Ovarian Cyst

Overview

What is an ovarian cyst?

An ovarian cyst is a fluid-filled sac in or on a woman’s ovary. The ovaries are part of the female reproductive system. They produce a woman’s eggs and her female hormones.

Ovarian cysts are very common. They often occur when a woman ovulates. This is when the ovary releases an egg each month. These are called functional cysts. Most are noncancerous. Many times, these cysts go away on their own without treatment.

Symptoms

Often, functional cysts do not cause any symptoms. You may have one and not know it. Other times they can cause symptoms. These include:

  • Sharp or dull pain in the lower abdomen, usually on one side.
  • Bloating.
  • Menstrual irregularities.
  • Nausea and vomiting.
  • Feeling full after eating a small amount.
  • Constipation.

If you are menopausal and are not having periods, functional cysts shouldn’t form. But it is possible for other types of ovarian cysts to form. Call your doctor if you experience any of the symptoms of an ovarian cyst.

Causes & Risk Factors

What causes an ovarian cyst?

The most common causes of ovarian cysts include:

  • They can be caused by problems with your hormones. They can also be caused by hormone-based medicines that help you ovulate.
  • It is normal for an ovarian cyst to form during early pregnancy. It helps support the pregnancy until the placenta forms.
  • Women with a condition called endometriosis can develop a type of ovarian cyst called an endometrioma. This is when endometriosis tissue attaches to the ovary and forms a growth.
  • Pelvic infections. Severe infections can spread to the ovaries and cause cysts to form.
  • Polycystic ovary syndrome. This is a disease where the ovaries make many small cysts. It can cause problems with the ovaries and with getting pregnant.

Who gets ovarian cysts?

It is common for a woman with regular periods to develop an ovarian cyst. It is usually harmless and goes away on its own. They are less common after menopause. Women who have reached menopause and have an ovarian cyst are at higher risk for ovarian cancer.

Diagnosis & Tests

How is an ovarian cyst diagnosed?

Often times, your doctor will feel a cyst during a pelvic exam. If you do have a cyst, your doctor can do two things. One is to wait and watch to see if the cyst changes or starts causing symptoms. The other is to order tests to help plan treatment. What he or she chooses to do depends on several factors. These include your age and if you’re having symptoms.

If your doctor orders tests, he or she will probably want you to have a sonogram so they can look at the cyst. A sonogram uses sound waves to make pictures of organs in the body. With a sonogram, your doctor can see the size, shape, and location of the cyst, as well as if it is solid or filled with fluid.

Your doctor could also order other tests. These could include:

  • A pregnancy test to rule out pregnancy as the cause of the cyst.
  • Hormone level tests to see if you have problems with your hormones.
  • A CA-125 blood test to measure the amount of cancer-antigen 125 in your blood. If you are past menopause, your doctor may order this test to see if your cyst could be cancerous.

Treatment

Functional cysts normally shrink on their own over time, usually in about 1 to 3 months. If you have a functional cyst, your doctor may want to check you again in 1 to 3 months to make sure the cyst has gotten smaller or gone away completely. If you develop functional cysts often, your doctor may want you to take birth control pills or other hormonal birth control so you won’t ovulate. If you don’t ovulate, you won’t form functional cysts.

Do I need surgery for an ovarian cyst?

The treatment for ovarian cysts depends on several things. This includes your age, whether you are having periods, the size of the cyst, its appearance, and your symptoms.

You may need to have surgery if the cyst:

  • Doesn’t go away after several menstrual periods.
  • Gets larger.
  • Looks unusual on the sonogram.
  • Causes pain.

In addition, if you’re past menopause and have an ovarian cyst, your doctor will probably want you to have surgery. Ovarian cancer is rare, but women 50 to 70 years of age are at greater risk. Women who are diagnosed with cancer at an early stage do much better than women who are diagnosed later.

What type of surgery would I need?

There are 2 main ways surgery can be done on an ovarian cyst:

Laparoscopy. This type of surgery is done with a lighted instrument called a laparoscope that’s like a slender telescope. This is put into your abdomen through a small incision (cut) just above or just below your navel (belly button). With the laparoscope, your doctor can see your organs. Often the cyst can be removed through small incisions at the pubic hair line. If the cyst is small (about the size of a plum or smaller) and if it looks benign on the sonogram, your doctor may decide to do a laparoscopy.

Laparotomy. If the cyst looks too big to remove with a laparoscope or if it looks suspicious in any way, your doctor will probably do a laparotomy. This surgery uses a bigger cut to remove the cyst. The cyst is then tested for cancer. If it is cancerous, you may need to have the ovary and other tissues removed. This could include the fallopian tubes, the other ovary, or the uterus. It’s very important that you talk to your doctor about all of this before the surgery.

Your doctor will talk to you about the risks of each kind of surgery. He or she will tell you how long you are likely to be in the hospital and how long it will be before you can go back to your normal activities.

Prevention

Can an ovarian cyst be prevented or avoided?

If you are ovulating normally, there is nothing you can do to prevent a functional ovarian cyst from forming. If you get cysts frequently, your doctor may prescribe you hormonal birth control. This will stop you from ovulating and lower your chances of getting new cysts.

Living With an Ovarian Cyst

If you have an ovarian cyst, you can usually just wait for it to go away on its own in a few months. But sometimes cysts can break open, or rupture. This can cause a lot of pain and heavy bleeding. If you know you have an ovarian cyst and you experience any of the following symptoms, get medical help right away.

  • Sudden, severe abdominal pain.
  • Abdominal pain with fever and vomiting.
  • Faintness, dizziness, or weakness.
  • Rapid breathing.

Questions

  • Do I need a sonogram?
  • What kind of cyst do I have?
  • If it’s a functional cyst, do I need any treatment?
  • How will I know if my functional cyst is getting worse?
  • If I have another type of cyst, what are my treatment options? Will I need surgery?
  • Am I at risk of having another ovarian cyst in the future?
  • Can having ovarian cysts make it harder to get pregnant?