Ovarian Cysts

Ovarian cysts are fluid-filled sacs that develop on or within an ovary. Most women will have an ovarian cyst at some point in their lives, but most will never realize it. The majority of these cysts are harmless, don’t cause symptoms, and disappear without treatment within a few months.

Some ovarian cysts, however, can be a sign of a more serious condition, such as ovarian cancer, or cause problems if they become large or rupture.

Types of Ovarian Cysts

There are several types of ovarian cysts, but most form during the menstrual cycle.

Functional Cysts

Functional cysts comprise the majority of ovarian cysts. During a woman’s childbearing years, the ovaries produce and release eggs in monthly cycles. The eggs grow within a sac. When the egg is ready, the sac releases the egg and then dissolves.

One of two types of functional cysts may form during this process:

• Corpus luteum cysts: These form when the sac closes after releasing the egg, traps fluid inside, and does not dissolve. This type of cyst usually disappears within a few weeks.
• Follicle cysts: These form when the sac fails to release the egg. Follicle cysts usually disappear within three months.

Other types of ovarian cysts

Ovarian cysts that are not related to the menstrual cycle are less common, but can include:

• Cystadenomas: These cysts develop from ovarian tissue.
• Dermoid cysts: These cysts develop from cells that produce eggs and may contain tissue such as hair, skin, or teeth.
• Endometriomas: Tissue normally found in the uterus can develop outside the uterus, attach to the ovaries, and form a cyst.

Symptoms of Ovarian Cysts

Most ovarian cysts will not cause symptoms, but they may cause problems if they rupture or twist. Signs of an ovarian cyst include:

• Menstrual irregularities
• Pelvic pain
• Pain during bowel movements
• Nausea, vomiting, or breast tenderness
• Bloating, fullness, or heaviness in your abdomen
• Frequent or difficult urination

These symptoms are similar to ovarian cancer symptoms. If you experience any of these symptoms for more than 12 days, see your doctor immediately. 

Diagnosing Ovarian Cysts

While most ovarian cysts are benign, it’s important we check them to rule out cancer. It is especially important for postmenopausal women to be examined because they are at increased risk for ovarian cancer. 

The doctor may first detect an ovarian cyst during a routine pelvic exam. We can then use several tests to determine the cyst’s type, size, and composition (what it’s filled with). Cysts that are filled with fluid are less likely to be cancerous. Those that are solid or filled with fluid and solids may indicate cancer.

Tests and procedures we may use to diagnose ovarian cysts include:

• CA-125 blood test: This blood test looks for a protein called cancer antigen 125. Women with ovarian cancer tend to have higher levels of this protein.
• Laparoscopy: In this surgical procedure, a doctor inserts a laparoscope (a thin, lighted instrument) into the abdomen through a small incision to see your ovaries, remove the cyst, or take a small piece of tissue to test for cancer.
• Pregnancy test: A corpus luteum cyst can cause a false positive on a pregnancy test.
• Ultrasound: This imaging test uses high-frequency sound waves to create an image of your uterus and ovaries.

If the diagnosis is ovarian cancer, consult a gynecologic oncologist for treatment options. 

Treatments for Ovarian Cysts

How we treat an ovarian cyst depends on your age, the type and size of the cyst, and your symptoms. 

• Watchful waiting: Cysts often go away on their own. If no symptoms are present and the cyst is small and fluid-filled, the doctor may recommend follow-up exams to ensure the cyst disappears or does not grow.
• Birth control pills: Birth control pills can reduce the development of new cysts.
• Surgery: The doctor can surgically remove a cyst that is large, growing, or causing pain. Some cysts can be removed without taking out the ovary. If the cyst is cancerous, your doctor will likely recommend a hysterectomy to remove the ovaries and uterus.