Ovarian Cysts

What is an Ovarian Cyst?

Ovarian cysts are little sacs of fluid or other tissue that forms on or in a woman’s ovary. Each woman has 2 ovaries, on each side of her low­er belly. In women who are having their monthly period, the ovaries release an egg about once a month. Ovarian cysts are quite common, even expected, in women during their childbearing years. During childbearing years, cysts most often are due to ovulation. The egg is contained in this cyst and is release at ovulation.

A woman can develop one cyst or many cysts. Ovarian cysts can vary in size in most cases; cysts are harmless and go away on their own. In other cases, they may cause problems and need treatment.

Ovarian cysts can cause pain or a feeling of pressure in the belly. Or women might not feel them at all. Many women worry about cancer when they learn they have cysts. But most of the time, cysts are not cancer.
What are the Symptoms of Ovarian Cysts?

Most ovarian cysts are small and do not cause symptom. Some cysts may cause a dull or sharp ache in the abdomen and pain during certain activities, or during ovulation. Larger cysts may cause, but rarely, torsion (twisting) of the ovary that causes pain. Some cysts that bleed or rupture (burst) may lead to serious problems requiring prompt treatment.
What Causes Ovarian Cysts?

There are many possible causes of ovarian cysts. The most common causes include:

  • Ovulation or pregnancy—ovulation is when an egg is released from the ovary each month. For this to happen, the ovary grows a sac, called a follicle. Sometimes, a follicle grows but does not release an egg and instead forms a cyst. Or, if a woman gets pregnant after the egg is released, a cyst can stay on the ovary for weeks or months. These kinds of cysts are not harmful and usually go away on their own.
  • Dermoid cysts—these are a common type of cyst. They sometimes have teeth, hair, or fat in them. Dermoid cysts are normally not harmful to your health, but your provider might want to remove them with surgery
  • Polycystic Ovary Syndrome (PCOS)—in women with this con­dition, the ovary grows many small cysts, instead of one big follicle that goes away each month. These cysts usually do not go away but the cysts themselves do not need to be treated or removed. PCOS does sometimes require treatment for reasons unrelated to the cysts.
  • Endometriosis—a condition where tissue normal found in a woman’s uterus grows outside of the uterus. Endometriosis can also form cysts on the ovary, called an endometrioma or “chocolate cyst”.
  • Cancer—this is the cause of ovarian cysts in less than 1 in 100 cases. Ovarian cancer is most likely to affect older women who have been through menopause (no longer have a monthly period) or who have a family history of ovarian cancer.

How are Ovarian Cysts Diagnosed?

Ovarian cysts may be found during a routine pelvic exam. If your health care provider finds an enlarged ovary, tests may be recom­mended to provide more information:

  • Vaginal ultrasound—this procedure uses sound waves to create pictures of the internal organs that can be viewed on a screen. For this test, a slender instrument (transducer) is placed in the vagina. The views created by the sound waves show the shape, size, location, and makeup of the cysts; this will not tell us exactly what the cyst is caused by, but it will often give us a very strong indication.
  • Laparoscopy—in this type of surgery, a laparoscope (a thin tube with a camera) is inserted into the abdomen to view the pelvic organs. Laparoscopy can also be used to treat cysts.
  • Blood tests—if you are past menopause, in addition to an ultrasound exam, you may be given a test that measures the amount of a substance called CA 125 in your blood. An in­creased CA 125 level may be a sign of ovarian cancer in women past menopause. In premenopausal women, an increased CA 125 level can be caused by many other conditions besides cancer. Therefore, this test is not a good indicator of ovarian cancer in premenopausal women.

How are Ovarian Cysts Treated?

Treatment depends on what is causing your cysts and what your symptoms are. Possible treatments include:

  • Waiting—your provider might want to do an ultrasound every couple of months. Your cysts might stay the same size, get smaller, or even go away. In those cases, you usually don’t need to do anything to treat them.
  • Hormonal contraception—this medicine can stop some types of new cysts from growing.
  • Surgery—removal of a cyst of the whole ovary, often done laparoscopically.

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