OVARIAN CYSTS
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Ovarian cysts are fluid-filled sacs or pockets in an ovary or on its surface. Women have two ovaries — each about the size and shape of an almond — on each side of the uterus. Eggs (ova), which develop and mature in the ovaries, are released in monthly cycles during the childbearing years.
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Many women have ovarian cysts at some time. Most ovarian cysts present little or no discomfort and are harmless. The majority disappears without treatment within a few months.
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Symptoms
Most cysts don't cause symptoms and go away on their own. However, a large ovarian cyst can cause:
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Pelvic pain — a dull or sharp ache in the lower abdomen on the side of the cyst
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Fullness or heaviness in your abdomen
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Bloating
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Types of cysts
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Follicular cyst. Around the midpoint of your menstrual cycle, an egg bursts out of its follicle and travels down the fallopian tube. A follicular cyst begins when the follicle doesn't rupture or release its egg, but continues to grow.
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Corpus luteum cyst. When a follicle releases its egg, it begins producing estrogen and progesterone for conception. This follicle is now called the corpus luteum. Sometimes, fluid accumulates inside the follicle, causing the corpus luteum to grow into a cyst.
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Dermoid cysts. Also called teratomas, these can contain tissue, such as hair, skin or teeth, because they form from embryonic cells. They're rarely cancerous.
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Cystadenomas. These develop on the surface of an ovary and might be filled with a watery or a mucous material.
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Endometriomas. These develop as a result of a condition in which uterine endometrial cells grow outside your uterus (endometriosis). Some of the tissue can attach to your ovary and form a growth.
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Risk factors
Your risk of developing an ovarian cyst is heightened by:
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Hormonal problems. These include taking the fertility drug clomiphene (Clomid), which is used to cause you to ovulate.
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Pregnancy. Sometimes, the cyst that forms when you ovulate stays on your ovary throughout your pregnancy.
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Endometriosis. This condition causes uterine endometrial cells to grow outside your uterus. Some of the tissue can attach to your ovary and form a growth.
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A severe pelvic infection. If the infection spreads to the ovaries, it can cause cysts.
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A previous ovarian cyst. If you've had one, you're likely to develop more.
Complications
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Ovarian torsion. Cysts that enlarge can cause the ovary to move, increasing the chance of painful twisting of your ovary (ovarian torsion). Symptoms can include an abrupt onset of severe pelvic pain, nausea and vomiting. Ovarian torsion can also decrease or stop blood flow to the ovaries.
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Rupture. A cyst that ruptures can cause severe pain and internal bleeding. The larger the cyst, the greater the risk of rupture. Vigorous activity that affects the pelvis, such as vaginal intercourse, also increases the risk.
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Diagnosis
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A cyst on your ovary can be found during a pelvic exam.
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Pregnancy test. A positive test might suggest that you have a corpus luteum cyst.
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Pelvic ultrasound. A wand-like device (transducer) sends and receives high-frequency sound waves (ultrasound) to create an image of your uterus and ovaries on a video screen.
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CA 125 blood test. Blood levels of a protein called cancer antigen 125 (CA 125) often are elevated in women with ovarian cancer. Elevated CA 125 levels can also occur in noncancerous conditions, such as endometriosis, uterine fibroids and pelvic inflammatory disease.
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Treatment
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Watchful waiting. In many cases, you can wait and be re-examined to see if the cyst goes away within a few months.
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Medication such as birth control pills, to keep ovarian cysts from recurring. However, birth control pills won't shrink an existing cyst.
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Surgery. Some cysts can be removed without removing the ovary (ovarian cystectomy).
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