Overview Of Ovarian Cysts
An ovarian cyst is a sac filled with fluid that forms on or inside an ovary. This article is about cysts that form during your monthly menstrual cycle, called functional cysts. Functional cysts are not the same as cysts caused by cancer or other diseases. The formation of these cysts is a perfectly normal event and is a sign that the ovaries are working well.
Commonly Associated With
Physiologic ovarian cysts; Functional ovarian cysts; Corpus luteum cysts; Follicular cysts
Causes Of Ovarian Cysts
Each month during your menstrual cycle, a follicle (cyst) grows on your ovary. The follicle is where an egg is developing.
The follicle makes the estrogen hormone. This hormone causes normal changes of the uterine lining as the uterus prepares for pregnancy.
When the egg matures, it is released from the follicle. This is called ovulation.
If the follicle fails to break open and release an egg, the fluid stays in the follicle and forms a cyst. This is called a follicular cyst.
Another type of cyst occurs after an egg has been released from a follicle. This is called a corpus luteum cyst. This type of cyst may contain a small amount of blood. This cyst releases progesterone and estrogen hormones.
Ovarian cysts are more common in the childbearing years between puberty and menopause. The condition is less common after menopause.
Taking fertility drugs often causes the development of multiple follicles (cysts) in the ovaries. These cysts most often go away after a woman’s period, or after a pregnancy.
Functional ovarian cysts are not the same as ovarian tumors or cysts due to hormone-related conditions such as polycystic ovary syndrome.
Symptoms Of Ovarian Cysts
Ovarian cysts often cause no symptoms.
An ovarian cyst is more likely to cause pain if it:
- Becomes large
- Bleeds
- Breaks open
- Interferes with the blood supply to the ovary
- Is twisted or causes twisting (torsion) of the ovary
- Symptoms of ovarian cysts can also include:
- Bloating or swelling in the abdomen
- Pain during bowel movements
- Pain in the pelvis shortly before or after beginning a menstrual period
- Pain with intercourse or pelvic pain during movement
- Pelvic pain — constant, dull aching
- Sudden and severe pelvic pain, often with nausea and vomiting (may be a sign of torsion or twisting of the ovary on its blood supply, or rupture of a cyst with internal bleeding)
- Changes in menstrual periods are not common with follicular cysts. These are more common with corpus luteum cysts. Spotting or bleeding may occur with some cysts.
Exams & Tests
Your health care provider may find a cyst during a pelvic exam, or when you have an ultrasound test for another reason.
Ultrasound may be done to detect a cyst. Your provider may want to check you again in 6 to 8 weeks to make sure it is gone.
Other imaging tests that may be done when needed include:
- CT scan
- Doppler flow studies
- MRI
The following blood tests may be done:
- CA-125 test, to look for possible cancer if you have an abnormal ultrasound or are in menopause
- Hormone levels (such as LH, FSH, estradiol, and testosterone)
- Pregnancy test (Serum hCG)
Treatment Of Ovarian Cysts
Functional cysts often do not need treatment. They often go away on their own within 8 to 12 weeks.
If you have frequent ovarian cysts, your provider may prescribe birth control pills (oral contraceptives). These pills may reduce the risk of developing new cysts. Birth control pills do not decrease the size of current cysts.
You may need surgery to remove the cyst or ovary to make sure that it is not ovarian cancer. Surgery is more likely to be needed for:
- Complex cysts that do not go away
- Cysts that are causing symptoms and do not go away
- Cysts that are increasing in size
- Simple ovarian cysts that are larger than 10 centimeters
- Women who are near menopause or past menopause
- Types of surgery for ovarian cysts include:
- Exploratory laparotomy
- Pelvic laparoscopy
- You may need other treatments if you have polycystic ovary syndrome or another disorder that can cause cysts.
