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.
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.
However, ovarian cysts — especially those that have ruptured — can cause serious symptoms. To protect your health, get regular pelvic exams and know the symptoms that can signal a potentially serious problem.
What are ovarian cysts?
Ovarian cysts are sacs that form on or inside the ovary. A fluid-filled ovarian cyst is a simple cyst. A complex ovarian cyst contains solid material or blood.
Simple cysts
Simple cysts are common. They develop when your ovary fails to release an egg or when a follicle in your ovary continues to grow after an egg has been released. Because they form due to your normal menstrual cycle, they’re also called functional cysts. Functional cysts usually have no symptoms. They tend to resolve on their own within a few menstrual cycles.
Symptoms
Most cysts don’t cause symptoms and go away on their own. However, a large ovarian cyst can cause:
- Pelvic pain — a dull or sharp ache in the lower abdomen on the side of the cyst
- Fullness or heaviness in your abdomen
- Bloating
When to see a doctor
Seek immediate medical attention if you have:
- Sudden, severe abdominal or pelvic pain
- Pain with fever or vomiting
If you have these signs and symptoms or those of shock — cold, clammy skin; rapid breathing; and lightheadedness or weakness — see a doctor right away.
Ovarian Cyst Causes
Most cysts are “functional.” They’re a part of your monthly cycle
Functional cysts occur due to a minor problem, usually involving hormones, in your normal menstrual cycle. Polycystic ovary syndrome (PCOS) is a condition that causes many small, simple ovarian cysts. The exact cause is unknown, but it involves a hormone imbalance.
If a normal monthly follicle keeps growing, it’s known as a functional cyst. There are two types of functional cysts:
- 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.
- 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.
- Functional cysts are usually harmless, rarely cause pain, and often disappear on their own within two or three menstrual cycles.
Other cysts
Types of cysts not related to the normal function of your menstrual cycle include:
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.
Cystadenomas. These develop on the surface of an ovary and might be filled with a watery or a mucous material.
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.
Dermoid cysts and cystadenomas can become large, causing the ovary to move out of position. This increases the chance of painful twisting of your ovary, called ovarian torsion. Ovarian torsion may also result in decreasing or stopping blood flow to the ovary.
Risk factors
Your risk of developing an ovarian cyst is heightened by:
- Hormonal problems. These include taking the fertility drug clomiphene (Clomid), which is used to cause you to ovulate.
- Pregnancy. Sometimes, the cyst that forms when you ovulate stays on your ovary throughout your pregnancy.
- 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.
- A severe pelvic infection. If the infection spreads to the ovaries, it can cause cysts.
- A previous ovarian cyst. If you’ve had one, you’re likely to develop more.
Complications
Some women develop less common types of cysts that a doctor finds during a pelvic exam. Cystic ovarian masses that develop after menopause might be cancerous (malignant). That’s why it’s important to have regular pelvic exams.
- Symptoms
- Complications
- Diagnosis
- Treatment
- Prevention
- Outlook
What are ovarian cysts?
The ovaries are part of the female reproductive system. They’re located in the lower abdomen on both sides of the uterus. Women have two ovaries that produce eggs as well as the hormones estrogen and progesterone.
Sometimes, a fluid-filled sac called a cyst will develop on one of the ovaries. Many women will develop at least one cyst during their lifetime. In most cases, cysts are painless and cause no symptoms.
Types of ovarian cysts
There are various types of ovarian cysts, such as dermoid cysts and endometrioma cysts. However, functional cysts are the most common type. The two types of functional cysts include follicle and corpus luteum cysts.
Follicle cyst
During a woman’s menstrual cycle, an egg grows in a sac called a follicle. This sac is located inside the ovaries. In most cases, this follicle or sac breaks open and releases an egg. But if the follicle doesn’t break open, the fluid inside the follicle can form a cyst on the ovary.
Corpus luteum cysts
Follicle sacs typically dissolve after releasing an egg. But if the sac doesn’t dissolve and the opening of the follicle seals, additional fluid can develop inside the sac, and this accumulation of fluid causes a corpus luteum cyst.
Other types of ovarian cysts include:
dermoid cysts: sac-like growths on the ovaries that can contain hair, fat, and other tissue
cystadenomas: noncancerous growths that can develop on the outer surface of the ovaries
endometriomas: tissues that normally grow inside the uterus can develop outside the uterus and attach to the ovaries, resulting in a cyst
Some women develop a condition called polycystic ovary syndrome. This condition means the ovaries contain a large number of small cysts. It can cause the ovaries to enlarge. If left untreated, polycystic ovaries can cause infertility.
Symptoms of an ovarian cyst
Often times, ovarian cysts do not cause any symptoms. However, symptoms can appear as the cyst grows. Symptoms may include:
- abdominal bloating or swelling
- painful bowel movements
- pelvic pain before or during the menstrual cycle
- painful intercourse
- pain in the lower back or thighs
- breast tenderness
- nausea and vomiting
Severe symptoms of an ovarian cyst that require immediate medical attention include:
- Severe or sharp pelvic pain
- Fever
- Faintness or dizziness
- Rapid breathing
These symptoms can indicate a ruptured cyst or an ovarian torsion. Both complications can have serious consequences if not treated early
Ovarian cyst complications
Most ovarian cysts are benign and naturally go away on their own without treatment. These cysts cause little, if any, symptoms. But in a rare case, your doctor may detect a cancerous cystic ovarian mass during a routine examination.
Ovarian torsion is another rare complication of ovarian cysts. This is when a large cyst causes an ovary to twist or move from its original position. Blood supply to the ovary is cut off, and if not treated, it can cause damage or death to the ovarian tissue. Although uncommon, ovarian torsion accounts for nearly 3 percent of emergency gynecologic surgeries.
Ruptured cysts, which are also rare, can cause intense pain and internal bleeding. This complication increases your risk of an infection and can be life-threatening if left untreated.
Diagnosing an ovarian cyst
Your doctor can detect an ovarian cyst during a routine pelvic examination. They may notice swelling on one of your ovaries and order an ultrasound test to confirm the presence of a cyst. An ultrasound test (ultrasonography) is an imaging test that uses high-frequency sound waves to produce an image of your internal organs. Ultrasound tests help determine the size, location, shape, and composition (solid or fluid filled) of a cyst.
Imaging tools used to diagnose ovarian cysts include:
CT scan: a body imaging device used to create cross-sectional images of internal organs
MRI: a test that uses magnetic fields to produce in-depth images of internal organs
ultrasound device: an imaging device used to visualize the ovary
Because the majority of cysts disappear after a few weeks or months, your doctor may not immediately recommend a treatment plan. Instead, they may repeat the ultrasound test in a few weeks or months to check your condition.
If there aren’t any changes in your condition or if the cyst increases in size, your doctor will request additional tests to determine other causes of your symptoms.
These include:
Pregnancy test to make sure you’re not pregnant hormone level test to check for hormone-related issues, such as too much estrogen or progesterone
CA-125 blood test to screen for ovarian cancer
Infrequent complications associated with ovarian cysts include:
- 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.
- 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.
Prevention
Although there’s no way to prevent ovarian cysts, regular pelvic exams help ensure that changes in your ovaries are diagnosed as early as possible. Be alert to changes in your monthly cycle, including unusual menstrual symptoms, especially ones that persist for more than a few cycles. Talk to your doctor about changes that concern you.
