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Cysts are fluid-filled sacs that can form in the ovaries. They are very common in women, especially during the childbearing years. Often they form during the process of ovulation. It can happen when the egg is not released or when the sac follicle holding the egg doesn’t dissolve after the egg is released. Ovarian cysts usually cause no symptoms and dissolve on their own. They can, though, create a dull ache or a sharp pain if one twists or ruptures.
Causes of Ovarian cysts
Each month during your menstrual cycle, a follicle grows on your ovary. The follicle is where an egg is developing. Most months, an egg is released from this follicle, called ovulation. If the follicle fails to break open and release an egg, the fluid stays in the follicle and forms a cyst. This is called a follicular cyst.
Another type of cyst occurs after an egg has been released from a follicle. This is called a corpus luteum cyst. This type of cyst often contains a small amount of blood.
Ovarian cysts are more common in the childbearing years between puberty and menopause. The condition is less common after menopause.
Taking fertility drugs can cause a condition in which multiple large cysts are formed on the ovaries. This is called ovarian hyperstimulation syndrome. The cysts most often go away after a woman’s period, or after a pregnancy.
Functional ovarian cysts are not the same as ovarian tumors, or cysts due to hormone-related conditions such as polycystic ovary syndrome.
Symptoms of Ovarian cysts
Ovarian cysts often cause no symptoms. When symptoms occur, they are typically pain or a late period.
An ovarian cyst is more likely to cause pain if it:
- Becomes large
- Breaks open
- Interferes with the blood supply to the ovary
- Is bumped during sexual intercourse
- Is twisted or causes twisting (torsion) of the Fallopian tube
Symptoms of ovarian cysts can include:
- Bloating or swelling in the abdomen
- Pain during bowel movements
- Pain in the pelvis shortly before or after beginning a menstrual period
- Pain with intercourse or pelvic pain during movement
- Pelvic pain — constant, dull aching
- Sudden and severe pelvic pain, often with nausea and vomiting, may be a sign of torsion or twisting of the ovary on its blood supply, or rupture of a cyst with internal bleeding
Changes in menstrual periods are not common with follicular cysts, and are more common with corpus luteum cysts. Spotting or bleeding may occur with some cysts.
Different types of Ovarian cysts
The most common types of ovarian cysts (called functional cysts) form during the menstrual cycle. They are usually benign (not cancerous).
The two most common types of cysts are:
- Follicle cysts. In a normal menstrual cycle, the ovaries release an egg each month. The egg grows inside a tiny sac called a follicle. When the egg matures, the follicle breaks open to release the egg. Follicle cysts form when the follicle doesn’t break open to release the egg. This causes the follicle to continue growing into a cyst. Follicle cysts often have no symptoms and go away in one to three months.
- Corpus luteum cysts. Once the follicle breaks open and releases the egg, the empty follicle sac shrinks into a mass of cells called corpus luteum. Corpus luteum makes hormones to prepare for the next egg for the next menstrual cycle. Corpus luteum cysts form if the sac doesn’t shrink. Instead, the sac reseals itself after the egg is released, and then fluid builds up inside. Most corpus luteum cysts go away after a few weeks. But, they can grow to almost four inches wide. They also may bleed or twist the ovary and cause pain. Some medicines used to cause ovulation can raise the risk of getting these cysts.
Other types of benign ovarian cysts are less common:
- Endometriomas are caused by endometriosis. Endometriosis happens when the lining of the uterus (womb) grows outside of the uterus.
- Dermoids come from cells present from birth and do not usually cause symptoms.
- Cystadenomas are filled with watery fluid and can sometimes grow large.
In some women, the ovaries make many small cysts. This is called polycystic ovary syndrome (PCOS). PCOS can cause problems with the ovaries and with getting pregnant.
Malignant (cancerous) cysts are rare. They are more common in older women. Cancerous cysts are ovarian cancer. For this reason, ovarian cysts should be checked by your doctor. Most ovarian cysts are not cancerous.
Treatment for Ovarian cysts
Functional ovarian cysts often do not need treatment. They often go away on their own within 8 – 12 weeks.
If you have frequent cysts, your doctor or nurse may prescribe birth control pills (oral contraceptives). These medicines may reduce the risk of new ovarian cysts. Birth control pills do not decrease the size of current cysts.
Surgery to remove the cyst or ovary may be needed to make sure that it is not ovarian cancer. Surgery is more likely to be needed for:
- Complex ovarian cysts that do not go away
- Cysts that are causing symptoms and do not go away
- Simple ovarian cysts that are larger than 10 centimeters
- Women who are near menopause or past menopause
Types of surgery for ovarian cysts include:
- Exploratory laparotomy
- Pelvic laparoscopy to remove the cyst or the ovary
You may need other treatments if you have polycystic ovary syndrome or another disorder that can cause cysts.
Possible Complications of Ovarian cysts
Complications have to do with the condition causing the cysts. Complications can occur with cysts that:
- Break open
- Show signs of changes that could be cancer
Can Ovarian cysts be Prevented?
No, you cannot prevent functional ovarian cysts if you are ovulating. If you get ovarian cysts often, your doctor may prescribe hormonal birth control to stop you from ovulating. This will help lower your risk of getting new cysts.