What is an ovary?
An ovary is an almond sized organ located on either side of the uterus. Eggs develop and mature within the ovaries and are released in monthly cycles during your childbearing years
What is an ovarian cyst?
Ovarian cysts are fluid-filled sacs or pockets within or on the surface of an ovary.
Ovarian cysts are quite common before the menopause and about 1 in 7 women will develop one at some point.
Most ovarian cysts cause little or no discomfort and are harmless and disappear within a few months without treatment.
What are the symptoms of ovarian cysts?
Most cysts don’t cause any symptoms and resolve spontaneously.
Ovarian cysts can cause:
- Pain or dull ache that may radiate to your lower back and thighs
- Pain shortly before your period begins or just before it ends
- Pain during intercourse (dyspareunia)
- Pain during bowel movements or pressure on your bowels
- Fullness or heaviness in your abdomen
- Feeling bloated
- Indigestion and early satiety
- Pressure on your bladder that causes you to urinate more frequently
When should I seek urgent medical advice?
- Sudden, severe abdominal or pelvic pain
- Pain accompanied by fever or vomiting
Why do women develop ovarian cysts?
Most ovarian cysts develop as a result of the normal function of your menstrual cycle. These are known as functional cysts. Other types of cysts are much less common.
Your ovaries grow cyst-like structures called follicles each month. The follicles release an egg when you ovulate and produce the hormones estrogen and progesterone. When a normal monthly follicle keeps growing and fails to release an egg, it develops into a functional cyst.
There are two types of functional cysts:
- Follicular cyst. A follicular cyst begins when the follicle doesn’t rupture or release its egg.
- Corpus Luteum cyst. When a follicle releases its egg, the ruptured follicle becomes the corpus luteum. If the escape opening seals off and fluid accumulates inside the follicle, the corpus luteum expands into a cyst.
Functional cysts are usually harmless, rarely cause pain, and often disappear on their own within two or three menstrual cycles.
Other cysts include:
- Dermoid cyst. These cysts may contain tissue, such as hair, skin or teeth, because they form from cells that produce human eggs. They are rarely cancerous.
- These cysts develop from ovarian tissue and may be filled with a mucous containing material.
- These ovarian cysts develop as a result of endometriosis (a condition in which uterine endometrial cells grow outside the uterus) within the ovary.
Some women develop less common types of cysts that may not produce symptoms, but that a doctor may find during a pelvic exam. Cystic ovarian masses that develop after menopause may be cancerous (malignant). That’s why it’s important to have regular pelvic exams.
What are the risks of ovarian cysts?
Infrequent complications associated with ovarian cysts include:
- Ovarian torsion. Large cysts may cause the ovary to move out of its usual position in the pelvis and increase the risk of painful twisting.
- A cyst may rupture causing severe pain and lead to internal bleeding.
What tests do I need?
A cyst may be found during a pelvic exam.
To identify the type of cyst, the following tests or procedures are useful:
- Pelvic ultrasound. A probe is placed in the vagina to view the ovaries and confirm the presence of a cyst and help identify the type of cyst.
- A slim, telescope like instrument is inserted into your abdomen through a small cut under general anaesthetic to view the ovaries and remove the ovarian cyst.
- CA 125 blood test. Blood levels of a protein called cancer antigen 125 (CA 125) is often 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.
What treatment options are available?
Treatment will depend on your age, the type and size of the cyst, and any symptoms.
- Watchful waiting. If you have no symptoms and an ultrasound shows you have a small, fluid-filled cyst, the likely recommendation will be pelvic ultrasounds at periodic intervals to see if the cyst has changed in size.
- Contraceptive pill. The pill to reduces the chance of new cysts developing in future menstrual cycles. Oral contraceptives offer the added benefit of significantly reducing your risk of ovarian cancer.
- Removal of a cyst is recommended if it is large, doesn’t look like a functional cyst, is growing, or persists through two or three menstrual cycles. Cysts that cause pain or other symptoms should be removed. Some cysts can be removed preservation of the ovary. If a cystic mass is cancerous, a hysterectomy and removal of both tubes and ovaries will be necessary. Surgery will be advisable when a cystic mass develops on the ovaries after menopause.
A discussion on the best option for you individual circumstance will take place during your consultation.