts. But, birth control pills will not shrink an existing cyst.
  • Of the cirugía.Su a professional doctor may suggest removal of a cyst that is large, does not have the appearance of a cyst functional, it is growing or cause pain. Some cysts can be removed without removing the ovary (cystectomy). In some cases, the ovary with the cyst is removed (oophorectomy). The surgery can often be done using minimally invasive surgery (laparoscopy) with a laparoscope and instruments that are inserted through small incisions in the abdomen. If the cyst is large or the cancer is a concern, an open procedure through a larger incision may be necessary. An ovarian cyst that develops after menopause-is sometimes the cancer. In this case, you may need to see a specialist in gynecologic cancer. You may need surgery to remove the uterus, cervix, fallopian tubes, and ovaries. You may also need chemotherapy or radiation.

Surgery. Your healthcare provider may suggest removal of a cyst that is large, does not have the appearance of a cyst functional, it is growing or cause pain. Some cysts can be removed without removing the ovary (cystectomy). In some cases, the ovary with the cyst is removed (oophorectomy).

The surgery can often be done using minimally invasive surgery (laparoscopy) with a laparoscope and instruments that are inserted through small incisions in the abdomen. If the cyst is large or the cancer is a concern, an open procedure through a larger incision may be necessary.

An ovarian cyst that develops after menopause-is sometimes the cancer. In this case, you may need to see a specialist in gynecologic cancer. You may need surgery to remove the uterus, cervix, fallopian tubes, and ovaries. You may also need chemotherapy or radiation.

Preparing for your appointment

Your first visit may be with your primary care provider or a specialist in diseases that affect the female reproductive system (gynecologist).

Think about bringing a family member or a friend with you to the appointment, if you can. You can listen to what your doctor tells you and help you recall the information later.

What you can do

Before your appointment, make a list of:

  • Its symptoms, including those that may seem unrelated to the reason for the appointment, and when they began
  • All the drugs, vitamins, herbs and other supplements you are taking and the dose
  • Your medical history, including menstrual irregularities
  • Questions to ask your health care provider

Questions include:

  • What is likely causing my symptoms?
  • What tests might I need?
  • My cyst goes away on its own, or will I need treatment?
  • Do you have any printed materials or brochures that you might have? What sites do you recommend?

Do not hesitate to ask other questions as they occur during your appointment.

What to expect from your doctor

Questions your doctor may ask include:

  • How often do you have symptoms?
  • How bad are the symptoms?
  • Do your symptoms seem to be related to the menstrual cycle?
  • Is there something to improve the symptoms?
  • Does anything make your symptoms worse?
  • Have had ovarian cysts in the past?

Your doctor will ask you other questions based on your responses, symptoms, and needs. Be prepared to answer the questions will help you make the most of your appointment time.

The symptoms and treatment of Ovarian cysts