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Ovarian Cysts

Ovarian cysts at a glance

  • Ovarian cysts (fluid-filled sacs) can form on the surface of or inside an ovary.
  • Most ovarian cysts cause no symptoms and will go away over time without any treatment.
  • If symptoms are present, they may include pelvic pain, pressure on the bladder or rectum, and/or a feeling of heaviness in the abdomen.
  • If necessary, treatment may include birth control pills or surgery.

Symptoms of ovarian cysts

For many women, ovarian cysts cause no symptoms. If symptoms are present, they may include:

  • Menstrual irregularities
  • Sensations of heaviness or fullness in the abdomen
  • Pelvic pain that may radiate to the lower back and thighs
  • Pelvic pain during intercourse
  • Pressure on the bowels or bladder
  • Pain during bowel movements
  • Difficulty emptying the bladder completely
  • Nausea, vomiting or breast tenderness similar to that experienced during pregnancy

Immediate medical attention is necessary if a woman experiences:

  • Sudden, severe pain in the abdomen or pelvis
  • Pain accompanied by vomiting and fever

These may be signs of a ruptured cyst or ovarian torsion (painful twisting of the ovary).

Causes

The most common types of ovarian cysts are known as functional cysts, and they grow during the normal menstrual cycle. Normal cyst-like growths, called follicles, develop throughout the month and rupture to release an egg. If a follicle keeps growing and accumulating fluid, it is considered a functional cyst.

There are two types of functional cysts, a follicular cyst and a corpus luteum cyst. Follicular cysts occur when the follicle does not release the egg, but instead continues to grow.

Corpus luteum cysts develop after the follicle has ruptured to release the egg, if the opening seals off and fills with fluid. In some cases, clomiphene (a fertility drug) can cause a corpus luteum cyst to develop after ovulation, but it poses no risk to a resulting pregnancy.

Other types of cysts can develop on the ovaries that are not related to the menstrual cycle, such as dermoid cysts or cystadenomas.

Dermoid cysts form from cells that create human eggs, so they may contain hair, skin, or teeth. Cystademomas form from ovarian tissue, and are filled with a watery, mucus-like liquid.

These less-common types of ovarian cysts may grow large and displace the ovary, which increases the chance of ovarian torsion, or the painful twisting of the ovary.

Endometriomas are ovarian cysts caused by endometriosis, a condition where the tissue that usually lines the uterus grows in other locations.

Treatment

Most functional cysts will disappear on their own within two or three menstrual cycles. A physician may recommend watching the cysts and waiting if there are no symptoms and an ultrasound indicates that the cyst is small and fluid-filled. Periodic follow-up ultrasounds may be necessary to monitor any cysts.

In other cases, depending on a woman’s age, symptoms, and type of cyst, the doctor may prescribe birth control pills or recommend surgery. Birth control pills will lower the chances of cysts developing during the menstrual cycle.

Surgery may be necessary to remove a cyst if it:

  • Does not appear to be a functional cyst
  • Is growing
  • Lasts more than two or three menstrual cycles
  • Causes pain or uncomfortable symptoms
  • Forms on a woman’s ovaries after menopause

In some cases, the cyst can be removed while keeping the ovary intact in a procedure called a cystectomy.

An oophorectomy is another surgical procedure in which one entire ovary is removed but the other is left intact.

A hysterectomy may be necessary if the cystic mass is cancerous.