Ovarian Cysts – the 411

Ovarian Cysts - the 411

What are ovarian cysts?

A cyst is a fluid-filled sac. They can form anywhere in the body. Ovarian cysts (sists) form in or on the ovaries. The most common type of ovarian cyst is a functional cyst.

Functional cysts often form during the menstrual cycle. The two types are:

Follicle cysts. These cysts form when the sac doesn’t break open to release the egg. Then the sac keeps growing. This type of cyst most often goes away in 1 to 3 months.

Corpus luteum cysts. These cysts form if the sac doesn’t dissolve. Instead, the sac seals off after the egg is released. Then fluid builds up inside. Most of these cysts go away after a few weeks. They can grow to almost 4 inches. They may bleed or twist the ovary and cause pain. They are rarely cancerous. Some drugs used to cause ovulation, such as Clomid® or Serophene®, can raise the risk of getting these cysts.

Other types of ovarian cysts are:

Endometriomas (EN-doh-MEE-tree-OH-muhs). These cysts form in women who have endometriosis (EN-doh-MEE-tree-OH-suhss). This problem occurs when tissue that looks and acts like the lining of the uterus grows outside the uterus. The tissue may attach to the ovary and form a growth. These cysts can be painful during sex and during your period.

Cystadenomas (siss-tahd-uh-NOH-muhs). These cysts form from cells on the outer surface of the ovary. They are often filled with a watery fluid or thick, sticky gel. They can become large and cause pain.

Dermoid (DUR-moid) cysts. These cysts contain many types of cells. They may be filled with hair, teeth, and other tissues that become part of the cyst. They can become large and cause pain.

Polycystic (pol-ee-SISS-tik) ovaries. These cysts are caused when eggs mature within the sacs but are not released. The cycle then repeats. The sacs continue to grow and many cysts form.

What are the symptoms of ovarian cysts?

Many ovarian cysts don’t cause symptoms. Others can cause:

Pressure, swelling, or pain in the abdomen
Pelvic pain
Dull ache in the lower back and thighs
Problems passing urine completely
Pain during sex
Weight gain
Pain during your period
Abnormal bleeding
Nausea or vomiting
Breast tenderness

If you have these symptoms, get help right away:

Pain with fever and vomiting
Sudden, severe abdominal pain
Faintness/dizziness/weakness
Rapid breathing

How are ovarian cysts found?

Doctors most often find ovarian cysts during routine pelvic exams. The doctor may feel the swelling of a cyst on the ovary. Once a cyst is found, tests are done to help plan treatment. Tests include:

An ultrasound. This test uses sound waves to create images of the body. With an ultrasound, the doctor can see the cyst’s:

Shape
Size
Location
Mass — if it is fluid-filled, solid, or mixed

A pregnancy test. This test may be given to rule out pregnancy.

Hormone level tests. Hormone levels may be checked to see if there are hormone-related problems.

A blood test. This test is done to find out if the cyst may be cancerous. The test measures a substance in the blood called cancer-antigen 125 (CA-125).

The amount of CA-125 is higher with ovarian cancer. But some ovarian cancers don’t make enough CA-125 to be detected by the test. Some noncancerous diseases also raise CA-125 levels.

Those diseases include uterine fibroids (YOO-tur-ihn FEYE-broidz) and endometriosis. Noncancerous causes of higher CA-125 are more common in women younger than 35. Ovarian cancer is very rare in this age group. The CA-125 test is most often given to women who:
-Are older than 35
-Are at high risk for ovarian cancer
-Have a cyst that is partly solid

How are cysts treated?

Watchful waiting. If you have a cyst, you may be told to wait and have a second exam in 1 to 3 months. Your doctor will check to see if the cyst has changed in size. This is a common treatment option for women who:

Are in their childbearing years
Have no symptoms
Have a fluid-filled cyst

It may be an option for postmenopausal women.

Surgery. Your doctor may want to remove the cyst if you are postmenopausal, or if it:

Doesn’t go away after several menstrual cycles
Gets larger
Looks odd on the ultrasound
Causes pain

The two main surgeries are:

Laparoscopy (lap-uh-ROSS-kuh-pee) – Done if the cyst is small and looks benign (noncancerous) on the ultrasound. While you are under general anesthesia, a very small cut is made above or below your navel. A small instrument that acts like a telescope is put into your abdomen. Then your doctor can remove the cyst.

Laparotomy (lap-uh-ROT-uh-mee) – Done if the cyst is large and may be cancerous. While you are under general anesthesia, larger incisions are made in the stomach to remove the cyst. The cyst is then tested for cancer. If it is cancerous, the doctor may need to take out the ovary and other tissues, like the uterus. If only one ovary is taken out, your body is still fertile and can still produce estrogen.

Birth control pills. If you keep forming functional cysts, your doctor may prescribe birth control pills to stop you from ovulating. If you don’t ovulate, you are less likely to form new cysts. You can also use Depo-Provera®. It is a hormone that is injected into muscle. It prevents ovulation for 3 months at a time.

When are women most likely to have ovarian cysts?

Most functional ovarian cysts occur during childbearing years. And most of those cysts are not cancerous. Women who are past menopause (ages 50­–70) with ovarian cysts have a higher risk of ovarian cancer. At any age, if you think you have a cyst, see your doctor for a pelvic exam.

More information on ovarian cysts

For more information about ovarian cysts, call womenshealth.gov at 800-994-9662 (TDD: 888-220-5446) or contact the following organizations:

Agency for Healthcare Research and Quality, HHS
Phone: 301-427-1104

American Academy of Family Physicians
Phone: 800-274-2237 or 913-906-6000

American College of Obstetricians and Gynecologists Phone: 202-638-5577

American Society for Reproductive Medicine Phone: 205-978-5000

Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, HHS Phone: 800-370-2943 (TDD: 888-320-6942)

The InterNational Council on Infertility Information Dissemination, Inc. Phone: 703-379-9178

Source: WomensHealth.gov

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