Definition

The ovaries are organs in women that function to produce eggs every month, starting from puberty until menopause. Additionally, the ovaries produce sex hormones such as estrogen and progesterone.

The ovaries themselves are shaped like two almonds and are part of the female reproductive organs. The function of the ovaries can be disrupted, one cause being ovarian cysts. An ovarian cyst is a fluid-filled or semi-solid material sac that develops or grows in one or both ovaries.

Most ovarian cysts can disappear naturally within a few months without treatment and rarely cause complications. Ovarian cysts come in several types, most of which are harmless, cause no pain, and don't produce symptoms. You may not even know you have an ovarian cyst unless you undergo a pelvic examination or imaging test like an MRI.

The majority of ovarian cysts are functional cysts, which form as a response to changes in the body during the menstrual cycle. In rare cases, ovarian cysts form without being related to menstruation.

• Functional cysts or simple cysts: These are common ovarian cysts and are not related to any disease. They form as a result of ovulation (the release of an egg from the ovary) and may indicate that the ovaries are functioning normally. Functional cysts typically shrink over time within about 60 days without special treatment.
• Follicular Cyst: A follicle is a small sac in the ovary that releases an egg each month as part of the menstrual cycle. A follicular cyst forms when the follicle doesn't release the egg but instead fills with fluid and enlarges.
• Corpus Luteum Cyst: After the follicle releases an egg, a structure called the corpus luteum, which produces hormones, forms. A cyst can form when fluid accumulates in the corpus luteum, causing it to enlarge.

• Other Non-Menstrual Related Cysts: These cysts are not always indicative of disease, but doctors may want to monitor them to ensure they don't cause complications. These include:
• Cystadenomas: These form on the surface of the ovary and can contain thin, watery, or thick, mucus-like fluid.
• Dermoid Cysts (Teratomas): These cysts contain cells that can form various types of tissues found in the body, including skin, hair, teeth, and even brain tissue.
• Endometriomas: These cysts contain endometrial tissue, the same tissue that sheds during menstruation.
• Ovarian Cancer: Unlike other conditions, ovarian cancer involves solid masses of cancerous cells.

Causes

Ovarian cysts can be caused by the menstrual cycle, leading to functional cysts such as follicular cysts and corpus luteum cysts. Functional cysts are not dangerous, rarely cause pain, and usually disappear within two to three menstrual cycles. Other non-menstrual-related cysts can grow large and shift the ovary out of position (e.g., dermoid cysts and cystadenomas). These cysts can cause pain and may cut off blood flow to the ovary. Ovarian cysts typically occur between adolescence and menopause and are rare after menopause. In addition to the menstrual cycle, other causes of ovarian cysts include:

• Abnormal cell reproduction: Atypical reproductive cells can cause cysts like dermoid and cystadenomas
• Endometriosis
• Pelvic inflammatory disease

If you want to know more about pelvic inflammation, you can read it here: Pelvic Inflammatory Diseases - Definition, Cause, Symptoms, And Treatment.

Risk Factor

• Age. Ovarian cysts are more common if you have not yet reached menopause.
• Pregnancy. Ovarian cysts are more likely to form during pregnancy.
• Previous ovarian cysts
• Medical condition. If you have endometriosis, hormone issues, or take ovulation-inducing medications like clomiphene, you may be more likely to develop ovarian cysts.

Symptoms

Symptoms vary from person to person. You may not feel any pain, discomfort, or fullness; pain that can be described as sharp or dull; discomfort that comes and goes without explanation. Small cysts typically do not cause symptoms. In some cases, you may not even know you have a cyst. Larger cysts can cause:

• Lower back pain or dull pain in the lower back
• A feeling of bloating in the lower abdomen, causing one side to appear more prominent
• Pain during sexual intercourse (dyspareunia)
• Pain during menstruation

These symptoms could indicate Polycystic Ovary Syndrome (PCOS), which can cause abnormal menstrual cycles and other hormone-related issues, including obesity and infertility. Other symptoms of PCOS include excessive hair growth (hirsutism) and difficulty losing weight.

Diagnosis

Doctors will rule out pregnancy as the cause of your symptoms and then perform several tests for ovarian cysts:

• Pelvic examaniation: A doctor or healthcare provider will check your pelvis to detect changes or lumps.
• Ultrasound: This imaging test uses sound waves to create an image of the inside of your body. It can detect ovarian cysts, including their location and whether the cyst is fluid-filled or solid.
• Laparoscopy: This procedure involves inserting a camera through a small incision in your abdomen to view your reproductive organs and pelvic area. If a cyst is diagnosed, it can also be removed during this procedure.

Management

Treatment for ovarian cysts depends on several factors, including age, symptoms, and the cause of the cyst. Some treatment options include:

• Wait and see (Watchful Waiting)
• Functional cysts usually resolve without treatment. If your cyst is functional, your doctor may recommend a watchful waiting approach. You will be asked to have follow-up ultrasounds over several weeks or months to confirm that the cyst has resolved on its own.
• Ovarian cyst treatment
• Your doctor may prescribe hormone-containing medications (like birth control pills) to stop ovulation and prevent future cysts.
• Ovarian cyst surgery. If the cyst is causing symptoms and growing, you may need surgery to remove it. The type of surgery depends on the size of the cyst and its appearance on ultrasound. Some procedures include:
• Laparoscopy. The healthcare provider inserts a small camera through a small incision in your abdomen to view your reproductive organs. Ovarian cysts can be removed through a small incision (ovarian cystectomy).
• Laparotomy. This procedure is used for very large cysts or other considerations.

Complications

• Cancerous cysts. Ovarian cysts that develop after menopause are more likely to be cancerous than those that form before menopause.
• Ovarian cyst rupture. Functional cysts usually rupture without causing negative symptoms. However, sometimes a ruptured cyst can cause pain and swelling in your abdomen. The larger the cyst, the greater the chance of rupture.
• Ovarian torsion. Cysts can grow large enough to cause the ovary to twist (torsion), which can block blood flow and cause ovarian tissue death. Extreme pain, nausea, and vomiting are signs of ovarian torsion.

Prevention

Taking hormone-containing medications (like birth control pills) will stop ovulation. Some studies suggest that these pills may reduce the recurrence of certain cysts. Generally, ovarian cysts are not dangerous, so prevention is not necessary. Instead, note any symptoms that may indicate the presence of a cyst and inform your doctor. Regular pelvic exams allow your doctor to detect cysts that may require treatment.

When to See a Doctor?

You should see your doctor if:

• Your menstrual periods are late, irregular, or painful
• Abdominal pain does not relieve
• Your abdomen is enlarged or swollen
• You have difficulty urinating or emptying your bladder
• You experience pain during sexual intercourse
• You feel bloated, pressure, or discomfort in your abdomen
• You lose weight for no apparent reason
• You generally feel unwell

Seek immediate medical attention if you experience symptoms of ovarian torsion:

• Sudden, severe abdominal pain accompanied by vomiting or fever
• Dizziness or fainting and rapid breathing
• Cold and clammy skin

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