Ovarian Cysts: Causes, Symptoms, and How They Are Treated
Ovarian cysts are fluid-filled sacs that develop on or inside an ovary. Most women will have at least one cyst during their lifetime, often without even knowing it. While most ovarian cysts are harmless and resolve on their own, some can cause symptoms or lead to complications that need medical attention.
What Are Ovarian Cysts?
Ovarian cysts are especially common during a woman’s reproductive years. They can develop for different reasons, but the majority are related to the menstrual cycle. These are known as functional cysts and usually disappear within a few weeks.
Other types of ovarian cysts include:
• Dermoid cysts: These contain different types of tissue, such as hair, skin, or even teeth, because they form from embryonic cells.
• Cystadenomas: These grow on the surface of an ovary and are filled with watery or mucous fluid.
• Endometriomas: These result from endometriosis, when uterine-like tissue grows outside the uterus and attaches to the ovary.
Most cysts are non-cancerous (benign), but regular monitoring helps catch any potential problems early.
Common Symptoms and When to See a Doctor
Many ovarian cysts are “silent” and go unnoticed. But larger cysts or those that rupture or twist the ovary (ovarian torsion) can cause noticeable symptoms.
Common signs include:
• Pelvic pain, especially on one side
• Bloating or a feeling of fullness in the abdomen
• Pain during or after sex
• Irregular menstrual periods
• Difficulty emptying your bladder or frequent urination
If you experience sudden, sharp pelvic pain, fever, nausea, or vomiting, you should seek immediate medical attention. These may be signs of a ruptured cyst or ovarian torsion, which are emergencies.
Simple vs Complex Ovarian Cysts
Understanding the type of cyst can guide treatment decisions:
• Simple cysts: Typically fluid-filled and small, these are rarely cancerous and often resolve on their own.
• Complex cysts: May contain solid areas, blood, or septations (dividers within the cyst) and require closer evaluation.
Your doctor may use pelvic ultrasound to assess the size, appearance, and characteristics of the cyst. This helps determine if it needs further monitoring or removal.
Diagnosis and Monitoring
If an ovarian cyst is suspected, the following steps may be taken:
• Pelvic ultrasound: This non-invasive test gives a clear image of the ovaries and helps identify the size and type of cyst
• Blood tests: These may include CA-125, a marker that can be elevated in ovarian cancer, particularly in postmenopausal women.
• Physical exam: A pelvic exam may reveal an enlarged ovary or abnormal masses.
• Repeat imaging: If the cyst is small and looks benign, your doctor may recommend a follow-up scan in a few weeks or months.
In most cases, monitoring is all that’s needed. But if symptoms worsen or the cyst grows, further steps are taken.
Treatment Options (Medication to Surgery)
Your treatment plan will depend on your age, the type and size of the cyst, and whether you have symptoms.
Watchful Waiting
If you’re not in pain and the cyst looks simple and small, your doctor may suggest monitoring it with repeat ultrasounds. Many cysts resolve without intervention.
Medications
Hormonal contraceptives (like birth control pills) can help regulate your cycle and may prevent the formation of new functional cysts. However, they won’t shrink existing cysts.
Surgery
Surgical treatment is considered when:
• The cyst is large or growing
• It causes significant symptoms
• There’s a suspicion of cancer
Two main surgical methods include:
• Laparoscopy: A minimally invasive option using small incisions, usually for smaller, benign cysts.
• Laparotomy: An open surgery used for larger or possibly cancerous cysts, allowing more thorough removal and examination.
In some cases, only the cyst is removed (cystectomy), while in others, the entire ovary may need to be removed (oophorectomy), especially if malignancy is suspected.
Key Takeaways About Ovarian Cysts
Ovarian cysts are common, and in most cases, they are not cause for alarm. Still, it’s important to pay attention to symptoms and follow up with your doctor if something feels off.
Consult Dr JJ Chee if you’re experiencing pelvic pain, bloating, or irregular periods.
FAQs
Do ovarian cysts affect pregnancy?
Most ovarian cysts do not affect pregnancy and often resolve on their own. However, larger cysts or certain types of cysts may require monitoring during pregnancy to reduce the risk of complications such as ovarian torsion or rupture.
Are ovarian cysts common after menopause?
Ovarian cysts are less common after menopause than during the reproductive years. Because the risk of ovarian cancer increases with age, ovarian cysts found after menopause usually require further assessment to determine the appropriate management.
Can ovarian cysts come back after treatment?
Yes. Some women may develop new ovarian cysts after a previous cyst has resolved or been removed, particularly during their reproductive years. If cysts recur frequently or cause persistent symptoms, your gynaecologist may recommend further assessment to identify any underlying condition and discuss long-term management.