Ovarian Cysts

Ovarian Cysts

Ovarian cysts are fluid filled sacs or membrane formed inside the ovary or on its surface. Ovaries are part of the female reproductive system in which the eggs (ova) develop and mature. Mature egg is released from the ovary to the fallopian tube this is known as ovulation. Ovarian cysts are normally formed during ovulation. Usually ovarian cysts are non-cancerous. These are caused by various factors such as hormonal imbalance, conditions like endometriosis, pregnancy. There are various types of ovarian cysts:

Follicular cysts: In a menstrual cycle, every month an ovary releases an egg. This egg develops inside a sac or a follicle. When it reaches maturity the sac opens and the egg is released from the ovary to the fallopian tube. When the follicle doesn’t open to release the egg it turns into a cyst and continues to grow. Normally there are no symptoms of follicle cysts and these cysts disappear within 1 to 3 months.

Corpus luteum cysts: when the follicle breaks and releases the egg, it shrinks and makes hormones for the next cycle. This mass of cell is known as corpus luteum. When this follicle fails to shrink it re-seals itself forming a cyst. This type of cysts disappears within weeks.

Endometriomas: these types of cysts are caused by endometriosis. This is a condition in which uterus lining grows outside the uterus.

Dermoids: Also called as teratomas these cysts are usually non-cancerous ovarian tumours. These cysts are mostly asymptomatic,  but can grow to a large size.

Cystadenomas: these cysts are filled with watery or mucus like liquid and develop on the surface of the ovaries. These cysts continue to get bigger as they do not always disappear like follicle cysts or corpus luteum cysts, and often need surgery.

Symptoms

Usually small ovarian cysts do not cause any symptoms. In rare cases some cysts cause symptoms like pelvic pain, bloating, swelling, pain on the side of the cyst, etc.

Less common symptoms include painful sex, unusual vaginal bleeding, painful periods, problems in emptying the bladder, irregular periods.

When a cyst ruptures open, severe pain may be experienced.

Causes of Uterine fibroids

Common causes of ovarian cysts are:

Hormonal problems: certain functional cysts (Corpus luteum cysts and Follicle cysts) may be developed by hormonal issues. These cysts usually go away without any treatment.

Endometriosis: the endometrial tissue gets attached to the ovary and starts forming a tumour. These cysts can cause painful sex and painful menstruation.

Pregnancy: sometimes cyst developed during the pregnancy fails to shrink and stays on the ovary until removed after pregnancy.

Pelvic infections: infections on the ovaries and the fallopian tubes can lead to cysts.

There are certain risk factors involved with ovarian cysts if these cysts rupture or twist the ovaries. Due to cysts, the size of the ovaries increases causing them to twist or move. this affects the blood flow to the ovaries. This twisting is often painful and is accompanied by fever and vomiting. When a cysts ruptures it causes internal bleeding and pain. Mostly larger cysts are at higher risk of rupture.

When to seek medical help

Get in touch with your doctor if you experience:

  • Sudden excruciating abdominal pain
  • Pain accompanied by fever, nausea and vomiting
  • Weakness

Ovarian Cysts, Fertility and Pregnancy

Normal ovarian cysts do not hamper fertility. However certain conditions developed due to ovarian cysts can diminish fertility. Conditions like endometriosis and PCOS can cause infertility.

Generally, ovarian cysts that are formed during pregnancy are non-cancerous cysts. However, sometimes when these cysts become large in size they can rupture or twist the ovary increasing the chances of complications during childbirth.

Treatment and prevention

For diagnosis of ovarian cysts, the doctor may do a physical pelvic exam to feel any swelling. A watchful waiting may be done by the doctor to prepare the treatment plan. Following test may be done:

Ultrasound: to ascertain the size, shape and location of the cysts.

Pregnancy test: at times a corpus luteum cyst may produce a positive pregnancy test.

Hormone level test: to ascertain any hormone related problems

Blood test: Sometimes the doctor may order blood test – tumor markers. This will help to determine if the cysts are cancerous.

Depending on the diagnosis the ovarian cysts can be treated with the help of medicines or surgery. Functional cyst disappears on its own therefore only monitoring is required. Birth control pills may be prescribed to stop the cysts from reappearing. However existing cysts do not shrink away with medication. Certain painkillers may also be prescribed to ease the pain caused by cysts.

Existing cysts can be removed surgically. Cysts that are not functional or are bigger in size, and appear to be growing, require surgical removal. Laparoscopy is done by making a small incision in the naval area to locate and remove the cyst. This procedure is done for cysts that are non-cancerous. For cancerous cysts procedure called laparotomy is done. In this procedure, a large cut is made to remove the cysts and at times ovaries or other reproductive parts may be removed if they are affected.

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