What Are Ovarian Cysts?
Ovarian cysts are fluid‐filled sacs or pockets that grow inside or on the surface of an ovary. There are various types of ovarian cysts, most of which are harmless, show no symptoms, and disappear independently without any specific treatment within a few months. But in rare circumstances, the ovarian cysts can burst open or become twisted and cause severe pelvic pain. These cysts usually range in size from a few centimeters to the size of an almond or more. Mostly all women will develop ovarian cysts at some point in their lifetime. This is considered one of the most common reasons women seek gynecologic consultation.
What Are the Different Types of Ovarian Cysts?
The different types of ovarian cysts are as follows:
-
Functional cysts.
-
Endometriotic cyst.
-
Benign neoplastic cysts.
-
Malignant cysts.
What Is a Functional Ovarian Cyst?
Functional ovarian cysts are fluid-filled sacs formed on an ovary's surface. This sac usually forms during ovulation to hold a maturing egg, and the sac goes away after releasing the egg. But if an egg is not released at the correct time, or if the sac closes up after releasing the egg, the sac can swell up with fluid. During the monthly menstrual cycle, any one type of functional cyst may form.
-
Follicular Cyst - This cyst occurs when a sac on the ovary does not release an egg causing the sac to swell up with fluid.
-
Luteal Cyst - This cyst occurs when the sac releases an egg, closes on its own, and fills it with fluid.
What Is the Cause of Functional Ovarian Cysts?
A functional ovarian cyst can occur when there are slight changes in how the ovary produces or releases an egg. The cyst formation happens when a sac on the ovary does not release an egg causing the sac to swell up with fluid. Or it can be due to resealing of the sac after egg release, which can result in a fluid-filled cyst.
What Symptoms Do Functional Ovarian Cysts Cause?
Most functional ovarian cysts do not cause any symptoms. If the cysts are large, there are chances of symptoms, including pelvic pain, lower belly pain, pain with intercourse, and changes in the period.
How Are Functional Cysts Treated?
Most functional ovarian cysts go away on their own without treatment. The doctor may suggest using heat packs and medicine to relieve pain. Surgery may be needed if the cyst is large, bleeds, or causes severe pain. To prevent the formation of new cysts, doctors may advise taking birth control pills as they can stop ovulation and prevent new cysts formation.
What Is an Endometriotic Cyst?
An endometrioma is a cyst filled with the same fluid present in the uterus lining, known as the endometrium. This cyst is also known as chocolate cyst because the endometrial tissue present on the ovarian surface cannot be shed; this leads to the accumulation of tissues and forms dark, reddish brown cysts that resemble chocolate syrup. Instead of being in the uterus, the endometrial cells form in the ovaries. An endometrioma cyst can also be a sign of endometritis. These cysts generally do not resolve spontaneously; if they burst, they can cause pelvic pain and infertility.
What Are the Symptoms of Endometriotic Cysts?
The most common symptom is consistent pain in the lower belly. It can get worse before and during the period and cause heavy bleeding. Some women have complained of noticeable pressure in the pelvic area. This cyst is often diagnosed during a pelvic examination or ultrasound.
What Is the Treatment for Endometriotic Cysts?
Since there is no cure for endometriosis, there is no way to prevent ovarian endometrioma formation. But, health care professionals can provide medications to help prevent ovarian endometrioma from growing back after its removal or growing big, which includes progestins, vaginal rings, birth control pills, birth control patches, and gonadotropin-releasing hormone (GnRH agonist). Also, medications to reduce pain will be given.
What Are Benign Ovarian Cysts?
Benign ovarian cysts are rare and present in multiple forms. These cysts consist of abnormal tissue growth. They develop from a germ cell and can contain various types of tissue, including skin cells, hair follicles, or sebaceous glands. Sometimes these cysts show no symptoms but occasionally cause pelvic pain and other medical complications. Generally, these types of cysts do not resolve independently and need medical attention.
What Is the Treatment for Benign Ovarian Cysts?
If the ovarian cyst is simple, based on ultrasound findings, it does not require treatment.
1) Expectant Management:
-
If the cyst is small (less than 50 mm in diameter), no specific treatment is needed, as these cysts resolve within three menstrual cycles.
-
A yearly ultrasound follow-up is needed if the ovarian cysts are 50 to 70 mm in diameter.
-
If the ovarian cyst is larger than 70 mm, further imaging (MRI) or surgical intervention is needed.
2) Surgery:
-
Surgical therapy for benign ovarian tumors is often very effective and provides the best result with minimal effect on reproductive capacity.
-
Surgery is considered for a simple ovarian cyst bigger than ten centimeters with symptoms and in case of complex ovarian cysts.
-
For teenagers and younger women, cystectomy may be preferable to oophorectomy, as it does not affect fertility.
-
Immediate surgery is indicated for a hemorrhagic cyst.
What Are Malignant Ovarian Cysts?
In most cases, ovarian cysts are benign, but they can become malignant or cancerous at any instance. A tumor or malignant cysts are indicative of ovarian cancer. A cyst is considered to be malignant when certain characteristics are found in a patient’s medical history, during a physical exam, or ultrasound. In such a situation, a biopsy is recommended for further confirmation.
What Is the Treatment for Malignant Ovarian Cysts?
If the diagnostic test shows that the ovarian cyst is malignant, then both the ovarian and the uterus should be removed along with the surrounding tissues. This can cause early menopause and infertility.
Conclusion:
Ovarian cysts are classified depending on their size, location, and characteristics. In general, ovarian cysts are very common, and every woman may experience them at some point. It is often asymptomatic and resolves without any specific treatment. If any symptoms occur, then further examination and treatment are needed.
