Ovarian Cysts: Causes, Symptoms, Diagnosis, Treatment, and Prevention
An ovarian cyst is a fluid-filled sac inside or on the ovaries, which produce eggs and hormones. Ovarian cysts are very common and usually harmless, but they sometimes cause pain, bleeding, or other problems.
Causes of Ovarian Cysts
Most ovarian cysts are functional cysts, which form during the menstrual cycle as a result of ovulation. Two types of functional cysts exist:
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Follicular cysts: These form when the egg is not released from the follicle (a small sac in the ovary) and the follicle fills with fluid instead.
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Corpus luteum cysts: These form when the follicle releases the egg and then becomes a hormone-producing structure called the corpus luteum. Sometimes, fluid accumulates inside the corpus luteum and forms a cyst.
Other types of ovarian cysts are not related to the menstrual cycle and may be associated with certain conditions or diseases. They include:
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Dermoid cysts: These are sac-like growths that contain hair, fat, and other tissue. They are formed from cells that can develop into different types of tissue.
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Endometriomas: These are cysts that contain blood and tissue from the lining of the uterus (endometrium). They are caused by endometriosis, a condition where endometrial tissue grows outside the uterus.
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Cystadenomas: These are cysts that develop on the surface of the ovary and may be filled with watery or mucous-like fluid.
It is possible to have polycystic ovary syndrome (PCOS), which causes many small cysts to form on the ovaries. PCOS can affect hormone levels, ovulation, and fertility.
Symptoms of Ovarian Cysts
Many ovarian cysts do not cause any symptoms and go away on their own. However, some cysts may grow large or rupture (burst) and cause symptoms such as:
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Abdominal pain or bloating
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Pelvic pain before or during the menstrual cycle
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Painful intercourse
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Painful bowel movements
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Nausea or vomiting
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Irregular periods or spotting
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Difficulty getting pregnant
Some symptoms may indicate a serious complication that requires immediate medical attention. These include:
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Sudden, severe abdominal or pelvic pain
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Fever
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Dizziness or fainting
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Rapid breathing or heartbeat
These symptoms may be caused by a ruptured cyst, a twisted ovary (torsion), or an infection.
Diagnosis of Ovarian Cysts
Ovarian cysts are often diagnosed during a routine pelvic exam or an imaging test such as an ultrasound, CT scan, or MRI. Your doctor may also order blood tests to check your hormone levels and rule out pregnancy or cancer.
In order to diagnose PCOS, your doctor may ask you about your medical history, your menstrual cycle, and your symptoms. You may also need blood tests to measure hormone levels and glucose levels. An ultrasound can be used to look for multiple cysts on your ovaries.
Treatment of Ovarian Cysts
Some possible treatments for ovarian cysts depend on the type, size, and symptoms of the cysts, your age, and your desire to have children.
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It is often recommended for functional cysts that are small and do not cause symptoms to undergo regular exams and imaging tests in order to see if they grow or disappear over time.
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Birth control pills and other hormonal drugs may be prescribed to prevent ovulation and reduce cyst formation. In addition to regulating your periods and reducing pain, they may also improve insulin resistance and ovulation in PCOS patients. Metformin (an anti-diabetic drug) and clomiphene (an anti-fertility drug) may be used to treat PCOS.
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It may be necessary to remove cysts if they are large, persistent, symptomatic, or suspicious of cancer. The type of surgery depends on the location and extent of the cysts. In some cases, only the cyst is removed (cystectomy), while in others, all or part of the ovary is removed (oophorectomy). In the case of a bilateral oophorectomy, you will be unable to conceive and enter menopause.
Prevention of Ovarian Cysts
There is no sure way to prevent ovarian cysts from forming, but you may be able to reduce your risk by:
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Taking birth control pills or other hormonal medications as prescribed by your doctor
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Maintaining a healthy weight and lifestyle
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Managing chronic conditions such as diabetes or endometriosis
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Having regular pelvic exams and reporting any changes or symptoms to your doctor
There are usually no problems associated with ovarian cysts, but sometimes they can cause problems that require treatment. If you have any questions or concerns about ovarian cysts, talk to your doctor. The doctor can help you understand your condition and recommend the best course of action.
