What are ovarian cysts?
The ovaries are two small organs located on either side of the uterus in a woman’s body. They make hormones, including estrogen, which trigger menstruation. Every month, the ovaries release a tiny egg. The egg makes its way down the fallopian tube to potentially be fertilized. This cycle of egg release is called ovulation.
Ovarian cysts are fluid-filled sacs or pockets within or on the surface of an ovary. Many women have ovarian cysts at some time during their lives. Most ovarian cysts present little or no discomfort and are harmless. The majority of ovarian cysts disappear without treatment within a few months.
What are ovarian cyst causes?
Cysts are fluid-filled sacs that can form in the ovaries. They are very common. They are particularly common during the childbearing years.
There are several different types of ovarian cysts. The most common is a functional cyst. It forms during ovulation. That formation happens when either the egg is not released or the sac -- follicle -- in which the egg forms does not dissolve after the egg is released.
Other types of cysts include:
Polycystic ovaries. In polycystic ovary syndrome (PCOS), the follicles in which the eggs normally mature fail to open and cysts form.
Endometriomas. In women with endometriosis, tissue from the lining of the uterus grows in other areas of the body. This includes the ovaries. It can be very painful and can affect fertility.
Cystadenomas. These cysts form out of cells on the surface of the ovary. They are often fluid-filled.
Dermoid cysts. This type of cyst contains tissue similar to that in other parts of the body. That includes skin, hair, and teeth.
What are ovarian cyst symptoms?
Small ovarian cysts can bring no symptoms at all. A large ovarian cyst can cause abdominal discomfort.
The symptoms of ovarian cysts, if present, may include:
- Menstrual irregularities
- Pelvic pain - a constant or intermittent dull ache that may radiate to your lower back and thighs
- Pelvic pain shortly before your period begins or just before it ends
- Pelvic pain during intercourse (dyspareunia)
- Pain during bowel movements or pressure on your bowels
- Nausea, vomiting or breast tenderness similar to that experienced during pregnancy
- Fullness or heaviness in your abdomen
- Pressure on your rectum or bladder that causes a need to urinate more frequently or difficulty emptying your bladder completely
How is ovarian cyst diagnosed?
Sometimes ovarian cysts may be noticed by a health care practitioner during a bimanual examination of the pelvis. If a cyst is suspected based upon the symptoms of physical examination, imaging techniques are used. Most cysts are diagnosed by ultrasound, which is the best imaging technique for detecting ovarian cysts. Ultrasound is an imaging method that uses sound waves to produce an image of structures within the body. Ultrasound imaging is painless and causes no harm.
Cysts can also be detected with other imaging methods, such as CT scan or MRI scan (magnetic resonance imaging).
How is ovarian cyst treated?
Watchful waiting. If you have a cyst, you may be told to wait and have a second exam in 1 to 3 months. Your doctor will check to see if the ovarian cyst has changed in size. This is a common treatment option for women who:
- Are in their childbearing years
- Have no symptoms
- Have a fluid-filled cyst
- It may be an option for postmenopausal women.
Surgery. Your doctor may want to remove the cyst if you are postmenopausal, or if it:
- Doesn't go away after several menstrual cycles
- Gets larger
- Looks odd on the ultrasound
- Causes pain
The two main surgeries are:
- Laparoscopy – Done if the cyst is small and looks benign (noncancerous) on the ultrasound. While you are under general anesthesia, a very small cut is made above or below your navel. A small instrument that acts like a telescope is put into your abdomen. Then your doctor can remove the cyst.
- Laparotomy – Done if the cyst is large and may be cancerous. While you are under general anesthesia, larger incisions are made in the stomach to remove the cyst. The cyst is then tested for cancer. If it is cancerous, the doctor may need to take out the ovary and other tissues, like the uterus. If only one ovary is taken out, your body is still fertile and can still produce estrogen.
Birth control pills. If you keep forming functional cysts, your doctor may prescribe birth control pills to stop you from ovulating. If you don’t ovulate, you are less likely to form new cysts. You can also use Depo-Provera. It is a hormone that is injected into muscle. It prevents ovulation for 3 months at a time.
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