What are Ovarian Cysts?
The ovaries produce the eggs in the female reproductive
system. Eggs grow, develop, and mature in the ovaries and
then are released during ovulation, part of the monthly
menstrual cycle that
occurs during the childbearing years. Ovarian cysts are
fluid-filled sacs that form on the ovaries when the follicles
(sacs) on the ovary that contain the egg mature, but do not
release the egg into the fallopian tube where it would be
fertilized. A woman can develop one cyst or many cysts.
Ovarian cysts can vary in size-from as small as a pea to as
big as a grapefruit. Most cysts are small and do not cause
symptoms. Some cysts might cause a dull ache in the abdomen
because they are twisted, bleeding, or have burst; others
might cause pain during sexual intercourse. Most cysts are
benign (not cancerous). A few cysts, though, may turn out to
be malignant (cancerous). For this reason, your doctor should
check all cysts. If ovarian cysts are found early, many of
the problems they cause can be treated. There are different
types of ovarian cysts:
Functional cysts - These cysts are completely
normal and form during ovulation. The follicles (sacs) on the
ovary that contain the egg often do not mature, and become
cysts. These cysts usually disappear during menstruation,
before another menstrual cycle begins. If not, they will
shrink in about one to three months. Your doctor may want to
check in a few months to make sure the cyst has gotten
smaller. Only women who are ovulating form functional cysts.
If a woman is in menopause define or past menopause
and not having periods, she should not have functional
cysts.
Endometriomas - These cysts develop in women who
have endometriosis, a condition in which tissue from the
lining of the uterus (endometrium) grows in other areas, such
as on the fallopian tubes, the ovaries, and on other organs
outside of the uterus in the
stomach
abdomen.
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These may be filled
with a thick, brown blood and so also are called "chocolate
cysts." Because uterine tissue is sensitive to hormones, even
when it's located outside the uterus, the tissue will bleed
monthly, which may cause the formation of a growing cyst on
the ovary. These cysts can be painful during sexual
intercourse and during menstruation.
Benign cystic tumors(cystadenomas) - These tumors
are non-cancerous and are often filled with a fatty liquid.
They develop from cells on the outer surface of the ovary.
Some of these tumors, called dermoid cysts, are lined with
structures such as hair, or pieces of bone. They are often
small and may not cause symptoms. They can, however, become
large and uncomfortable.
Multiple Cysts - Women who do not ovulate regularly
can develop multiple cysts. This is a disorder in which the
ovaries are enlarged and contain many small cysts. This can
be caused by a condition called polycystic ovary syndrome
(PCOS). Symptoms of PCOS include irregular menstrual periods,
infertility, and increased body hair.
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What are the Symptoms of Ovarian Cysts?
Many women may have functional cysts or benign cystic
tumors without having any symptoms. Sometimes, though, a cyst
will swell large enough to cause pressure or pain in the
abdomen. The cysts also may put pressure on the urinary tract
and cause problems with urine flow. Some women may have pain
during sexual intercourse. Although it is rare, it is
possible for a very large cyst to become twisted, stopping
its own supply of blood. This can cause nausea, fever, and
severe abdominal pain. In women with endometriosis, ovarian
cysts can cause the commonly felt symptoms of pelvic pain,
painful menstrual periods, abnormal bleeding and painful
sexual intercourse.
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When are Women Most Likely to Have Ovarian Cysts?
Ovarian cysts are very common during the childbearing
years so that means as college women many of us will have
them. Most often, cysts in women of this age group are not
cancerous. Women who are past menopause (ages 50-70),
however, and have ovarian cysts, have a higher risk of having
ovarian cancer. If you are over 50 and have an ovarian cyst,
your doctor will probably want to do surgery to remove it.
However, if you think you might have a cyst, at any age, you
should tell your health care provider.
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How are Ovarian Cysts Diagnosed and Treated?
Ovarian cysts usually are found during routine pelvic
examinations. During this examination, your doctor is able to
feel the swelling of the cyst on your ovary. Once a cyst is
found, the doctor may perform an ultrasound, or a screening
to see if the cyst is hollow or solid, determine its size and
exact location, and see if it contains fluid or abnormal
structures that help show its type. The doctor may decide to
"wait and see" if the cyst will shrink on its own in a few
months. If you frequently develop cysts, your doctor may
prescribe birth control pills link to contraception
page to section on these to prevent you from ovulating. This
will prevent follicles from developing and new cysts from
forming. Your doctor might talk with you about birth control
pills, and if they are right for you.
If the cyst does not go away after several menstrual
periods, if it has gotten larger or more painful, or it does
not appear to be a functional cyst, your doctor may want to
perform other tests or procedures to look at and remove the
cyst. To detect your risk for ovarian cancer, your doctor may
want to do a blood test to measure a substance in the blood
called CA-125. The amount of this protein is increased in the
blood of women with ovarian cancer. However, some ovarian
cancers do not produce enough CA-125 to be detected by the
test, and there are other non-cancerous diseases that also
increase the levels of CA-125. For these reasons, the CA-125
test is recommended mostly for women who are at high risk for
the disease.
If the cyst is small and looks benign on the ultrasound,
your doctor may perform a laparoscopy. This procedure is done
under general anesthesia on an outpatient basis and allows
the doctor to closely examine all of your reproductive
organs. A very small incision is made above or below the
navel, and a small instrument called a laparoscope that acts
like a telescope is inserted into the abdomen. If the cyst is
small and looks benign, it can be removed after the doctor
makes very small incisions in the pubic hairline.
If the cyst is too large to remove this way, the doctor
may perform a procedure called a laparotomy. This procedure
involves making bigger incisions in the stomach to remove the
cyst. While you are under general anesthesia, the doctor is
able to have the cyst tested to find out if the tissue is
cancerous. If it is cancerous, the doctor will then be able
to remove other tissue that could be affected, like the
ovary, fallopian tubes, uterus, or lymph nodes. Before any
surgery, your doctor will talk to you about what will happen
during the surgery, the risks, and how long it will take you
to recover. It is important to remember that most cysts are
not cancerous and are relatively harmless if treated
properly.
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What Questions Should a Woman With an Ovarian Cyst Ask her Doctor?
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If you have an ovarian cyst, you may want to ask:
- How big is the cyst and where is it located?
- Do I need to have it removed immediately, or can we "watch
and wait" for one to two months?
- How much of my ovary might be removed along with the cyst,
and how would this affect my fertility?
- What did the pathologist's report say about the cyst?
- What are the chances that the cyst will recur, or that
another cyst will form?
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Myths and Facts about Ovarian Cysts
All Ovarian Cysts are malignant
This is a myth. In fact, most Ovarian Cysts are
benign (non-cancerous). Since functional cysts are
common during menstruation, they often appear and disappear
quickly without causing harm.
Ovarian Cysts can affect women of any age group
Fact. Although they occur most often during a
woman's child-bearing years (puberty to menopause), they may
occur at any time. In fact, women during menopause are
more prone to ovarian cancer.
Ovarian Cysts can grow as large as the size of an egg and
may contain follicles and cartilage.
Fact. These types of cysts are called dermoids and
come from undeveloped tissue forming into, usually, a
non-cancerous growth over a period of time.
Some complicated forms of Ovarian Cysts require surgical
removal and some may go away on their own
Fact. Since some cysts are f unctional and thus
present during the menstrual cycle, they are usually harmless
and disintegrate on their own. However, cysts that are
non-functional and may affect the ovary with their size
and/or location need to be removed.
Biopsy is recommended for ALL women diagnosed with an
Ovarian Cyst.
Myth. Since some cysts are functional and are
directly linked with the menstrual cycle, they mostly
dissolve on their own. However, a biopsy may be advised
when a cyst persists or causes symptoms so that your doctor
can determine whether the growth is cancerous or
non-cancerous.
There is no known way to prevent functional Ovarian
Cysts.
Fact. They are part of a natural biological process
and are often present during ovulation. Therefore,
there is no method of preventing cyst formation.
However, birth control pills may help women who are
constantly forming cysts and experiencing heavy menstrual
cycles. Birth control pills stabilize your period and
help minimize cyst formation in many women.
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References
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