Ovarian Cysts

What are Ovarian Cysts?

Ovarian cysts fluid-filled sacs that can grow on the ovaries in females. The female reproductive system has two ovaries, one on each side of the uterus. Eggs grow and mature in the ovaries and are released each month during a woman’s reproductive years.

Ovarian cysts are quite common. They usually do not cause discomfort or other problems and will go away without treatment within a few months. However, in some cases larger cysts can twist (ovarian torsion) or rupture, causing more serious symptoms. The include:

• Sudden or severe pelvic pain on one side
• Bloating
• Nausea or vomiting

Complications from ovarian torsion or rupture, though uncommon, may include loss of blood supply to the ovaries or internal bleeding in the pelvis.

Types of Ovarian Cysts

Functional cysts: The most common type of ovarian cyst, functional cysts form as a result of a woman’s menstrual cycle. They include:

• Follicular cysts: During each cycle, the ovaries grow small cysts that rupture to release an egg. When a follicle doesn’t rupture, it can continue to grow, causing a follicular cyst to develop.
• Corpus luteum cyst: This type of functional cyst develops when the follicle opening where the egg was released becomes blocked, causing fluid to build up in the burst follicle, or corpus luteum.

Generally, functional cysts are harmless and many will disappear on their own within a few cycles.

Non-functional cysts are not related to the menstrual cycle and include:

• Dermoid cyst (teratomas): This type of cycle forms from germ cells that make eggs in the ovary. It can contain hair, skin or teeth, and is usually benign, though in rare cases it can be cancer.
• Cystadenoma: These cysts can get very large and grow on the surface of the ovary and may be filled with fluid.
• Endometrioma: When endometrial tissue grows outside the uterus in women with endometriosis, some of the tissue can attach to the ovary and cause a cyst to develop.

Ovarian cysts that are not functional cysts and form after menopause may be benign, but can be a cancer. If you are diagnosed with ovarian cysts in the emergency department or by your primary care provider, you should follow up with a gynecologist to discuss what, if any, further management is needed.

Who’s at Risk for Ovarian Cysts?

Factors that can increase a woman’s chance of developing ovarian cysts include:

• Taking fertility drugs that stimulate ovulation
• Pregnancy
• Endometriosis
• Polycystic ovary syndrome (PCOS) 
• Pelvic infections that affect the ovaries
• Personal history of ovarian cysts

Ovarian Cyst Diagnosis

Your healthcare provider may perform the following tests when diagnosing an ovarian cyst:

• Pregnancy test: Your provider may have you take a pregnancy test to rule it out as a cause of your symptoms.
• Pelvic exam: This allows your provider to look for any lumps or changes in your pelvis.
• Pelvic ultrasound: Ultrasound uses sound waves to create images of your pelvic organs, enabling your provider to detect and locate ovarian cysts.
• Laparoscopy: During this minimally invasive procedure a camera attached to a thin instrument (laparoscope) is inserted through a small incision in the abdomen to view the ovaries. If a cyst is found, it can be removed during the same procedure.

Ovarian Cyst Treatment

Treatment for ovarian cysts depend on many factors, including the cyst’s type and size, as well as the patient’s symptoms, age and overall health.

Treatment options include:

• Watchful waiting: Cysts that are not large or bothersome may not require immediate treatment. Instead, your provider can reexamine periodically to evaluate changes in the cyst’s size, appearance or worsening symptoms.
• Medications: Hormonal contraceptives or medications that stop ovulation can prevent more cysts from forming.
• Surgery: If a cyst is large or causing severe symptoms, surgery to remove the cyst is an option. Surgery can often be performed using laparoscopic procedures, which require only small incisions with less pain and faster recovery. Surgery to remove the cyst while keeping the ovary intact is called a cystectomy. Sometimes, the ovary will need to be removed along with the cyst (oophorectomy).