Ovaries are the organs of the female reproductive system and are located in the lower region of the abdomen on either side of the uterus. They are responsible for the release of eggs, as well as the reproductive hormones: oestrogen and progesterone. Occasionally, fluid-filled sacs known as cysts may arise on one of the ovaries. They do not usually cause any symptoms and a majority of women develop ovarian cysts at some time. However, serious symptoms can be observed if a cyst bursts. Read on to find out more about these cysts.
Types of Ovarian Cysts
The most common type of ovarian cysts are formed after each menstrual period and are known as functional cysts, such as follicle cysts or corpus luteum cysts. Less common ovarian cysts include dermoid cysts and endometrioma cysts.
Follicles are cyst-like structures that form in the ovaries during the menstrual cycle and are responsible for producing the hormones oestrogen and progesterone which aid the release of an egg during ovulation. Following the release of the egg, the follicle typically ruptures. However, if it fails to rupture, it will continue to grow and a follicular cyst forms.
Following the release of an egg, oestrogen and progesterone are produced by the body to prepare for implantation of a fertilised egg. This follicle then becomes what is known as the corpus luteum. In some rare instances, if liquid builds up inside the follicle, a corpus luteum cyst will form.
Functional cysts are not harmful or symptomatic and typically disappear after two or three menstrual cycles.
These include cysts that are abnormal and not related to a natural menstrual cycle such as:
- Dermoid cysts: Also referred to as teratomas, these may have hair, skin, or teeth as they arise from embryonic cells.
- Cystadenoma: These form on the outer part of an ovary and may contain a watery or a mucous substance.
- Endometriomas: These are formed when uterine endometrial tissue develops outside the uterus (endometriosis). If these tissues stick to the ovary, they can develop into a cyst. These cysts are generally large and symptomatic, they are also associated with ovarian torsion, which may block the blood flow to the ovary.
- Polycystic ovary syndrome is when numerous tiny cysts are present in the ovaries. If untreated, this may cause infertility.
Symptoms of ovarian cysts
Cysts are typically asymptomatic. However, if a cyst is very large or if it ruptures, the patient might experience the following:
- Abdominal fullness
- Pain while defecating
- Severe lower abdominal pain before or during the menstruation
- Pain during sex
- Soreness in the lower back
- Breast tenderness
If you experience any of the signs and symptoms above, accompanied with fever, vomiting, or difficulties when breathing you should go to the hospital as soon as possible.
Complications of ovarian cysts
Almost all ovarian cysts are harmless and tend to disappear spontaneously with no medical intervention. However, in some instances, precancerous cysts can be discovered.
Ovarian torsion is also an infrequent complication associated with ovarian cysts. This usually occurs when a cyst grows and becomes large enough that it causes the ovary to rotate from its natural position, which can result in the blockage of blood flow to the ovary and ovarian tissue injury.
A cyst may also rupture which can cause severe pain and bleeding in the abdomen. This may cause an elevated risk of infection and can be serious if left untreated.
A physician will begin by obtaining a detailed medical history and physical examination of the patient. If there are any suspicious findings during the pelvic exam, the physician might order the following diagnostic tests:
- Pregnancy test: Corpus luteum cysts are suspected if the patient is pregnant.
- Pelvic ultrasound: An ultrasound test helps to confirm the presence of a cyst by utilising high-frequency sound waves to create an image of the internal organs. This test helps to determine the size, location, shape, and composition (solid or liquid-filled) of a cyst.
- Laparoscopy: This can be used to both diagnose and remove cysts. It utilises a laparoscope – a straight, lighted device that is pierced into the abdomen through a small incision in the skin to aid visualisation of the ovaries.
- CA 125 blood test: CA 125 is a protein marker for ovarian cancer. This test is requested by a physician if the cyst is solid and there is reason to suspect an increased chance of ovarian cancer.
Management of ovarian cysts
Treatment is not required for the majority of women with ovarian cysts, instead they should monitor their symptoms and follow-up with their physician periodically. Treatment may be advised if a cyst persists for a long period or grows continuously. Some treatment options include:
- Birth control pills: These are given if there is a recurrence of ovarian cysts. Birth control pills will cease ovulation, end the formation of new cysts, and decrease the chance of ovarian cancer.
- Laparoscopy: This is a surgical procedure done to remove a sample of cysts that are suspected to be malignant for a biopsy.
- Laparotomy: In the event that a cyst is large, an incision is made in the abdomen to perform a tissue biopsy. In the event of malignancy, a hysterectomy might be recommended.
Although it is not possible to prevent the formation of ovarian cysts, regular pelvic examinations will allow for early diagnosis and treatment.