Most ovarian cysts are functional and don’t cause any issues; they typically disappear within two to three menstrual cycles. Some women, known as polycystic ovaries, produce numerous small cysts; these women may also suffer from endometriosis or another condition.
Some cysts require surgery if they are large, non-migrating, or cause symptoms; such as cysts that twist, grow very large, or cut off blood supplies to the ovary.
Symptoms
Most ovarian cysts are small fluid-filled pockets found on or in an ovary and are very common among women who experience regular periods (menstrual cycles). Although most cysts don’t cause pain or noticeable symptoms, some larger or persistent ones could require treatment if they persist over time.
Ovarian cysts may result from various circumstances. One such cause is polycystic ovary syndrome (PCOS). PCOS causes too many male sex hormones, preventing egg cells from maturing correctly and leading to cyst formation in follicles. They may also result from an infection affecting your ovaries and fallopian tubes.
Ovarian cyst symptoms often include lower belly discomfort. The pain may be dull or sharp and come and go; however, if an ovarian cyst ruptures, you could experience severe tummy discomfort as well as vaginal bleeding and nausea.
Another symptom is disrupting your menstrual cycle, such as heavy or irregular periods and spotting between periods. A large cyst may press against the bowel or bladder, creating symptoms like fullness, pressure, and pain when urinating.
Most ovarian cysts aren’t dangerous and tend to go away independently over time, although regular ultrasound scans should be performed for monitoring. When pain arises, medicine or laparoscopy (in which doctors make several small incisions in your abdomen and insert thin instruments to remove the cyst) might help relieve symptoms. Some types of cysts, like those caused by adenomyomas or cancerous growths, require surgery for removal.
For most ovarian cysts, watchful waiting is the most effective treatment strategy. Your doctor may prescribe pain relievers or birth control pills; while birth control pills won’t disappear the cysts, they may help stop their growth. If you are over 50, it is also essential to have regular blood tests to look out for increased levels of chemicals that could signal cancerous growth in your cyst.
Diagnosis
Ovarian cysts are fluid-filled sacs that form on or within the ovaries. While most are harmless and tend to resolve independently, some may be dangerous if they grow too large or cause complications. When diagnosed by a physician, monitoring with ultrasound scans, blood tests, or surgery to remove all or part of an ovary may be recommended depending on its size and location.
An initial step in diagnosing an ovarian cyst is a pelvic exam with your primary care provider or gynecologist, who will feel any swelling of your ovaries during their examination and inquire about any symptoms you are experiencing. Your healthcare professional may also order an ultrasound test, which uses sound waves to view your ovaries and detect cysts as they form, providing information such as size, shape, location, and whether they contain liquid.
Follicular cysts are a type of ovarian cysts. While these tend to be small and dissipate within several menstrual cycles, larger ones might require removal.
Pathological cysts are another type of ovarian cyst found commonly among women who have already gone through menopause, typically when fertilized eggs fail to release and dissolve as planned, and can be quite painful and require removal for proper functioning.
Pelvic severe infections may result in pus-filled cysts near or on ovaries and fallopian tubes, typically benign but sometimes cancerous.
On occasion, cysts can develop into cancerous tumors over time in postmenopausal women; however, this is rare; in most cases, a cyst will not become cancerous and should be monitored regularly using ultrasound scans and blood tests.
Some women with numerous small ovarian cysts may develop Polycystic Ovary Syndrome, making pregnancy harder. A surgical procedure called laparoscopy may be used to remove them; however, this does not guarantee they won’t recur later on.
Treatment
Most ovarian cysts are benign (non-cancerous). If they do not become cancerous, they usually resolve independently within several menstrual cycles. A doctor will monitor it with regular ultrasound scans to monitor progress; any cyst that remains or grows more oversized may need further tests and treatments.
In some instances, cysts rupture or twist and impede blood flow to an ovary, leading to internal bleeding and necessitating surgery to remove them. Minimally invasive techniques usually used include inserting a laparoscope and instruments through minor cuts in your abdomen; in rare instances, an open procedure may be necessary if gynecologists suspect cancerous cysts or there are additional complications such as twisted ovaries present.
Gynecologists often recommend birth control pills or progesterone implants to reduce the chance of cysts forming or, in some cases, non-steroidal anti-inflammatory drugs like ibuprofen or paracetamol; if these do not relieve pain effectively, then more potent painkillers like co-codamol with codeine may be prescribed instead.
If a doctor suspects an ovarian cyst is cancerous, he or she will usually take steps to test its cells for malignant tumors. Additional tests could include taking blood samples from the cyst to measure estrogen and progesterone levels to identify women at increased risk of ovarian cancer or testing for CA-125, which is produced when an ovarian tumor develops (and found most often among women diagnosed with clear cell serous cancer).
If a gynecologist suspects you of having an ovarian cyst, they will often refer you to a specialist gynecologist for evaluation and possible surgery. An ultrasound scan will usually be conducted, and other tests, including CA-125 levels in blood tests, could also be ordered as further measures.
Prevention
Most ovarian cysts are harmless and don’t produce symptoms, but in certain instances, a healthcare provider should intervene to manage ovarian cysts. These include severe pelvic infections that lead to pus-filled cysts near ovaries and fallopian tubes; small amounts of cancerous tissue can grow into an ovarian cyst and become dangerous; ruptures may occur and cause painful bleeding, cutting off blood flow to an ovary and necessitating surgery as the only means of stopping the bleeding.
Doctors diagnose ovarian cysts by reviewing your medical history and conducting a physical exam that includes a pelvic exam to check for swelling on your ovaries and any related pain, followed by an ultrasound test to see whether or not the cyst has grown and its size; they’ll also order blood tests to detect high levels of chemicals that could indicate cancer.
Ideally, if a doctor thinks an ovarian cyst is not dangerous, they’ll usually advise watching and waiting to see if it goes away. Pain medication may help ease any symptoms you are experiencing; birth control pills might stop ovulation to aid the cyst going away more quickly, but taking birth control won’t prevent functional cysts from reforming or new ones from appearing.
But sometimes, a cyst ruptures (bursts), releasing fluid into its surrounding space. Once this happens, your ovary may twist, known as torsion, and can be very painful; additionally, cutting off its blood supply could potentially kill it and necessitate immediate medical intervention if this complication arises. For this reason, immediate medical assistance must be sought if this complication occurs.
Doctors typically recommend laparoscopy for treating large or persistent ovarian cysts that don’t resolve after monitoring. A surgeon makes several tiny incisions near your belly button and inserts a tool into them to extract the cyst; otherwise, they might suggest surgical removal of an entire ovary if symptoms exist.
