Ovarian Cysts

Ovarian cysts are growths that form on the ovaries, the two small organs on either side of a woman's uterus that produce an egg each month. Ovarian cysts are very common in women during their reproductive years. Some types of ovarian cysts are normal and usually harmless, often going away without any treatment. Other cysts are abnormal and may cause problems.

Since ovarian cysts are often first found during a pelvic, it is important to have regular checkups by your doctor. This is especially important if you have symptoms of ovarian cysts, if you have had abnormal ovarian cysts before, or if you are over age 40, when the risk of ovarian cancer is greater. If ovarian cysts are found early, many of the problems caused by them can be prevented.

Types and Causes of Ovarian Cysts
A cyst is a fluid-filled sac, similar to a blister. Some cysts are formed as a result of the normal process of ovulation-the monthly release of an egg from an ovary. Cysts that are abnormal often occur as the result of an imbalance in the female hormones estrogen and progesterone, which are produced in the ovaries.

Functional Cysts
The most common type of ovarian cyst is called a functional cyst. It is formed from a cystlike structure normally produced in an ovary during the course of ovulation (see figure). If this structure doesn't go through its normal cycle and eventually dissolve, a functional cyst may be formed. Functional cysts usually don't cause symptoms or require treatment. Normally they stop growing, shrink, an disappear within one, or at the most three, menstrual cycles. These cysts are common in women who menstruate, but they are rare in women who have reached menopause, when menstrual periods end, because more eggs are being produced.

Other Types of Cysts

Functional cysts are normal and must be distinguished from abnormal cysts by a doctor. These other, abnormal ovarian cysts are more likely to cause problems and usually require treatment:

• Dermoid: A cystic growth filled with various types of tissue, such as hair and skin tissue
• Cystadenoma: Cysts that develop from cells on the outer surface of the ovary
• Endometrioma: A cyst formed when tissue similar to that lining the uterus is attached to the ovaries, a condition known as endometriosis; sometimes called endometrial cysts or chocolate cysts (because of the dark, reddish-brown blood inside the cyst)
• Polycystic ovarian disease: A buildup of follicle cysts that causes the ovaries to become enlarged and form a thick outer covering, preventing ovulation.

Symptoms

Although most ovarian cysts don't cause any symptoms, when symptoms do occur there may be a dull ache or a sense of pressure or fullness in the abdomen. Ovarian cysts may cause pain during intercourse or at other times. Severe pain sometimes requires hospitalization. Pain or pressure may be caused by a number of factors:

• A cyst bleeding or breaking open, irritating the tissues inside the abdomen
• The large size of a cyst
• Torsion (twisting of a cyst), which blocks blood flow to the cyst

Delayed, irregular, or unusually painful periods may also be a symptom of ovarian cysts. Enlargement or swelling of the lower abdomen is another possible symptom of ovarian cysts.

Diagnosis
Ovarian cysts are often first found during a pelvic exam performed routinely, as a regular part of a woman's health care, or for some other unrelated reason. Through a pelvic exam , a cyst can be found before it becomes so large that it ruptures or undergoes torsion, causing pain or other symptoms. If your doctor detects what may be an abnormal ovarian growth during a pelvic , other tests may be performed to confirm the diagnosis.

Treatment
Treatment of ovarian cysts will depend on several factors, including the size and type of the cyst, the woman's age and overall state of health, her plans to have children, and whether she is having any symptoms. If a cyst is found early, less extensive treatment may be needed.

If a young woman has a small cyst that is not causing any symptoms, a doctor may decide to wait two or three menstrual cycles before treating it to see if it goes away. Most functional cysts will go away without any treatment after 1-3 months.

In some cases a doctor may prescribe hormones (such as birth control pills) to "shrink" the cysts. Since oral contraceptives prevent ovulation, functional cysts are very rare in women taking the pill. Although the pill does not prevent other types of benign cysts, it does offer some protection against malignant, or cancerous, ovarian cysts. The chances of new cysts forming are also decreased when oral contraceptives are taken, because ovulation is prevented.

Some types of ovarian cysts don't respond well to treatment with oral contraceptives. In these cases surgery may be needed to remove the cysts.

Source: Patient education material from the American College of Obstetrics and Gynecology was used as a source of information to develop the content for this topic.

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