Ovarian Cysts: Symptoms, Investigations, Complications & Treatment
Have you heard of ovarian cysts? If you are concerned woman with her health or who want to remain pregnant, than you most definitely have heard about them. Still, going into details about such important things is always a good move.
Table of Contents
- 1 What Is an Ovarian Cyst?
- 2 Ovarian Cysts & Normal Function of Ovaries
- 3 Follicular Cysts & Corpus Luteum Cysts
- 4 When Can Cysts Be a Sign of Ovarian Disease?
- 5 When to Contact a Doctor?
- 6 Signs & Symptoms
- 7 Complications & Consequences
- 8 Ovarian Cysts & Pregnancy
- 9 Investigations & Analyzes for Detecting Ovarian Cysts
- 10 What to Do in Case You Have an Ovarian Cyst?
- 11 Treatment
What Is an Ovarian Cyst?
An ovarian cyst is nothing more than a fluid-filled sac located on the surface or within the ovary. The size of an ovarian cyst can vary from a few millimeters to a few centimeters.
In most cases, ovarian cysts form as a result of a normal function of the ovaries (functional cysts) and doesn`t represent a threat to women`s health. Still, as it will be mentioned below, the appearance of ovarian cysts in some cases can be a sign of severe diseases which require special treatment immediately.
Ovarian Cysts & Normal Function of Ovaries
Every month, at every healthy woman, there`s a small cyst that appears in one of the ovaries, known as the dominant follicle (graafian follicle, mature follicle).
The dominant follicle is a fluid-filled sac inside of which is located the ovule (the female sexual cell) in the maturation process. The size of the sac can be of up to 25 – 28 mm.
Averagely, in the middle of the menstrual cycle, the dominant follicle breaks and releases an egg, which penetrates the fallopian tubes, where it may be fertilized by sperm.
Instead of the dominant follicle, it forms the so-called corpus luteum (a compact area of the ovary similar to a small blister in the center), which actively produced hormones capable to support the development of a pregnancy.
In some cases, from still unclear reasons, the dominant follicle doesn`t break and continue to grow, accumulating the liquid inside. In this case, the follicle transforms in a follicular cyst.
More rarely, the corpus luteum can transform itself in the cyst.
So at healthy women, ovarian cysts can appear during the normal function of ovaries.
Follicular Cysts & Corpus Luteum Cysts
As it was already mentioned, follicular cysts and corpus luteum cysts form during the normal function of the ovaries in healthy women. Due to this reason, cysts of this type are known as functional cysts (physiological cysts). Functional ovarian cysts share is of around 90% from all cases of ovarian cysts in girls and young women.
Usually, functional cysts form in one of the ovaries (right or left), and disappear on their own after a few weeks or months.
The sizes of follicular cysts and of corpus luteum cysts can reach 5 cm or even more.
When Can Cysts Be a Sign of Ovarian Disease?
The formation of cysts is also possible due to various ovarian diseases. See below what diseases may occur by the formation of such cysts.
The hemorrhagic cyst occurs in case of hemorrhage in an ordinary functional cyst. The main symptom of hemorrhagic cysts is dull pain with a pulling sensation (more pronounced in the right or left) in the lower abdomen.
A dermoid cyst is a benign ovarian tumor which contains tissue non-specific to female genital organs (e.g. hear, bones, cartilage). Essentially, dermoid cysts are formed from cells that were to participate to the development of other organs (e.g. skin), but they found themselves in the ovaries accidentally. Dermoid cysts can become very large and they are almost always removed by special surgery, which is the only efficient treatment for this disease.
An endometrial cyst is a cavity filled with blood, which forms on the ovaries due to a common complication known as endometriosis. Besides the formation of cysts on the ovaries, endometriosis can manifest through dull long pains in the lower abdomen, infertility and extremely painful menstruation.
Polycystic ovary syndrome is a widely spread gynecological disease of which main manifestations are: the formation of multiple cysts of various sizes in the ovaries, menstrual disorders, infertility and increased level of male sexual hormones in the woman`s blood.
Cyst adenoma is a benign ovarian tumor which can grow until large sizes (25 – 30 cm), without practically causing any symptoms.
Ovarian cancer can develop under the form of a slow-growing cyst. The presence of the cyst can be the only symptom of ovarian cancer for a long period of time, until the moment when tumor metastases occur in adjacent organs.
Because benign functional cysts form, mostly, in women of fertile age, and ovarian cancer form in women of 40 – 45 years old (in menopause), the appearance of ovarian cysts in women with ages of over 40 years old should be considered as a possible symptom of cancer.
Detecting an ovarian cyst in a girl who has never had a menstruation yet may also indicate the presence of cancer.
When to Contact a Doctor?
You need to get in contact with your doctor when you notice one or several of the symptoms below:
- Increased body temperature.
- Acute abdominal pains.
- Sudden weakness, loss of consciousness, dizziness.
- Nausea or vomiting.
- Menstruations unusually painful or irregular.
- The increase of abdominal waist.
- Palpation of swelling in the abdomen.
- Unexplained weight loss.
- Increased facial and body hair growth.
- You are over 40 years old.
- You noticed long burns in the stomach, abdominal pains or constipation.
Signs & Symptoms
Functional ovarian cysts, most of the times, don`t show any symptom and are detected randomly, either during a preventive examination, either during investigations made for other medical problems.
Only in rare cases, cysts of large sizes in women evidenced by the following symptoms:
- Abdominal pains with a pulling sensation.
- A short episode of acute pain in the lower abdomen, in the middle of the menstrual cycle, after which there`s a mild vaginal bleeding.
- Mild vaginal bleeding which aren`t related to menstruation.
- Abdominal pains, which intensify during sexual intercourse or after a physical exertion.
- Irregular menstruations.
- False frequent need of defecating or urinating.
You should keep in mind that these symptoms can be a sign not only of ovarian cyst, but also for many other diseases (some of them, very dangerous).
Complications & Consequences
Usually, functional cysts don`t present a serious treat for women`s health and they usually disappear on their own without any treatment.
In rare cases in women with large cysts, they might break or twist and this may lead to a strong internal bleeding.
The main signs of internal bleeding associated with cysts are:
- Sudden severe abdominal pains.
- Dizziness or weakness.
- Mild vaginal bleeding which aren`t related to menstruation.
A bleeding caused by a cyst can be dangerous. Due to these reasons, if you noticed you experience the above symptoms, don`t wait another minute and call an ambulance.
Ovarian Cysts & Pregnancy
Functional ovarian cysts, usually, don`t affect the ability of conceiving a child or the normal development of a pregnancy.
If the conception took place a while after detecting the cyst, you don`t need to worry – cysts disappear on their own up to 16 – 20 weeks of pregnancy.
However, if you know you have an ovarian cyst and you want to remain pregnant any time soon, talk to your gynecologist about this aspect.
You may need treatment for a safe and complete removal of the cysts, and this may be contraindicated during pregnancy.
In case the cyst is detected at an ultrasound during the first trimester of pregnancy, the doctor may recommend repeating the ultrasound along the way several times to monitor its development.
If in a few months the size of the cyst won`t decrease at 5 – 10 cm, it`s possible you require a surgical intervention.
Investigations & Analyzes for Detecting Ovarian Cysts
The main method of diagnosing ovarian cysts is the ultrasound of the pelvic organs. The ovarian cyst at ultrasound is similar to a dark and round bubble with thin walls.
Because the ultrasound of the pelvic organs only offers the viewing of the cyst`s structure, but it doesn`t say anything about its origin, the doctor may recommend a series of repeated ultrasound examinations with the purpose of monitoring the development of the cyst. Usually, follicular cysts and corpus luteum cysts disappear on their own after a few weeks or months, but not dermoid cyst or ovarian cancer, either because they don`t change in time or are in development.
Ovarian cysts caused by endometriosis increase during menstruation and decrease after this period ends.
To clarify the exact cause of the formation of a cyst (especially in cases in which there are reasons to believe the cyst isn`t functional), the doctor may recommend performing the following investigations:
- Diagnostic laparoscopy – a minor surgical intervention in which doctors, using special instruments and video cameras, monitor the cyst and take a piece of its tissue for further analysis.
- Determining the level of the marker CA-125 in blood is used in case of suspicion of ovarian cancer. An increased level of CA-125 in blood isn`t always a sign of ovarian cancer and can increase due to other diseases.
- Determining the level of sexual hormones in blood – helps in identifying the hormonal disorders which may lead to the formation of ovarian cysts.
What to Do in Case You Have an Ovarian Cyst?
If you have ovarian cysts:
- Talk to your doctor about the necessity of performing additional tests (or repeated ultrasound examinations).
- Talk right away with your doctor about the treatment you should follow and any side effects that may appear after you finish the treatment.
- Follow carefully your health and talk to your doctor if you notice one of the symptoms listed above in the “When to Contact a Doctor?”
The treatment of ovarian cysts depends on the cause, their sizes, the dynamic of their evolution and the woman`s age.
As mentioned above, most of the times functional cysts in young women don`t require treatment.
Less frequent, in the purpose of treating functional ovarian cysts, the doctor can recommend the administration of oral contraceptives for several months. These will block the functionality of the ovaries, inhibit the development of new cysts and lead to the decrease and disappearance of already formed cysts. The treatment with hormonal contraceptives helps in normalizing the menstrual cycle and reduces the risk for ovarian cancer. Oral contraceptives can also be used as treatment for endometrial cysts.
In women at menopause, cysts smaller than 5 cm in diameter, with a normal level of CA-125, there is no need for treatment as well. In such cases, the doctor can recommend only a repeated ultrasound after 2 -3 months for monitoring the development of the cysts.
Surgical Intervention to Remove the Cyst
In some cases, the doctor can recommend a surgery to remove the cysts, either those that are larger than 5 – 10 cm, either those that don`t disappear after treatment.
Usually, the procedure of removing the cysts is known as a laparoscopy (the cyst is removed through small holes in the abdomen).
More rarely, a cyst can also be removed by another procedure known as laparotomy (a small incision in the abdomen wall).
The final choice of the surgical procedure may depend on several factors:
- The woman`s general health.
- The cyst`s type and sizes.
- The existence and probability of developing complications.
- The equipment available in the clinic in which the surgery is performed.
The main purpose of the surgical intervention, no matter the type of the procedure, is:
- The confirmation of the ovarian cyst`s diagnosis and establishing its nature.
- The exclusion of the ovarian cancer.
- The removal of the cyst and its content and, if possible, keeping the healthy tissues of the ovary.
Recommendations after the Surgery
The recovery after removing an ovarian cyst by surgery is usually fast and don`t require any special treatment. For 3 – 4 weeks after the surgical procedure, it`s recommended to limit any physical activity and avoid constipations.
The doctor may recommend you to continue the treatment with oral contraceptives for a few months after the procedure.
The diet after experiencing such an intervention needs to be maximal appropriate from a healthy diet.
Currently, there are no known remedies with a proven efficiency for treating ovarian cysts or any diseases that may cause them to appear.
More than that, most of the popular remedies involve vaginal washes or introducing tampons soaked into medicinal infusions into the vagina, which may exacerbate the woman`s condition and can lead to more dangerous complications.
Even if you decide to use such popular methods in treating ovarian cysts, at least talk to your doctor first before taking any final decision.