What is an ovarian cyst?
An ovarian cyst is a sac filled with fluid or semi-solid material that forms on or inside one or both of your ovaries. Your ovaries are small organs in your pelvis that hold eggs and produce hormones like estrogen and progesterone.
There are different types of ovarian cysts, most of which are painless and harmless (benign). Ovarian cysts usually do not cause symptoms. Your provider probably won’t know if you have one unless they find one during a routine pelvic exam or imaging procedure.
In rare cases, ovarian cysts can cause complications. Scheduling regular pelvic exams and talking to your doctor about any symptoms you may be experiencing can help prevent any cyst-related problems.
What are the types of ovarian cysts?
Most ovarian cysts are functional cysts. These occur when your body responds to changes during your menstrual cycle. Ovarian cysts are less likely to develop for reasons unrelated to menstruation.
Functional cyst
Functional cysts are the most common type of ovarian cyst and are not associated with disease. They occur as a result of ovulation (the release of an egg from the ovary). These cysts can be a sign that your ovaries are functioning normally. Functional cysts usually shrink within 60 days without specific treatment.
Follicular cyst. Small sacs in your ovaries, called follicles, release eggs every month as part of your menstrual cycle. Follicular cysts occur when the follicle does not release an egg. But the follicle fills with fluid and enlarges.
Corpus luteum cyst. After the follicle releases an egg, it produces a group of hormone-producing cells called the corpus luteum. A cyst is formed when fluid accumulates in the corpus luteum, which causes it to grow.
Functional cysts are sometimes called simple cysts.
Other cysts
Not all ovarian cysts develop in response to the menstrual cycle. These aren’t always signs of illness, but your provider may want to monitor them to make sure they don’t cause complications. It includes:
Cystadenoma. These cysts form on the surface of the ovary. They can be thin, watery, or filled with a thicker, mucilaginous fluid.
Dermoid cyst (teratoma). Dermoid cysts are made up of cells that make up every type of tissue in the human body, from skin, hair, teeth, and brain tissue.
Endometrioma. These cysts are filled with endometrial tissue, which is the tissue that bleeds every month during your period.
Ovarian cancer. Unlike the above conditions, ovarian cancer cysts (tumors) are solid masses of cancer cells.
Who gets ovarian cysts?
Anyone with ovaries can develop ovarian cysts. Your chances increase depending on:
Age Ovarian cysts are more common if you haven’t gone through menopause.
Pregnancy status. Cysts are more likely to form and remain during pregnancy.
History of ovarian cysts. If you have had ovarian cysts in the past, you are more likely to develop ovarian cysts.
Current health status. If you have endometriosis, hormone problems, or are taking medication to help with ovulation, such as clomiphene (Clomid©), you are more likely to develop ovarian cysts.
How common are ovarian cysts?
Ovarian cysts are very common, especially if you haven’t gone through menopause. Functional cysts are the most common type of ovarian cyst.
Are ovarian cysts serious?
Usually not. Most ovarian cysts are harmless and often go away on their own. Certain types of cysts are more likely to become cancerous or cause complications, but this is rare. Less than 1 percent of ovarian cysts become cancerous. Your provider may also monitor you closely for anything related to cysts to reduce your risk of complications.
Symptoms and causes
What causes ovarian cysts?
Ovulation is the main cause of ovarian cysts. Other reasons are:
Abnormal cell reproduction. Abnormal cell reproduction can lead to the formation of cysts such as dermoids and cystadenomas.
Endometriosis. These cysts usually develop on the ovaries during the advanced stages of endometriosis.
Pelvic inflammatory disease (PID). Severe pelvic infections can spread to the ovaries and cause cysts.
What are the symptoms of ovarian cysts?
Some small cysts are asymptomatic. In these cases, you may not even know you have a cyst. Large cysts can cause:
Pelvic pain or a dull ache in the back.
A feeling of fullness (bloating) in your lower abdomen is more pronounced on one side of your body.
Pain during intercourse (dyspareunia).
Painful periods.
Persistent symptoms are similar to those of polycystic ovaries
or a feeling of fullness.
Pain that could be described as sharp or like a dull ache.
Discomfort or pain that comes and goes without explanation.
Can you gain weight with an ovarian cyst?
Yes. Cysts can cause bloating, which contributes to weight gain. Some cysts secrete hormones that can cause you to gain weight.
What are the complications of an ovarian cyst?
Cancerous cyst. Ovarian cysts that develop after menopause are more likely to be cancerous than cysts that form before menopause.
Ruptured ovarian cyst. Functional cysts usually rupture without causing any negative symptoms. But sometimes, a ruptured cyst can cause severe pain and swelling in your belly. The larger it is, the greater likelihood it has of breaking.
Ovarian torsion. Cysts can grow so big that they distort the shape of your ovary, increasing the likelihood that it will twist. The twisting can prevent blood flow to your ovary, causing it to die. Extreme pain, nausea and vomiting are all signs of ovarian torsion.
Seek medical assistance right away if you’re experiencing the symptoms of a ruptured ovarian cyst or ovarian torsion.
DIAGNOSIS AND TESTS
How is an ovarian cyst diagnosed?
Your healthcare provider will first rule out pregnancy as the cause of your symptoms. Then, they may use the following tests to diagnose an ovarian cyst:
A pelvic exam: Your provider will feel inside your pelvis for any lumps or changes.
Ultrasound: This imaging procedure uses sound waves to create images of your body’s internal organs. It can detect cysts on your ovaries, including their location and whether they’re primarily fluid or solid.
Laparoscopy: This is a procedure performed in an operating room. Your provider inserts a camera through an incision (cut) in your abdomen and can view your reproductive organs and pelvic cavity. If your provider diagnoses a cyst at this time, they can remove it.
MANAGEMENT AND TREATMENT
How is an ovarian cyst treated?
Treatment will depend on factors like your age, your symptoms and what’s likely causing your cyst.
Watchful waiting
Functional ovarian cysts usually go away without treatment. If your cyst is likely functional, your provider may suggest a wait-and-see approach. You may have a follow-up ultrasound within a few weeks or months after your diagnosis to see if your cyst has resolved on its own.
Ovarian cyst medications
Your provider may give you medications containing hormones (such as birth control pills) to stop ovulation and prevent future cysts from forming.
Ovarian cyst surgery
If a cyst is causing symptoms and getting bigger, you may need surgery to remove it. The type of surgery depends on the size of the cyst and how it appears on the ultrasound. The different procedures used include:
Laparoscopy: This is a procedure where your provider inserts a small camera through a small incision in your abdomen. They view your reproductive organs and pelvic cavity using the device. The ovarian cyst can be removed through tiny incisions (ovarian cystectomy).
Laparotomy: Your provider may perform this procedure if the cyst is very large or if there are other concerns.
If your provider suspects cancer, they may consult with a cancer specialist, or gynecological oncologist, about the best treatment options for you.