Ovarian Cysts

What Is an Ovarian Cyst?

Ovarian cysts are solid or fluid-filled pockets in or on your ovary. They’re common, especially in women who are pregnant or who haven’t gone through menopause yet. Most of the time, they’re painless and harmless. You might get one every month as part of your menstrual cycle and never know it. They usually go away on their own without treatment.

A cyst becomes a problem when it doesn’t go away or gets bigger. It can become painful. There’s also the possibility of cancer, but it’s rare. The chances go up as you get older

Ovarian Cyst Symptoms

Most ovarian cysts are small and don’t cause any problems. When there are symptoms, you might have pressure, bloating, swelling, or pain in one side of your lower belly. This pain may be sharp or dull, and it can come and go.

Sometimes, a cyst needs emergency attention. See your doctor right away if you have:

  • Sudden, severe belly pain
  • Pain with fever and throwing up
  • Dizziness, weakness, or feeling faint
  • Fast breathing

These things could mean your cyst has caused the ovary to twist.

Ovarian Cyst Causes

Most cysts are “functional.” They’re a part of your monthly cycle.

  • Follicle cyst. Your ovaries usually release one egg each month. It grows inside a tiny sac called a follicle. When the egg is ready, the follicle breaks open and releases it. If the sac doesn’t open, it causes a follicle cyst. These often go away in 1 to 3 months.
  • Corpus luteum cyst. Once the egg is released, the empty follicle usually shrinks and helps get ready for the next egg. It becomes a cyst when it closes back up and fluid collects inside. It may go away in a few weeks. But it may bleed or cause pain as it grows.

Others are nonfunctional. In some women, their ovaries make a lot of small cysts. This condition is called polycystic ovary syndrome (PCOS). It can make it hard to get pregnant. Other nonfunctional cysts may be caused by cancer. Ovarian cysts in women after menopause (once your period has stopped) are more likely to be cancerous than those in younger women.

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Ovarian Cyst Risk Factors

Things that may make you more likely to get ovarian cysts include:

  • Hormonal problems. Taking the fertility drug clomiphene (Clomid) to help you ovulate can increase your risk of cysts.
  • Pregnancy. The cyst that forms during ovulation may stay on your ovary after you get pregnant and throughout your pregnancy.
  • Endometriosis. Cells that usually line the inside of your uterus grow outside it. These wayward cells can attach to your ovary and cause a cyst to grow.
  • A severe pelvic infection. If this spreads to your ovaries, it can cause cysts there.
  • A previous ovarian cyst. If you’ve had at least one ovarian cyst before, you’re more likely to get others.

Ovarian Cyst Complications

Some women can have unusual complications with ovarian cysts. Your doctor might pick these up during a pelvic exam, so it’s important to get regular checkups.

  • Ovarian torsion. If cysts grow large, they can make the ovary move and twist. This twisting (ovarian torsion) is very painful.
  • Rupture. Cysts can break open, causing severe pain and bleeding, especially if the cysts are large. Vaginal sex and other activities can make a rupture more likely. A ruptured cyst sometimes heals on its own, but often, it’s a medical emergency.
  • Infected ovarian cyst. An ovarian cyst can develop in response to a pelvic infection, forming an abscess. If the abscess bursts, dangerous bacteria can spread through your body.

Ovarian Cyst Diagnosis

Sometimes, your doctor finds cysts during a pelvic exam. They’ll ask questions about your pain and other symptoms.

A cyst can be fluid-filled, solid, or mixed. To diagnose what kind you have, your doctor may recommend one or more of the following tests:

  • Pregnancy test. A positive pregnancy test may mean you have a corpus luteum cyst.
  • Pelvic ultrasound. This uses sound waves to make an image of your uterus and ovaries. Your doctor can confirm that you have a cyst, pinpoint its location, and figure out what kind it is.
  • Laparoscopy. Your doctor inserts a slim instrument with a light and a camera into your belly through a small cut. They can see your ovaries and remove any ovarian cysts.
  • CA 125 blood test. If you have a partially solid ovarian cyst, your doctor may want to test your blood for levels of a protein called CA 125 (cancer antigen 125). It’s often higher in women who have ovarian cancer and in those who have conditions such as uterine fibroids, endometriosis, and pelvic inflammatory disease (PID).

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Ovarian Cyst Treatment

Most cysts go away on their own. Your doctor may suggest watching and waiting for changes.

Your doctor can give you medicine for pain. They might also prescribe birth control pills. The hormones in the pills won’t make the cysts go away, but they can help prevent new ones.

Some ovarian cysts need surgery. That includes those that are large, don’t go away, or cause symptoms. You could also need surgery if you’re near menopause, because cysts are more likely to be cancerous. Depending on your case, the surgeon may take just the cyst or the entire ovary.

There are different types of surgery:

  • Laparoscopy is for smaller cysts. The doctor makes a tiny cut above or below your bellybutton. A small tool with a camera allows your doctor to see inside, and a different tool removes the cyst or ovary. You probably won’t have to stay in the hospital overnight.
  • Laparotomy is for cysts that may be cancerous. It is done with a bigger cut in the belly.

WebMD Medical Reference Reviewed by Hansa D. Bhargava, MD on July 29, 2020

Sources

SOURCES:

American Academy of Family Physicians: “Ovarian Cyst.”

Mayo Clinic: Diseases and Conditions, Ovarian cysts, “Definition,” “Ovarian Cysts.” 

American Family Physician: “Ovarian Cysts and Ovarian Cancer.”

Office on Women’s Health, U.S. Department of Health and Human Services: “Ovarian cysts.”

Mount Sinai Hospital: “Ovarian cysts.”

Lourdes Health System: “Ovarian Cysts.”

The Center for Innovative Gyn Care: “Ovarian Cysts.”

American College of Obstetrics and Gynecology: “Ovarian Cysts.”

Johns Hopkins Medicine: “What Risks Are Associated with a Ruptured Ovarian Cyst?”

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