Ovarian cysts are fluid-filled sacs that develop on a woman’s ovary. They are very common and usually don’t cause symptoms. However, some ovarian cysts can cause pelvic pain, bloating, or other concerning symptoms. This article provides an overview of ovarian cysts, their symptoms, and treatment options to help you understand if you should be worried about an ovarian cyst.
What is an ovarian cyst?
An ovarian cyst is a fluid-filled sac that develops on one of the ovaries. A follicle on the ovary that releases an egg each month is called a functional cyst. These cysts often form during ovulation and usually go away on their own within one to three months. Other types of cysts are called pathological cysts. These cysts can keep growing and don’t go away on their own. The types of pathological cysts include:
- Dermoid cysts – Cysts that contain tissue such as hair, teeth, or bone
- Cystadenomas – Fluid-filled cysts that develop on the outer surface of the ovary
- Endometriomas – Cysts caused by endometriosis that fill with old blood
Many women develop small cysts each month that go away without causing symptoms. However, cysts can become problematic if they don’t go away, continue growing, become large, or twist or rupture.
What are the symptoms of an ovarian cyst?
Many ovarian cysts don’t cause any symptoms. However, possible symptoms can include:
- Pelvic pain – This may range from a dull, aching pain to sudden, severe pain if a cyst ruptures. Pain may occur in the lower abdomen on the side of the cyst.
- Bloating or fullness in the abdomen
- Pressure on the bladder leading to frequent urination
- Pain during sex
- Changes in menstruation – Cysts can cause irregular, heavy, or painful periods.
- Difficulty emptying the bowels
- Nausea, vomiting, or breast tenderness if the cyst produces hormones
- Fever, vomiting, and faintness if an infection develops
Symptoms often come and go. They may be worse right before a menstrual period. Severe symptoms like sharp pelvic pain, vomiting, or fainting require prompt medical attention.
What causes ovarian cysts?
There are various causes of ovarian cysts:
- Functional cysts – These form as part of ovulation. During ovulation, the ovarian follicle releases an egg. It then seals off and fills with fluid, becoming a cyst. These cysts usually go away after 1 to 3 menstrual cycles.
- Hormonal problems – Issues with hormones like estrogen can prevent the ovarian follicle from dissolving after releasing the egg. Then a cyst forms.
- Pregnancy – Cysts can form during pregnancy when hormones prevent ovulation. These cysts typically disappear after giving birth.
- Endometriosis – Cells like those lining the uterus grow outside the uterus and can form cysts called endometriomas.
- Pelvic infections – Infections of the female reproductive organs can spread to the ovaries and lead to cysts.
- severe illnesses – Medical conditions like kidney failure or cirrhosis can alter hormone levels and increase cyst risk.
Doctors aren’t always sure what causes cysts. There are risk factors that increase the chances of developing them:
- Hormonal birth control use – Methods with estrogen may increase cysts.
- Infertility treatments – Fertility medications may overstimulate the ovaries.
- Obesity – Excess fat cells change estrogen levels, which can cause cysts.
- Family history – Some women inherit a tendency for cyst development.
- Previous cyst or endometriosis – Once you’ve had an ovarian cyst, you’re prone to more.
How are ovarian cysts diagnosed?
There are several methods your doctor can use to diagnose an ovarian cyst:
- Medical history – Your doctor will ask about your symptoms, menstrual cycle, medication use, and family history.
- Pelvic exam – During a pelvic exam, your doctor manually feels for masses or tenderness in the ovaries and uterus.
- Ultrasound – This imaging test uses sound waves to create pictures of the reproductive organs. It can detect cyst size, location, and composition.
- Blood tests – You may get blood tests to assess hormone levels and check for cancer markers.
- Pregnancy test – Your doctor may test for pregnancy since some cysts form during pregnancy.
- Laparoscopy – If needed, a minor surgery uses a thin, lighted tube inserted through a small incision to view the cyst.
After diagnosis, your doctor will categorize the cyst based on its appearance and features on imaging tests:
- Simple cyst – A simple fluid-filled sac with thin walls. Usually benign.
- Complex cyst – Has thick walls, bubbles, or growths. Can be cancerous.
- Endometrioma – Filled with old blood and linked to endometriosis.
- Dermoid cyst – Contains odd tissue like hair, fat, or bone.
What are the treatment options for ovarian cysts?
Many functional cysts resolve without treatment within a few months. Your doctor may recommend the following for symptom relief and close monitoring:
- Pain medication – Over-the-counter drugs like ibuprofen can help relieve pain.
- Hormonal birth control – Can help prevent new cysts by stopping ovulation.
- Frequent ultrasounds – Track the cyst to see if it changes or goes away.
For persistent or more complex cysts, treatment options may include:
- Hormone therapy – Medications regulate hormones to shrink the cyst.
- Surgery – Cyst removal through laparoscopic surgery may be needed.
- Drainage – A needle and catheter can drain large cysts.
Surgery is the main treatment for cysts that could be cancerous. This involves removing the cyst and often the affected ovary. Treatment also depends on your age, future fertility wishes, and the cyst type and size.
When should I see a doctor?
Make an appointment with your gynecologist if you have any unexplained pelvic or abdominal pain. You should also see a doctor if you have:
- Pain alongside nausea, vomiting, or fever
- Sudden, severe, or worsening pain
- Rapid cyst growth or rupture
- Cysts that persist longer than 2-3 menstrual cycles
- Cysts exceeding 3 cm (bigger than a golf ball)
While most cysts aren’t dangerous, it’s important to make sure serious conditions get diagnosed. Seek emergency care for severe pain, fainting, vomiting, or bleeding.
Can ovarian cysts affect fertility?
Most small ovarian cysts don’t affect fertility. The exceptions are:
- Cysts related to polycystic ovary syndrome (PCOS) – This is a hormonal disorder that can impact ovulation.
- Cysts blocking the fallopian tubes – This prevents sperm from reaching and fertilizing an egg.
- Twisted cysts cutting off blood flow – Loss of blood supply damages ovarian tissue.
- Cyst removal surgery – Taking out the ovary impacts egg production.
Large or persistent ovarian cysts can sometimes indicate underlying health issues that hinder fertility. Talk to your doctor if you’re unable to conceive and have recurring cysts.
Are ovarian cysts cancerous?
The majority of ovarian cysts are non-cancerous (benign). However, there are some rare cancerous (malignant) cysts, including:
- Epithelial ovarian cancer – Starts in the tissue covering the ovaries. Accounts for 85-90% of ovarian cancers.
- Germ cell tumors – Develop in the cells forming eggs. More common in younger women.
- Stromal tumors – Grow in the hormone-producing cells that support the ovaries. Rare.
Only about 1% of ovarian cysts are malignant. Complex or persistent cysts have a higher cancer risk. Factors like age over 50, family history, or BRCA gene mutations increase ovarian cancer likelihood. Rapid cyst growth, fluid buildup, and elevated levels of CA-125 (a cancer biomarker) raise suspicion for cancer.
Conclusion
Ovarian cysts are very common and typically resolve on their own without treatment. However, it’s important to monitor persistent, enlarging, or painful cysts. See a doctor promptly for severe symptoms, as large cysts can twist, rupture, or impede fertility. While most cysts are benign, there’s a small cancer risk to consider. Talk to your gynecologist about detection and prevention methods. With an early diagnosis and proper treatment, most women with ovarian cysts can go on to have healthy future pregnancies and normal ovarian function.