What are Ovarian Cysts?
Ovarian cysts are sacs filled with fluid that form inside or on the ovaries. Ovarian cysts are very common and often don't have any symptoms. They are usually harmless and may disappear without treatment.
Types of Ovarian Cysts
Functional cysts are the most common type of ovarian cyst, which are formed during the menstrual cycle. Functional cysts are usually benign. The two most common types of benign cysts include:
- Follicular Cysts: The follicle is the sac in which an egg grows and matures. Upon maturation, the follicle breaks and releases an egg every month. Follicle cysts form when the follicle does not break open to release the egg.
- Corpus Luteum Cysts: When the follicle sac does not dissolve after the egg is released, additional fluids accumulate inside the sac. This results in the formation of corpus luteum cysts.
Some women develop polycystic ovary syndrome, a condition in which the ovaries don’t ovulate properly and contain multiple tiny cysts. This condition is discussed separately as it is a different issue.
Malignant cysts are rare and are more common in older women.
Other causes of Ovarian Cysts
Common causes include:
- Dermoid cysts
- Severe pelvic infections
Symptoms of Ovarian Cysts
Most ovarian cysts don't cause any symptoms. If there are symptoms, they may include:
- Pain in the lower abdomen
Other less common symptoms include:
- Pelvic pain
- Pain in the lower back and thighs
- Trouble emptying the bladder completely
- Pain during sexual intercourse
- Weight gain
- Pain during your period
- Abnormal vaginal bleeding
- Breast tenderness
- Urinary urgency
Diagnosis of Ovarian Cysts
Your doctor may diagnose an ovarian cyst by performing a pelvic examination to identify a swelling on the ovaries. Additionally, ultrasound is usually ordered to help detect the location, shape, size, and mass of the cyst. A pregnancy test helps rule out pregnancy, and hormone levels are tested for any hormone-related problems. Your doctor may also order a “tumour marker” blood test to assess your risk of cancer; an elevated tumour marker does not necessarily mean you have cancer.
Treatment for Ovarian Cysts
You may just be monitored for your cyst with follow up ultrasound scans and blood tests. In many cases, ovarian cysts disappear without treatment. Oral contraceptive pills may be prescribed to stop ovulation and the formation of new cysts.
Surgery may be recommended when cysts do not go away on their own, cause symptoms or have concerning features. Your doctor may perform surgery to remove either the cyst, the entire ovary or both ovaries. Usually this is laparoscopic surgery; this procedure involves making a tiny incision near your navel and removing the cyst by inserting a small instrument into your abdomen.
Your doctor may perform a laparotomy for removing larger cysts by making a larger incision in your abdomen. If the cyst has features concerning for cancer, you may be referred to a Gynaecologic Oncology Surgeon for your treatment instead.