Ovarian Cysts: Types, Causes, Symptoms, and Treatment

What is an ovarian cyst?

An ovarian cyst is a fluid-filled sac that forms on one of the ovaries. Many of these are related to changes in menstrual hormones - and they usually resolve independently within a few weeks without any treatment. Ovarian cysts usually cause no symptoms. However, you may need treatment if they get larger or don't resolve independently.

What causes ovarian cysts?

Early in each menstrual cycle, the ovaries are usually made up of small sac-like structures called follicles, one of which releases an egg when you ovulate. If a normal follicle continues to grow, it becomes a "functional cyst." This type of cyst usually disappears within two to three cycles.

Factors that increase the risk of ovarian cysts include hormonal changes (including fertility drugs), pregnancy, endometriosis, and severe pelvic inflammation that has spread to the ovaries.

Symptoms of Ovarian Cysts

Most ovarian cysts are small, noncancerous (benign), and cause no symptoms. However, some symptoms of ovarian cysts may include one or more of the following:

Pain or discomfort in the lower abdomen (belly).

Sometimes your periods become irregular, heavier, or lighter than normal.

What does ovarian cyst pain feel like?

Ovarian cyst pain is different for different women. It may be sharp or blunt; it may come and go or be present all the time; it may or may not be affected by your menstrual cycle (you may also have irregular periods or spotting between cycles). If an ovarian cyst ruptures or twists, it can cause severe pain.

Ovarian cyst pain usually occurs on one side but can also occur in your lower abdomen, deep in your pelvis, or both. The main symptom may be a dull ache or discomfort associated with a feeling of bloating. Pain may only occur during intercourse.

Types of ovarian cysts

Ovarian cysts are prevalent. They come in all sizes - as small as a pea to as large as a large watermelon (and sometimes even bigger). They are of different types:

Functional ovarian cyst

These are the most familiar types of ovarian cysts. They develop in some women of childbearing age (still menstruating) when ovulatory dysfunction occurs. They are prevalent. There are two types:

Follicular cyst. Follicles sometimes become enlarged and filled with fluid. It most commonly occurs in women undergoing infertility treatment.

Luteal cyst. These occur when the corpus luteum (see 'Ovulation' above) fills with fluid or blood to form a cyst. Cysts that fill with blood are sometimes called hemorrhagic cysts.

Dermoid cyst (sometimes called benign mature cystic teratoma): Dermoid cysts tend to occur in young women. These ovarian cysts can grow very large - up to 15 centimeters in diameter. These cysts often contain foreign objects such as hair, parts of a tooth or bone, fatty tissue, etc. This is because these cysts develop from the cells in the ovaries that produce eggs. An egg has the potential to develop into any cell. Therefore, these cysts can form different types of tissue. In about one in ten cases, dermoid cysts develop on both ovaries. Dermoid cysts can run in families.

Endometriotic Cyst/ Chocolate Cyst / Hemorrhagic Cyst

Many women with endometriosis develop one or more ovarian cysts. Endometriosis is when endometrial tissue (tissue lining the uterus) is outside the uterus. Sometimes blood-filled cysts form. The old blood inside these cysts resembles chocolate, which is why these cysts are sometimes called chocolate cysts. They are benign.

PCOS (polycystic ovary syndrome)

Polycystic means there are many cysts. If you have PCOS, you develop many small, benign ovarian cysts. Cysts form due to ovulation problems caused by hormonal imbalances. PCOS has been linked to menstrual problems, decreased fertility, hair growth, obesity, and acne.

Rare Types of Ovarian Cysts

There are other rarer types of ovarian cysts. There are also different types of benign tumors of the ovary that are solid rather than cystic (no fluid in the center).

Possible Complications of Ovarian Cysts

While most cysts are benign, some types risk becoming cancerous.

In rare cases, some ovarian cysts produce abnormal amounts of female (or male) chemicals (hormones), which can cause unusual symptoms.

Sometimes cysts bleed or ruptured. This can cause sudden, severe pain in the lower abdomen, the most common symptom of ovarian cysts.

Occasionally, a cyst on the stalk of the ovary may cause the stalk to entangle itself (torsion). This blocks blood flow to the cyst through the leg and causes it to lose its blood supply. This can cause sudden, severe pain in the lower belly/abdomen.

Larger cysts can cause the abdomen to bulge or pressure nearby structures. For example, they can put pressure on the bladder or rectum, which can cause urinary symptoms or constipation.

How is an ovarian cyst diagnosed?

Because most ovarian cysts do not cause symptoms, many are diagnosed incidentally, for example, during a routine exam or when an ultrasound is done for other reasons.

If you have symptoms suggestive of an ovarian cyst, your doctor may examine your abdomen (abdomen) and do an internal (vaginal) exam. They may be able to feel an abnormal lump that may be a cyst.

Ultrasound can confirm the presence of ovarian cysts. An ultrasound is a safe and painless test that uses sound waves to create pictures of organs and structures in the body. A scanning probe may be placed in your abdomen to examine your ovaries. A small probe is often placed in the vagina to scan the ovaries for a more detailed picture.

In addition to the ultrasound, a blood test called a CA125 test is often done. If this test is normal, the cyst is unlikely to be cancerous. A normal blood test does not completely rule out ovarian cancer, but it may be related to benign cysts on ultrasound.

Some women may have other tests like computed tomography (CT) scans or magnetic resonance imaging (MRI). This is not necessary for the most common type of benign ovarian cyst. It may be useful when ultrasound is inconclusive and/, or CA125 results are higher than normal.

Ovarian Cyst Treatment

Your specialist will advise you on the best course of action. It depends on the following factors:

• Your age.
• Any past menopause.
• Ultrasound shows the appearance and size of the cyst.
• Or have any symptoms.

How long do ovarian cysts last?

Many small ovarian cysts will regress and disappear within a few months. They may recommend that you repeat the ultrasound in a few months. If the cyst has disappeared, no further action is required.

Operation

Ovarian cyst removal may be recommended, especially if you have symptoms or if the cyst is large. Sometimes, a specialist doctor may want to remove a cyst to determine the exact type of cyst and ensure no cancer cells are in it. Most small cysts can be removed with "keyhole" surgery (laparoscopy). Some cysts require a more open surgical approach, with an incision in the lower abdomen.

The type of surgery depends on factors such as the type of cyst, your age, and whether cancer is suspected or ruled out. In some cases, only the cyst is removed, leaving the ovarian tissue behind. In some cases, the ovaries, and sometimes other nearby structures such as the uterus and other ovaries, are also removed. Your specialist will advise you on your situation.

Are you worried about your health?

Find a range of women's health pharmacy services offered by Dr. Rehana Amir, an expert gynecologist in Pakistan, who provides Laparoscopic and Robotic Surgeries first ever in Pakistan. For information about your conditions and their treatment, contact us anytime.

The management of ovarian cysts depends on their size, type, and associated symptoms. Small, asymptomatic cysts may not require treatment. In some cases, larger cysts or those causing severe symptoms may require surgical intervention, ranging from minimally invasive laparoscopic cystectomy to open surgery.
Prof. Dr Rehana Aamer Khan is specialist in treating the large ovarian cysts in Lahore Pakistan. She is treating the ovarian cyst through laparoscopic cystectomy. She is treating the ovarian cysts from last fifteen years.
Laparoscopic cystectomy offers several advantages over traditional open surgery, including smaller incisions, reduced postoperative pain, shorter hospital stay, and faster recovery. It is generally considered a safe and effective treatment option for benign ovarian cysts, and it may be preferred in cases where fertility preservation is a priority.