Located within or on the surface of an ovary, an ovarian cyst is a fluid-filled sac that may appear periodically in a woman’s life. Most women will have an ovarian cyst in their lifetime. Though most cysts present no problems, some of them can be very painful and diminish a person's quality of life.
Definition & Facts
In the uterus, there are two oval-shaped ovaries on each side. In these ovaries, eggs develop and mature. Once a month during the childbearing years of a woman’s life, these eggs are released. However, if an egg is not released, it will remain in the follicle that lines the ovary. When this happens, the fluid in the ovary has the potential to form a cyst, called an ovarian cyst.
The majority of these cysts present no pain or discomfort and will typically disappear within a few days. However, some cysts do present some severe symptoms. This is typically the case when an ovarian cyst ruptures.
Symptoms & Complaints
- A dull, aching pain in the pelvis that extends to the lower back and thighs
- Pelvic pain that presents itself just before the start of, or just before the end of a menstrual cycle
- Pain the in the pelvis during sexual intercourse. This is referred to as dyspareunia.
- Pain or pressure on the bowels during bowel movements
- Pregnancy symptoms such as nausea, tenderness in the breasts, and vomiting
- The feeling of heaviness existing in the abdomen. In some cases, the abdomen will bloat or the abdomen will swell.
- Problems with the bladder that lead to increased bladder pressure, more frequent urination, and more difficulty fully emptying the bladder
The above symptoms are more common, and not as alarming as the following symptoms which require immediate medical treatment. They are often evidence of a ruptured cyst, or an ovarian torsion, which is when the ovary or fallopian tube becomes twisted and prevents blood from circulating to them. These are very serious medical conditions that can have severe consequences if not treated early in their existence.
- Pelvic pain that is severe and overwhelming
- A persistent fever
- Dizziness that feels as though it could lead to fainting
- Heavy and rapid breathing
In some rare cases, these symptoms can also result from a cancerous ovarian tumor, which is another reason why immediate medical treatment is necessary.
The majority of ovarian cysts result as a normal side effect of a person’s menstrual cycle. When the follicle that holds an egg doesn’t release the egg on schedule, it forms a cyst. These types of cysts are known as functional ovarian cysts. They are common, rarely cause any symptoms to occur, and typically disappear within two to three menstrual cycles. Follicular cysts are a type of functional ovarian cyst which typically occurs at the midpoint of a person’s menstrual cycle. When this happens, the egg and follicle grow and turn into a cyst.
Corpus luteum cysts occur when the follicle ruptures and the egg escapes successfully. After the egg has escaped, the follicle begins to produce estrogen and progesterone. At this point the follicle is called the corpus luteum. If the corpus luteum has accidentally closed off in the spot where the egg has escaped, fluid will begin to build up inside of it and cause a cyst.
There are other types of cysts that are less common, and more cause for concern. They have nothing to do with the normal function of the menstrual cycle. Dermoid cysts form from the cells that produce eggs, and often contain hair, skin, or teeth. They are typically not cancerous, but can often cause ovarian torsion, which is a serious condition in its own right. Cystadenomas form from ovarian tissue. They are often filled with a watery liquid or mucus, and can also often lead to ovarian torsion.
Endometriomas are cysts that develop in people who have endometriosis. Endometriosis is a condition in which uterine endometrial cells grow outside of the uterus. When this happens, some of the tissue can attach to the ovaries and form a growth.
Diagnosis & Tests
Doctors will typically find ovarian cysts during pelvic examinations though occasionally they are mistaken for other conditions during emergency room visits such as appendicitis. If a cyst is found, extra tests will often be run to determine whether or not the cyst needs further medical treatment. When running these tests, doctors often look for several different characteristics of the cyst. Its size is one of these characteristics. Another aspect is its consistency, such as whether its filled with fluid, or is solid.
Imaging tests such as CT scans and a pelvic ultrasound may be used to find the location, size, and consistency of cyst. A pregnancy test may be administered. A CA-125 blood test may be performed if the cyst is found to be solid. This test will help determine whether or not the cyst is cancerous because CA-125 is a biomarker for ovarian cancer.
Treatment & Therapy
The type of treatment depends on the person's age, cyst type, and symptoms. Three main methods are used to treat ovarian cysts. In many cases, patient's will be told to wait and see if the cyst goes away on its own. In other cases, a doctor might recommend birth control pills, as they will reduce the chance of developing a cyst, and often help to stave off ovarian cancer. In severe cases, surgery will be performed to remove the cyst called a cystectomy. This can often be done without removing the ovary, but if cancer exists, the entire ovary will often be removed. Surgery may be performed laparoscopically.
Prevention & Prophylaxis