Understanding Ovarian Cysts

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Ovarian CystsOvarian cysts are remarkably common in women. If you’re of childbearing age, it’s probable that you’ve been experiencing them monthly without realizing it. The reason why the ovaries see so many cysts is because of the menstrual cycle. Despite this frequency, only a fraction (around a tenth) of women experience cysts that are large enough to cause noticeable health problems and even fewer have cysts that develop into tumors. Understanding what to look for is a key part of preventative health.

Before we begin, it’s important to note that a cyst is technically an enclosed, fluid-filled sac. Since the body, and especially the ovaries, has many sacs that are supposed to be enclosed, the term “cyst” is usually reserved for the sacs that cause problems.

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Types of Ovarian Cysts

The most common types of ovarian cysts (the kinds you may have right now) are called “functional cysts” since they arise as part of the menstrual cycle.

  • Follicle cysts: In the ovaries, eggs grow inside follicles until the follicle breaks open to release the egg. During a single menstrual cycle, multiple follicles undergo this process but only one normally ends up releasing an egg—the rest just sort of fizzle out, lose the egg, or otherwise go back to square one. Sometimes, a follicle will continue to grow without breaking open and form what is called a follicle or follicular cyst. These tend to go away within three months and they rarely produce symptoms. In cases of polycystic ovary syndrome, this phenomenon happens en-mass and provokes more serious symptoms.
  • Corpus luteum cysts: When a follicle breaks open, the empty sac will then shrink down into a mass called the corpus luteum. The job of this mass is to produce hormones in preparation for the next menstrual cycle. In some cases, the sac won’t shrink and instead reseals itself and begins to fill with fluid, forming a cyst. These things tend to go away after a few weeks but are more likely to cause symptoms than a follicular cyst. Specifically, a corpus luteum cyst can bleed or cause pain by twisting the ovary.

Other, less common forms of ovarian cysts include the following:

  • Endometrioma: This is a growth that forms as a result of endometriosis. When part of the womb tissue develops outside the uterus, it can attach to the ovaries and form a cyst that can sometimes be filled with blood.
  • Dermoid: Dermoid cysts are an oddity since they are often present from birth and can be found anywhere in the body. Though normally benign, their presence can cause irritation or disruption of the surrounding tissue. Interestingly, dermoids are known to sometimes produce other forms of tissue like sweat glands, hair follicles, and even things like bone, teeth, or eyes.
  • Cystadenomas: A type of cyst that forms on the ovarian surface. They usually hold secretion fluids and can sometimes become cancerous.
  • Polycystic ovarian syndrome (PCOS): Not a cyst in and of itself, but PCOS can cause an increase in the number of ovarian cysts a woman suffers and can result in infertility. Cysts caused by this condition should be regarded separately from other types.

Symptoms of Ovarian Cysts

As mentioned, ovarian cysts do not normally provoke symptoms. Those that do cause problems as a result of their growth and size, possible hormonal disruptions, twisting the ovary, or rupturing and spilling their contents into the body. Symptoms of an ovarian cyst include:

  • Abdominal pain or bloating
  • Difficulty urinating or increased frequency
  • Pelvic pain during or prior to menstruation
  • Pain (dull ache) in the lower back or thighs that may come and go
  • Painful bowel movements
  • Nausea and vomiting
  • Weight gain
  • Loss of appetite
  • Pain during sexual intercourse
  • Unusual vaginal bleeding
  • Tender breasts
  • Reduced fertility (in cases of endometriomas or PCOS)

Ovarian tumors can sometimes create the same symptoms as an ovarian cyst, and some cysts can end up turning malignant. It’s important to get checked out by your doctor if you are showing the above symptoms.

Additionally, a cyst can sometimes rupture. This is a serious situation that requires medical attention immediately. The symptoms of a ruptured cyst include:

  • Sudden, stabbing abdominal pain
  • Feeling faint, dizzy, weak, or passing out.
  • Rapid breathing

Lastly, a cyst can sometimes cause what’s known as “ovarian torsion”, where the ovaries are twisted out of position. In addition to hurting like hell, this can cause the ovaries to lose their blood supply and lead to the death of ovarian tissue if not addressed quickly. Ovarian torsion presents itself with pain, fever, and vomiting and should be treated as an emergency.

Treating Ovarian Cysts

In most cases, an ovarian cyst will go away on its own. Birth control pills are sometimes used to prevent ovulation and stop the formation of functional-type cysts, but otherwise there are no known prevention methods. Your doctor may also prescribe pain medication to help tolerate the symptoms until the cyst goes away on its own. Surgery is only used in around five to ten percent of cases but can be employed to remove a cyst that is overstaying its welcome or for biopsy. The existence of an ovarian cyst doesn’t increase your chance of cancer, but some doctors prefer removing any cyst over a certain size.

Ovarian Cysts and Pregnancy

The cysts caused by endometriosis and PCOS make it harder to become pregnant. Your doctor can advise you on further fertility treatments or surgeries that are applicable to your case.

Being pregnant also increases your likelihood of developing ovarian cysts, but these are typically benign and a result of the changes your body undergoes during the process. Since these cysts can still rupture, twist, or make the birth difficult, your doctor will likely want to monitor any cysts found over the course of your pregnancy.

Complications

The risk of a cyst becoming cancerous or causing problems in general increases after menopause, which needs to be taken into account when assessing whether to remove a cyst. Additionally, your doctor may want to perform further tests or simply remove a cyst if it doesn’t go away after several menstrual cycles, is growing larger, or causing you significant pain.

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Sources for Today’s Article:
Higuera, V., “Ovarian Cysts,” Healthline web site, June 15, 2015; http://www.healthline.com/health/ovarian-cysts#Overview1.
“Ovarian Cysts and Tumors – Symptoms, Causes, and Treatment,” WebMD web site, September 30, 2014; http://www.webmd.com/women/guide/ovarian-cysts.
“Ovarian Cysts,” WomensHealth.gov, November 19, 2014; http://www.womenshealth.gov/publications/our-publications/fact-sheet/ovarian-cysts.html?from=AtoZ#.


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Dr. Victor Marchione, MD

About the Author, Browse Victor's Articles

Victor Marchione, MD received his Bachelor of Science Degree in 1973 and his Medical Degree from the University of Messina in 1981. He has been licensed and practicing medicine in New York and New Jersey for over 20 years. Dr. Marchione is a respected leader in the field of smoking cessation and pulmonary medicine. He has been featured on ABC News and World Report, CBS Evening News and the NBC Today Show and is the editor of the popular The... Read Full Bio »