An ovarian cyst is a fluid-filled sac that forms on the inside or outside of the ovary. It can cause pain in the pelvic region, irregular periods, and difficulty in getting pregnant.
Ovarian cysts are usually not a concern as they are common in women between the ages of 15 and 35. Some of these cysts, like a follicular cyst or a corpus luteum cysts cyst, may develop and resolve several times throughout the lifetime.
Generally, ovarian cysts are benign and disappear within a few months, without needing any treatment. However, if you do have symptoms that interfere with with your activities of daily living, you should discuss treatment options with your doctor.
Common symptoms
The most common symptoms of an ovarian cyst include:
- Pain in the ovary, on the side where the cyst is;
- Pain during ovulation;
- Pain during intimate contact;
- Irregular period;
- Increased breast tenderness;
- Vaginal bleeding outside your menstrual period;
- Weight gain, due to the hormonal changes;
- Difficulty getting pregnant.
These symptoms are most likely to appear when the cyst is large in size. These cases should be assessed and monitored by a gynecologist, who will determine the best treatment approach.
Confirming a diagnosis
To diagnose an ovarian cyst, the doctor will first assess your symptoms and also perform a pelvic exam. region. He or she may also order a order transvaginal ultrasound, a CT scan, or an MRI to visualize the ovarian cyst and the surrounding reproductive organs.
The doctor may also order a pregnancy test to check for the presence of beta HCG as a way of ruling out the possibility of an ectopic pregnancy. This condition may present with similar symptoms. Learn more about the symptoms and causes of an ectopic pregnancy.
Another eam your doctor may order is a laparascopy, which allows for better visualization of the abdomen and pelvis. During this procedure, a tissue specimen can also be collected for biopsy.
Possible causes
Most times, ovarian cysts are related to hormonal changes, which can be influenced by health conditions like:
- Pregnancy
- Endometriosis;
- Pelvic infection
- Polycystic ovarian syndrome
Additionally, some women may have excess ovarian tissue from birth that may have led to the formation of a cyst.
Types of ovarian cysts
The type of ovarian cyst diagnosed is usually characterized by the location where it developed.
1. Follicular cyst
A follicular cyst is a small fluid-filled sac located on the surface of or on the inside of an ovary. It can develop when follicles do not rupture during ovulation to release an egg. It is the most common type of ovarian cyst in women of childbearing age.
This type of cyst is benign and can range in size from 2.5 cm to 10 cm. It usually disappears on its own within 4 to 8 weeks and does not require treatment. However, a very large follicular cyst may rupture and require surgical treatment.
2. Corpus luteum cyst
The corpus luteum is a mass of cells in the ovary that appears with every menstrual cycle and disappears if a released egg is not fertilized. If fertilization does not occur and the corpus luteum does not dissolve, it may develop into a cyst.
The size o fa corpus luteum cysts may vary between 3 and 4 cm.
A corpus luteum cyst is a benign cyst and does not usually require treatment. However, it can rupture during sex, and lead to symptoms like intense pain, a drop in blood pressure and a fast heart rate. In these cases, removal through laparoscopic surgery may be necessary.
3. Theca lutein cyst
A theca lutein cyst is a rarer type of benign cyst that usually develops from overstimulation of the ovaries triggered by high levels of beta-HCG.
This type of cyst is more common in women who are pregnant with twins, and usually disappears on its own after delivery. However, it can also be caused by a molar pregnancy (also known as gestational trophoblastic disease), or ovarian hyperstimulation.
4. Hemorrhagic cyst
A hemorrhagic cyst occurs when there is bleeding from the cyst wall into the sac. It can occur with various types of cysts, such as a follicular cyst, corpus luteum cyst or an endometrioma.
This type of cyst usually disappears on its own. However, in cases where the cyst is larger than 5 cm or ruptures, surgical treatment may be necessary.
5. Dermoid cyst
This cyst is also referred to as a mature cystic teratoma. It can be diagnosed in infants or later on in life. This type of cysts typically contains hair, tooth or bone fragments, and requires laparoscopic removal;
6. Ovarian fibroma
An ovarian fibroma is a rare type of benign tumor, that is most commonly seen in menopausal women. Its size can vary from a microscopic size to weighing up to 23 kg. Larger cysts are typically must be removed surgically.
7. Ovarian endometrioma
An ovarian endometrioma an occur in cases of endometriosis in the ovaries. They are characterized by a blood-filled sac to that requires treatment with medication or surgery.
This type of cyst is most common during in women of childbearing age.
8. Cystadenoma
A cystadenoma is a benign ovarian tumor that develops on the surface of the ovary, It is generally filled with a watery or serous fluid, and must be removed through laparoscopy.
When to see a doctor
Warning signs that may indicate a possible ovarian torsion, which requires urgent surgery are:
- Intense pain on one side of the abdomen, which decreases when you put hot compresses on the region;
- Nausea and vomiting, which can be confused with appendicitis or bowel obstruction.
If you experience these symptoms, you should go to the emergency room as soon as possible.
Cysts over 8cm in size are more likely to rupture or twist. In addition, for a woman who gets pregnant and has a large cyst, there is a greater chance of torsion between 10 and 12 weeks of pregnancy due to the growth of the uterus. During this time, the uterus pushes on the ovary, which can lead to a torsion.
Treatment options
Having an ovarian cyst is not always dangerous, and it is expected to decrease in size on its own, without the need for treatment.
Painkillers such as acetaminophen can be used in cases of pain. Oral contraceptives are often prescribed in cases of follicular cysts to suppress ovulation Placing a warm compress over the painful region may also relieve the discomfort, but whenever the pain is very intense you should go to the doctor or emergency room for immediate assessment. The pain can be caused by a cyst that has grown, or a rupture, which requires surgery.
If symptoms are intense or if the cyst impedes with ovarian function, surgery may be recommended to remove the cyst. In more severe cases, where the cyst is very big, has signs of cancer or there is ovary torsion, it may be necessary to completely remove the ovary.
Is it still possible to get pregnant?
An ovarian cyst does not cause total infertility, but it may make getting pregnant more difficult. There are hormonal changes that occurred which led to the original cyst, and these changes can impede with conceiving. However, with proper treatment, the cyst will decrease in size or disappear, allowing the body to go back to its normal hormonal rhythm. This will facilitate fertilization.
If you have an ovarian cyst and become pregnant, you should make regular visits to your obstetrician because there is a greater risk of complications such as ectopic pregnancy.
Can a cyst be ovarian cancer?
An ovarian cyst is usually not cancer, as it is typically a benign lesion that disappears on its own. It is surgically removed when it is large in size, as their is a larger risk for rupture and can cause significant pain or discomfort. Ovarian cancer is more common in women over the age of 50, and is very rare in women under 30.
Cysts that are suspicious for cancer are those large in size, with a thick septum and a solid area. If these characteristics are present. the doctor may request a CA-125 blood test to check for high levels. High levels may be a sign of a carcinogenic lesion. It is important to note that, women with ovarian endometrioma may have elevated CA-125 without having cancer.