Ovarian Cysts
What are
ovarian cysts?
What are the symptoms of ovarian cysts?
When are women most likely to have ovarian cysts?
How
are ovarian cysts diagnosed and treated?
What questions should a woman with an ovarian cyst
ask her doctor?
Also
See:
Endometriosis
Ovarian Cancer
Polycystic Ovary Syndrome
Return to Frequently Asked Questions Index
What are ovarian cysts?
The ovaries produce
the eggs in the female reproductive system. Eggs grow, develop, and mature
in the ovaries and then are released during ovulation, part of the monthly
menstrual cycle that occurs during the childbearing years. Ovarian cysts
are fluid-filled sacs that form on the ovaries when the follicles (sacs)
on the ovary that contain the egg mature, but do not release the egg into
the fallopian tube where it would be fertilized. A woman can develop one
cyst or many cysts. Ovarian cysts can vary in size-from as small as a pea
to as big as a grapefruit. Most cysts are small and do not cause symptoms.
Some cysts might
cause a dull ache in the abdomen because they are twisted, bleeding, or
have burst; others might cause pain during sexual intercourse. Most cysts
are benign (not cancerous). A few cysts, though, may turn out to be
malignant (cancerous). For this reason, your doctor should check all
cysts. If ovarian cysts are found early, many of the problems they cause
can be treated. There are different types of ovarian cysts:
Functional cysts -
These cysts are completely normal and form during ovulation. The follicles
(sacs) on the ovary that contain the egg often do not mature, and become
cysts. These cysts usually disappear during menstruation, before another
menstrual cycle begins. If not, they will shrink in about one to three
months. Your doctor may want to check in a few months to make sure the
cyst has gotten smaller. Only women who are ovulating form functional
cysts. If you are in menopause or past menopause and not having periods,
you should not have functional cysts.
Endometriomas -
These cysts develop in women who have endometriosis, a condition in which
tissue from the lining of the uterus (endometrium) grows in other areas,
such as on the fallopian tubes, the ovaries, and on other organs outside
of the uterus in the stomach. These may be filled with a thick, brown
blood and so also are called "chocolate cysts." Because uterine tissue is
sensitive to hormones, it bleeds monthly, which may cause it to form a
growing cyst on the ovary. These cysts can be painful during sexual
intercourse and during menstruation.
Benign cystic tumors
(cystadenomas) - These tumors are non-cancerous and are often filled with
a fatty liquid. They develop from cells on the outer surface of the ovary.
Some of these tumors, called dermoid cysts, are lined with structures such
as hair, or pieces of bone. They are often small and may not cause
symptoms. They can, however, become large and uncomfortable.
Multiple Cysts -
Women who do not ovulate regularly can develop multiple cysts. This is a
disorder in which the ovaries are enlarged and contain many small cysts.
This can be caused by a condition called polycystic ovary syndrome (PCOS).
Symptoms of PCOS include irregular menstrual periods, infertility, and
increased body hair.
What are the
symptoms of ovarian cysts?
Many women may have
functional cysts or benign cystic tumors without having any symptoms.
Sometimes, though, a cyst will swell large enough to cause pressure or
pain in the abdomen. The cysts also may put pressure on the urinary tract
and cause problems with urine flow. Some women may have pain during sexual
intercourse. Although it is rare, it is possible for a very large cyst to
become twisted, stopping its own supply of blood. This can cause nausea,
fever, and severe abdominal pain. In women with endometriosis, ovarian
cysts can cause the commonly felt symptoms of pelvic pain, painful
menstrual periods, abnormal bleeding and painful sexual intercourse.
When are
women most likely to have ovarian cysts?
Ovarian cysts are
very common during the childbearing years. Most often, cysts in women of
this age group are not cancerous. Women who are past menopause (ages
50-70), however, and have ovarian cysts, have a higher risk of having
ovarian cancer. If you are over 50 and have an ovarian cyst, your doctor
will probably want to do surgery to remove it. However, if you think you
might have a cyst, at any age, you should tell your health care provider.
How are ovarian cysts
diagnosed and treated?
Ovarian cysts
usually are found during routine pelvic examinations. During this
examination, your doctor is able to feel the swelling of the cyst on your
ovary. Once a cyst is found, the doctor may perform an ultrasound, or a
screening to see if the cyst is hollow or solid, determine its size and
exact location, and see if it contains fluid or abnormal structures that
help show its type. The doctor may decide to "wait and see" if the cyst
will shrink on its own in a few months. If you frequently develop cysts,
your doctor may prescribe birth control pills to prevent you from
ovulating. This will prevent follicles from developing and new cysts from
forming. Your doctor might talk with you about birth control pills, and if
they are right for you.
If the cyst does not
go away after several menstrual periods, if it has gotten larger or more
painful, or it does not appear to be a functional cyst, your doctor may
want to perform other tests or procedures to look at and remove the cyst.
To detect your risk for ovarian cancer, your doctor may want to do a blood
test to measure a substance in the blood called CA-125. The amount of this
protein is increased in the blood of women with ovarian cancer. However,
some ovarian cancers do not produce enough CA-125 to be detected by the
test, and there are other non-cancerous diseases that also increase the
levels of CA-125. For these reasons, the CA-125 test is recommended mostly
for women who are at high risk for the disease.
If the cyst is small
and looks benign on the ultrasound, your doctor may perform a laparoscopy.
This procedure is done under general anesthesia on an outpatient basis and
allows the doctor to closely examine all of your reproductive organs. A
very small incision is made above or below the navel, and a small
instrument that acts like a telescope is inserted into the abdomen. If the
cyst is small and looks benign, it can be removed after the doctor makes
very small incisions in the pubic hairline.
If the cyst is too
large to remove this way, the doctor may perform a procedure called a
laparotomy. This procedure involves making bigger incisions in the stomach
to remove the cyst. While you are under general anesthesia, the doctor is
able to have the cyst tested to find out if the tissue is cancerous. If it
is cancerous, the doctor will then be able to remove other tissue that
could be affected, like the ovary, fallopian tubes, uterus, or lymph
nodes. Before any surgery, your doctor will talk to you about what will
happen during the surgery, the risks, and how long it will take you to
recover. It is important to remember that most cysts are not cancerous and
relatively harmless if treated properly.
What questions should a woman with an ovarian cyst ask her doctor?
The American Medical
Association (AMA) recommends that you ask your doctor the following
questions:
-
How big is the
cyst and where is it located?
-
Do I need to have
it removed immediately, or can we "watch and wait" for one to two
months?
-
How much of my
ovary might be removed along with the cyst, and how would this affect my
fertility?
-
What did the
pathologist's report say about the cyst?
-
What are the
chances that the cyst will recur, or that another cyst will form?
from
The Office On Women's Health - US Department of Health and Human Services
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