Ovarian Cysts

Ovarian cysts usually occur in women during reproductive years. The majority are benign, meaning that they do not contain cancer. If a cyst is discovered before puberty or after menopause, it has a higher probability of being cancerous.

Other, more common types of cysts occur throughout life and include:

• cystadenoma cysts, which develop from cells on the outer surface of the ovary
• dermoid cysts, which develop from the egg cells and may be filled with hair, mucus, and skin tissue
• endometriomal cysts, which are formed when tissue from the uterine lining attaches to the ovaries

Most ovarian cysts do not cause symptoms. They may be found during a routine pelvic exam. If symptoms do occur, they may include:

• delayed, irregular, or unusually painful periods
• dull abdominal aching
• an increase in facial or body hair
• irregular bowel or bladder function
• pain during exercise
• pain during intercourse
• a sense of pressure or fullness in the abdomen

If the cyst is twisted or has ruptured, symptoms may include:

• nausea and vomiting
• severe abdominal pain
• signs of shock from internal bleeding

Ovarian cysts are quite common. There are two types: functional and abnormal. Functional cysts develop as a part of the normal function of the ovary, or ovulation. Functional cysts are usually smaller than abnormal cysts. They generally go away without treatment. Most cysts are benign, that is, non-cancerous.

In general, ovarian cysts cannot be prevented.

Diagnosis of ovarian cysts begins with a history and physical exam, including a pelvic exam. The healthcare professional may order additional tests, including:

• pelvic ultrasound
• abdominal CT scan
• abdominal MRI
• diagnostic laparoscopy, in which a small tube is inserted into the abdomen
• X-ray of the urinary system

Functional cysts usually resolve without treatment. Some cysts may cause infertility, menstrual problems, and chronic pelvic pain. Cysts may become twisted, which can cut off their blood supply. This is considered an emergency, and surgery may be necessary to prevent gangrene of that ovary.

Occasionally, a cyst may turn out to be malignant. For this reason, all cysts must be evaluated carefully. Ovarian cancer is relatively uncommon, but tends to have no symptoms in the early stages and thus is frequently found only after it is too late to be treated successfully. Ovarian cancer is not common in women before menopause. Women who have an ovarian cyst between the ages of 50 to 70 are at a higher risk of having ovarian cancer.

Ovarian cysts are not contagious, and pose no risk to others.

Treatment options vary, depending on the woman's age and desire for children. The type, size, and age of the cyst are considered. Treatments include the following:

• oral birth control pills
• laparoscopy to drain fluid, remove the cyst, or remove the ovary
• laparotomy, a procedure in which an incision is made in the abdomen to remove the cyst

Oral contraceptives may cause nausea, bloating, and headaches. Surgery may cause bleeding, infection, or reactions to anesthesia.

The healthcare professional may recommend that the woman have more frequent pelvic exams for the first year after surgery, because certain cysts have a chance of returning.

The healthcare professional may recommend regular ultrasound exams to check for returning cysts. Any new or worsening symptoms should be reported.