Ovarian Cysts

Overview

Ovarian cysts are sacs filled with fluid that develop in or on the surface of the ovaries. They are common and often harmless, with most cysts going away without treatment within a few months. However, sometimes they can cause discomfort, twisting, or bursting open, leading to serious symptoms. Dermoid cysts, cystadenomas, and endometriomas are other types of cysts that can occur in the ovary, and they may also cause complications like ovarian torsion.

Understanding the disease

Symptoms

Symptoms of ovarian cysts may include pelvic pain that may come and go, feeling a dull ache or sharp pain in the area below your bellybutton toward one side, fullness, pressure, or heaviness in your belly (abdomen), and bloating. If you have sudden, severe abdominal or pelvic pain, pain with fever or vomiting, or signs of shock like cold, clammy skin, rapid breathing, and lightheadedness or weakness, it's important to seek immediate medical help.

Risk Factors

Risk factors for developing ovarian cysts include hormonal problems, pregnancy, endometriosis, severe pelvic infection, and previous ovarian cysts.

Development

Ovarian cysts can develop in different ways, depending on their type. Here is a brief overview of how some common types of ovarian cysts form:

1. Functional cysts: These are the most common type of ovarian cysts. They develop during the menstrual cycle, usually when a follicle does not fully release an egg or when the follicle breaks open after releasing an egg. The follicle then transforms into a cyst, which can be either a follicular cyst or a corpus luteum cyst.
2. Dermoid cysts: Also known as teratomas, these cysts form from reproductive cells that make eggs in the ovary (germ cells). They can contain various tissues such as hair, skin, or teeth. Dermoid cysts are rare and are not cancerous.
3. Cystadenomas: These cysts develop from cells on the surface of the ovary. They might be filled with watery or mucous material and can grow quite large.
4. Endometriomas: These cysts form when cells similar to those that line the inside of the uterus grow outside the uterus, often attaching to the ovary. They are associated with the condition endometriosis. Ovarian cysts can sometimes twist or rupture, causing pain or other complications. Regular pelvic exams are important for early detection and management of ovarian cysts.

Assessment and Diagnosis

Triage

You should see a doctor if you experience sudden, severe abdominal or pelvic pain, pain with fever or vomiting, or signs of shock such as cold, clammy skin, rapid breathing, and lightheadedness or weakness. These symptoms may indicate a serious problem with the ovarian cyst.

Diagnosis

To diagnose ovarian cysts, your healthcare provider will likely recommend tests such as:

1. Pregnancy test: to rule out a positive test that could suggest an early pregnancy and corpus luteum cysts.
2. Pelvic ultrasound: uses sound waves to create an image of your uterus and ovaries, confirming the presence of a cyst, its location, and whether it's solid or filled with fluid.
3. Tumor marker tests: blood tests to measure levels of a protein called cancer antigen 125 (CA 125) can help determine if a solid cyst may be cancerous, particularly if you are at high risk for ovarian cancer.
4. Laparoscopy: a surgical procedure in which a slim, lighted instrument is inserted into your abdomen to examine your ovaries and any cysts present. This is usually done if the cyst is large or if there is a concern about cancer.
5. Endometrial biopsy: a tissue sample from the inside of your uterus is taken and examined for signs of cancer or precancer.
6. Ultrasound: an imaging method that uses sound waves to create pictures of your uterus, ovaries, and pelvis. These tests will help your healthcare provider determine the type, size, and location of the cyst, as well as whether further treatment is necessary.

Management and Treatment

Complications

Complications of ovarian cysts can include ovarian torsion, which can cause sudden, severe pelvic pain and nausea, as well as reduced or stopped blood flow to the ovary. Other potential complications may include rupture of the cyst, which can cause pain or bleeding, or the cyst becoming twisted or ruptured during pregnancy.

Home Remedies

It is important to consult a healthcare professional for proper diagnosis and treatment of ovarian cysts.

Treatment

Treatment options for ovarian cysts depend on factors such as age, cyst size, type, and symptoms. Your health care provider may recommend:

1. Watchful waiting: If you have no symptoms and the cyst is small and fluid-filled, your provider may suggest waiting and monitoring the situation with follow-up pelvic ultrasounds.
2. Medication: Hormonal contraceptives can help prevent new cysts from forming, but they won't shrink existing cysts.
3. Surgery: Your provider may recommend removing a large cyst, a cyst that's causing symptoms, or a cyst that doesn't appear to be functional. Cysts can be removed through minimally invasive laparoscopy or, in some cases, through open surgery. Preparing for your appointment, consider bringing a family member or friend for support. Before the appointment, make a list of your symptoms, medical history, and any questions for your health care provider.

Preparing for medical consultation

To prepare for an appointment for ovarian cysts, you should:

1. Make a list of your symptoms, including any that seem unrelated to the reason for the appointment, and when they began.
2. Compile a list of all medicines, vitamins, herbs, and other supplements you take and their dosages.
3. Gather information about your medical history, including any menstrual irregularities.
4. Prepare a list of questions to ask your healthcare provider, such as:
   • What's likely causing my symptoms?
   • What tests might I need?
   • Will my cyst go away on its own, or will I need treatment?
   • Do you have printed materials or brochures I can have? What websites do you recommend?
5. Consider bringing a family member or friend with you to the appointment for support and to help recall information later. Remember to stay involved in your usual activities when you can and discuss any concerns or questions with your healthcare provider during the appointment.