|What Are Ovarian Cysts?
An ovarian cyst is an abnormal sac filled with fluid, rather like a blister, that forms on or inside the ovary. There are two ovaries in the female body, one situated on each side of the womb, attached to the end of the fallopian tubes. The ovaries are the place where eggs are produced ready for fertilization and the sex hormones estrogen and progesterone are created. Cysts can develop in one or both ovaries, in women of all ages, and can grow to the size of an orange or larger. Although most cysts remain harmlessly undiagnosed, occasionally they cause severe pelvic pain, particularly if they become large or if they twist and rupture. There are a few different types of cysts which form in the ovaries. The most common type is called functional cysts which occur during a woman's menstruation cycle. Cysts, (except for functional cysts), can be caused by cancer or hormone-related conditions like polycystic ovary syndrome (PCOS) and endometriosis. All types of cysts are more common during a woman's reproductive years and less common after menopause.
What Types Are There?
All women naturally have cysts in their ovaries. They are the sacs in which eggs are matured, and then during ovulation the sac ruptures and the egg is released. However sometimes this process doesn't quite work correctly. Functional ovarian cysts are closely linked to the menstrual cycle. There are two types of functional cysts: follicle and corpus luteum. Follicle cysts form when the ovary follicles (the sacs/cavities in which the egg develop) do not rupture as normal during ovulation but rather continue to grow and swell. Corpus luteum cysts are formed when the eggs are released from their sacs, but instead of dissolving, the sacs seal off and fluid builds up inside. Most functional cysts disappear naturally after a few weeks.
Endometriosis is a condition where the cells (endometrial cells) that line the inside of the uterus attach themselves to other areas of the body and grow. Endometrial cells are shed every month during menstruation, and when some, instead of being flushed out through the vagina, attach themselves to other tissues and organs like the fallopian tube or pelvis, endometriosis develops. If they attach to the ovaries they are called endometriomas cysts (image). Here they form into blood filled cysts which can induce painful periods (dysmenorrhea), cramps and even infertility. Endometriosis tend to cause the worst pain out of all the different types of ovary cysts.
Occasionally a woman will develop lots of tiny follicle cysts on the ovaries. This is known as polycystic ovaries ('poly' meaning many). If it is accompanied by other symptoms like excessive facial hair and irregular periods, you may be diagnosed with polycystic ovary syndrome. Note, it is possible to have multiple ovarian cysts without having PCOS. For a PCOS diagnosis, you need to display several characteristic PCOS symptoms, not just multiple cysts. See also, what is the difference between ovarian cysts and PCOS?
Common in young women, dermoid cysts (teratomas - image) are fatty cells which contain clumps of hair, bone and even teeth. They are not thought to result from a pregnancy but from the woman's own cells, which are stimulated to grow in this way for unknown reasons. Normally benign (non cancer forming) they can become large causing pain.
Ovarian Cystadenomas Cysts
These are a rare form of functional cysts. They differ in that they can grow quite large and may need surgery to treat. In rare cases cystadenomas cysts can become cancerous.
Who Develops Ovarian Cysts?
The most common type of cyst, functional cysts, can only occur in premenopausal women as they form during the menstruation cycle. Outside of this, there are no other known risk factors. Using oral contraceptives however is known to be a reverse risk. Women who take birth control pills rarely develop functional cysts (see also, does the coil increase the risk of ovarian cysts?). Cystadenomas cysts are more common in women with a family history of ovarian cancer.
What Are The Symptoms?
Ovarian cysts often cause no symptoms and may only be discovered by chance. Where symptoms do occur it generally reflects the size and location of the cyst or growth, rather than the specific type of cyst. Possible symptoms include:
• Irregular periods, typically heavy periods (menorrhagia) or missed periods (amenorrhea).
• Pelvic pain, particularly if cysts become twisted or ruptured.
• Menstruation-like cramps.
• Painful intercourse.
• Bloated stomach.
• Nausea or vomiting.
• Pain in the shoulder.
For more detail: Symptoms of ovarian cysts
Can ovarian cysts cause infertility?: Fertility issues.
Can ovarian cysts cause a missed period?: Changes in menstrual cycles.
What type of pain do ovarian cysts cause?: Describing your symptoms.
How Are They Diagnosed?
Most women only discover they have cysts by chance when they have a routine pelvic exam or have an ultrasound for a different reason. Diagnosis takes into account a woman’s age, medical and family history and symptoms. The doctor may carry out a blood test to check hormone levels and CA125 (to rule out ovarian cancer). An ultrasound (sonography), either transabdominal or transvaginal can be carried out to determine exact location of cysts.
How Are They Treated?
Functional Cysts in premenopausal women often requires no immediate treatment unless the cysts are unusually large or there is severe pelvic pain. If the cysts remain after 2 menstruation cycles the woman may be prescribed an oral contraceptive to see if this suppresses the cysts. If this does not work, and cysts rupture or cause pain, they can be removed by a surgical procedure called a cystectomy.
Although they are considered harmless, dermoid cysts are usually surgically removed. See also, do ovarian cysts usually need to be surgically removed?
As some ovarian cystadenomas can become cancerous, they are usually surgically removed as a precaution. See also, natural treatment for ovarian cysts.
Treatment for ovarian cysts.
Can They Be Prevented?
The only established way to prevent ovarian cysts seems to be to take contraceptive pills. Obviously though, this is not an option for women trying for a baby. An annual pelvic exam will ensure early detection which reduces complications at a later stage.
Ovarian Cysts After Menopause
A recent study showed that ovarian cysts are much more common postmenopause than previously suspected. Fortunately the vast majority of cases turn out to be benign non-cancerous cysts. However, as the risk of ovarian cancer increases with age, any growth or cyst in the ovary after menopause should be checked by ultrasound immediately. A CA125 blood test is also usually performed. Where results confirm benign cysts, a woman should still be monitored periodically to detect any changes.
Interesting Research: Medical Costs for Women
Based on a 3 year study from the Medical Expenditure Panel Survey (2000-02), 21 percent of women received medical care for a specific female condition in the previous 12 months, including problems to do with ovarian cysts during pregnancy and menopause symptoms. On average women spent $483 a year on menopausal disorders and $3,896 on female cancers.