What are Ovarian Cysts?

Cysts are fluid-filled sacs that form in or on the ovary. Most of the cysts are harmless and do not cause any symptoms. However, at times they may lead to painful menstruation. Most of the cysts disappear on their own. They are very common during the childbearing years of a woman.

Causes of Ovarian Cysts

The causes of ovarian cysts depend on the type of cyst. Let us have a look at the types and understand the causes. Functional Cysts: These are one of the most common cysts that form during ovulation. These cysts occur when the egg is not released from the sac or when the egg sac does not dissolve after the egg is released. When the normal egg follicle does not stop growing, it forms a functional cyst. There are types of functional cysts: Follicular cysts: These cysts are formed in the absence of ovulation or when a follicle collapses. This cyst can rupture at times and lead to a lot of pain. This pain occurs during ovulation or middle of menstruation. Corpus luteum cysts: This is a cyst that may be filled with fluid or blood. It rarely produces any symptoms and may suddenly rupture. Thus, causing internal bleeding as well as sharp pain. Nonfunctional Cysts: Cysts that are not grouped under functional cysts are placed here. These cysts include some of the following: Polycystic ovaries: These cysts commonly called as polycystic ovary syndrome (PCOS) are formed when eggs fail to open. Endometriomas: When the tissue or endometrium lining the uterus starts growing on other organs including ovaries, leads to endometriomas. This is a very painful condition that causes fertility problems. Mature cystic teratomas: These are cysts that contain different types of body cells like teeth, bone, hair, etc. This happens as egg cells can develop into any type of cell. They usually disappear on their own when small in size. Cystadenomas: These cysts develop from the ovarian tissue and are filled with fluid.

Symptoms of Ovarian Cysts

Cysts are normally non-cancerous in nature and usually do not produce any symptoms. When they do lead to problems, the symptoms include:

Constant or intermittent pain in the lower abdomen Irregular menstruation cycle that is either heavier or lighter than normal periods Severe pain when the cyst bursts The cysts may twist on the stalk of the ovary it is growing on. This causes blockage of blood supply and severe pain Loss of appetite Severe weight gain

Painful sex Painful urination Bloating

Diagnosis of Ovarian Cysts

Ovarian cysts are usually detected by chance. They are observed during an abdominal examination or internal examination. Constant pain, heavy bleeding, etc. call for an ultrasound test. During this test, most of the cysts are detected.

Treatment for Ovarian Cysts

The treatment for ovarian cysts depends on the symptoms as well as patients age. The doctor may first wait and watch for a few months. The cysts may disappear on it's own with time. If it does not, the doctor may recommend birth control pills that reduce the occurrence of more cysts. Pain relievers may be offered to reduce the pain in the pelvic region. If the cysts are too large or continues to grow, the doctor may recommend cystectomy. In some cases, if the ovary has to be removed too, a procedure is carried out called oophorectomy. Cysts cannot be prevented, but most cysts go away on their own and are non-cancerous in nature. They are very common in women of childbearing age. If you have any doubts, speak to a gynecologist today.

An ovarian cyst is any collection of fluid, surrounded by a very thin wall, within an ovary.[1] Any ovarian follicle that is larger than about two centimeters is termed an ovarian cyst. Such cysts range in size from as small as a pea to larger than an orange. Most ovarian cysts are functional in nature and harmless (benign).[2][1] Ovarian cysts affect women of all ages. They occur most often, however, during a woman's childbearing years. Some ovarian cysts cause problems, such as bleeding and pain. Surgery may be required to remove cysts larger than 5 centimeters in diameter.

Contents
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1 Classification o 1.1 Functional cysts o 1.2 Non-functional cysts 2 Signs and symptoms

3 Diagnosis 4 Treatment 5 References

[edit] Classification
[edit] Functional cysts
Functional ovarian cysts are usually of one of two types:[3]

Follicular cyst, the most common type of ovarian cyst. Corpus luteum cyst they are of two types

[edit] Non-functional cysts

There are several other conditions affecting the ovary that are described as types of cysts, but are not usually grouped with the functional cysts. (Some of these are more commonly or more properly known by other names.) These include:

A polycystic-appearing ovary is diagnosed based on its enlarged size usually twice normal with small cysts present around the outside of the ovary. It can be found in "normal" women, and in women with endocrine disorders. An ultrasound is used to view the ovary in diagnosing the condition. Polycystic-appearing ovary is different from the polycystic ovarian syndrome, which includes other symptoms in addition to the presence of ovarian cysts. Chocolate cyst of ovary: An endometrioma, endometrioid cyst, endometrial cyst, or chocolate cyst is caused by endometriosis, and formed when a tiny patch of endometrial tissue (the mucous membrane that makes up the inner layer of the uterine wall) bleeds, sloughs off, becomes transplanted, and grows and enlarges inside the ovaries. Haemorrhagic ovarian cyst Dermoid cyst Ovarian serous cystadenoma Ovarian mucinous cystadenoma Paraovarian cyst Cystic adenofibroma Borderline tumoral cysts

[edit] Signs and symptoms

Some or all of the following symptoms[4][5] [6][7][8] may be present, though it is possible not to experience any symptoms:

Dull aching, or severe, sudden, and sharp pain or discomfort in the lower abdomen (one or both sides), pelvis, vagina, lower back, or thighs; pain may be constant or intermittentthis is the most common symptom Fullness, heaviness, pressure, swelling, or bloating in the abdomen Breast tenderness Pain during or shortly after beginning or end of menstrual period. Irregular periods, or abnormal uterine bleeding or spotting Change in frequency or ease of urination (such as inability to fully empty the bladder), or difficulty with bowel movements due to pressure on adjacent pelvic anatomy Weight gain Nausea or vomiting Fatigue Infertility Increased level of hair growth Increased facial hair or body hair Headaches Strange pains in ribs, which feel muscular Bloating Strange nodules that feel like bruises under the layer of skin

[edit] Diagnosis

A 2cm left ovarian cyst as seen on ultrasound

An Axial CT demonstrating a large hemorrhagic ovarian cyst. The cyst is delineated by the yellow bars with blood seen anteriorly.

A CT scan showing a 8.5 cm cyst in a 29 year old female. Ovarian cysts are usually diagnosed by either ultrasound or CT scan.

[edit] Treatment
About 95% of ovarian cysts are benign, meaning they are not cancerous.[9] Treatment for cysts depends on the size of the cyst and symptoms. Pain caused by ovarian cysts may be treated with:

Pain relievers, including acetaminophen/paracetamol (Tylenol or Panadol), nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin, Advil), or narcotic pain medicine (by prescription) may help reduce pelvic pain.[10] NSAIDs usually work best when taken at the first signs of the pain. A warm bath, or heating pad, or hot water bottle applied to the lower abdomen near the ovaries can relax tense muscles and relieve cramping, lessen discomfort, and stimulate circulation and healing in the ovaries.[11] Bags of ice covered with towels can be used alternately as cold treatments to increase local circulation.[12] Combined methods of hormonal contraception such as the combined oral contraceptive pill the hormones in the pills may regulate the menstrual cycle, prevent the formation of follicles that can turn into cysts, and possibly shrink an existing cyst. (American College of Obstetricians and Gynecologists, 1999c; Mayo Clinic, 2002e)[10]

Also, limiting strenuous activity may reduce the risk of cyst rupture or torsion. Cysts that persist beyond two or three menstrual cycles, or occur in post-menopausal women, may indicate more serious disease and should be investigated through ultrasonography and laparoscopy, especially in cases where family members have had ovarian cancer. Such cysts may require surgical biopsy. Additionally, a blood test may be taken before surgery to check for elevated CA-125, a tumor marker, which is often found in increased levels in ovarian cancer, although it can also be elevated by other conditions resulting in a large number of false positives.[13]

For more serious cases where cysts are large and persisting, doctors may suggest surgery. Some surgeries can be performed to successfully remove the cyst(s) without hurting the ovaries, while others may require removal of one or both ovaries.[