Ovarian Cysts

What Is Polycystic Ovary Syndrome?

An ovarian cyst is a sac filled with fluid that forms on or inside of 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.

About 7 percent of women may have this hormonal disorder, according to a 2004 study in the Journal Clinical Endocrinology & Metabolism. Like its name implies, people with the condition can develop multiple ovarian cysts. They also can have irregular periods, trouble getting pregnant, and symptoms like a deepened voice and increase in body hair (both of which tend to show up when a person has high levels of male hormones). But keep in mind, this is a hormonal syndrome—it’s not synonymous with having multiple cysts during your lifetime.

Other names are Physiologic ovarian cysts; Functional ovarian cysts; Corpus luteum cysts; Follicular cysts

Causes

Each month during your menstrual cycle, a follicle (where the egg is developing) grows on your ovary. Most months, an egg is released from this follicle (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, called a corpus luteum cyst, occurs after an egg has been released from a follicle. These often contain a small amount of blood.

Ovarian cysts are somewhat common, and are more common during a woman’s childbearing years (from puberty to menopause). Ovarian cysts are less common after menopause.

No known risk factors have been found.

Functional ovarian cysts are not the same as ovarian tumors (including ovarian cancer) or cysts due to hormone-related conditions such as polycystic ovary disease.

Taking fertility drugs can cause a condition called ovarian hyper stimulation, in which multiple large cysts are formed on the ovaries. These usually go away after a woman’s period, or after a pregnancy.

 What Are The Symptoms Of An Ovarian Cyst?

Ovarian cysts often cause no symptoms. When symptoms occur, they are typically pain or a late period.

Symptoms of ovarian cysts (physiologic or pathologic) include:

  • pressure, swelling in the abdomen
  • pelvic pain
  • dull ache in the lower back and thighs
  • problems passing urine completely
  • pain during sex
  • abnormal bleeding
  • breast tenderness
  • nausea and vomiting
  • Pain during bowel movements
  • Pain in the pelvis shortly before or after beginning a menstrual period

Changes in menstrual periods are not common with follicular cysts, and are more common with corpus luteum cysts. Spotting or bleeding may occur with some cysts.

An ovarian cyst is more likely to cause pain if it:

  • Becomes large
  • Bleeds
  • Breaks open
  • Is bumped during sexual intercourse
  • Is twisted or causes twisting (torsion) of the Fallopian tube

Can I Still Get Ovarian Cysts If I’m Past Menopause?

Most of the time, cysts develop in pre-menopausal women. But it’s still possible to get them as you age, perhaps especially in the earlier post-menopausal years. In fact, one 2010 study in the American Journal of Obstetrics & Gynecology concluded that they might be fairly common. After looking at the transvaginal ultrasound test results of nearly 16,000 women who were older than 55, the researchers found that about 14 percent of the subjects had a cyst at their first screening. About one-third of those cysts disappeared the following year.

The bottom line: Ovarian cysts still make an appearance in women after menopause—and doctors shouldn’t automatically assume that all of them are cancerous.

Possible Complications

Complications have to do with the condition causing the cysts. Complications can occur with cysts that:

  • Bleed
  • Break open
  • Show signs of changes that could be cancer
  • Twist

Exams and Tests

Polycystic ovaries are usually discovered during a physical exam, or when you have an ultrasound test for another reason. Other imaging tests that may be done when needed include:

  • CT scan
  • Doppler flow studies
  • MRI

The doctor may order the following blood tests:

  • Ca-125 test, to look for possible cancer in women who have reached menopause or who have an abnormal ultrasound
  • Hormone levels (such as LH, FSH, estradiol, and testosterone)
  • Serum HCG (pregnancy test)

If you are not trying to get pregnant and you often get functional cysts, you can prevent them by taking hormone medications (such as birth control pills), which prevent follicles from growing.

Treatment

Functional ovarian cysts usually don’t need treatment. They usually disappear within 8 – 12 weeks without treatment.

Birth control pills (oral contraceptives) may be prescribed for 4 – 6 weeks. Longer term use may decrease the development of new ovarian cysts. Birth control pills do not decrease the size of current cysts, which often will go away on their own.

Surgery to remove the cyst or ovary may be needed to make sure there are no cancer cells. Surgery is more likely to be needed for:

  1. Complex ovarian cysts that don’t go away
  2. Cysts that are causing symptoms and do not go away
  3. Simple ovarian cysts that are larger than 5 – 10 centimeters
  4. Women who are menopausal or near menopause

Types of surgery for ovarian cysts include:

Exploratory laparotomy
Pelvic laparoscopy to remove the cyst or the ovary

The doctor may recommend other treatments if a disorder, such as polycystic ovary disease, is causing the ovarian cysts.

Any Chance That An Ovarian Cyst Could Be Cancerous?

Yes, there’s a small chance that a cyst could be ovarian cancer. And like many other cancers, your risk does increase with age. (About half of the women who develop it are older than 63. Each year, about 21,000 women receive this diagnosis, according to the American Cancer Society. It’s also the fifth cause of cancer deaths in women.

If your doctor is trying to determine whether your cyst is cancerous, she’ll probably do an ultrasound first. That test won’t definitively prove the mass is, in fact, cancer, but it can help your MD determine whether it’s filled with fluid (a functional cyst) or whether it’s solid (possibly a tumor).

A woman’s ovaries are two small organs that are the part of her reproductive system that produces eggs and female sex hormones. Ovarian cysts are fluid-filled sacs that develop in, or on the surface of, the ovaries. They are common before the menopause with about seven in 100 women worldwide getting one at some point in their life.

Ovarian cysts are usually benign, which means they aren’t cancerous.

Patrick Fynn

Patrick Fynn is the moderator and author of the Medical Practitioners forum.

3 thoughts on “Ovarian Cysts

  • December 11, 2015 at 8:20 am
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    Hi..is there an exact treatment ..

    Reply
  • December 11, 2015 at 2:22 pm
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    Please can you elaborate on the treatment?

    Reply
  • December 11, 2015 at 6:05 pm
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    I know abt the surgery and the contraceptives.But I think if detected early there can be help.I stand to be corrected

    Reply

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