Ovarian cysts are very common. Often painless and symptomless, they are usually just a sign of ovulation. In some cases, they can point to an underlying condition and may need to be removed.
The ovaries are part of the female reproductive system. There are two ovaries, and they’re located in the lower abdomen on both sides of the uterus. The ovaries produce egg, as well as the hormones estrogen and progesterone.
Read on to learn more about the types of ovarian cysts, what causes them, when they may need treatment, how they can be prevented, and more.
The terms “male” and “female”
In this article, we use “male and female” to refer to someone’s sex as determined by their chromosomes and “men and women” when referring to their gender (unless quoting from sources using nonspecific language).
Chromosomes determine sex, and gender is a social construct that can vary between periods and cultures. Both of these aspects are acknowledged to exist on a spectrum both historically and by modern scientific consensus.
There are various ovarian cysts, such as dermoid cysts and endometriomas (also called chocolate cysts).
However, the most common type is cysts filled with fluid formed during the menstrual cycle.
These are follicular cysts and corpus luteum cysts.
During the menstrual cycle, an egg grows in a follicle sac. This sac is located inside the ovaries.
In most cases, the follicle breaks open and releases an egg. If the follicle doesn’t break open, the fluid inside the follicle can form a cyst on the ovary.
Corpus luteum cysts
The corpus luteum is a benign structure that appears in an ovary after an egg is released. It’s job is to release hormones needed for pregnancy. However, it will break down after a few days unless a pregnancy starts.
In some cases, it may not dissolve. Instead, additional fluid
Ovarian cysts that aren’t formed as part of a typical menstrual cycle include:
- Dermoid cysts: These sac-like growths on the ovaries can contain hair, fat, and other tissue.
- Endometriomas: Tissues that normally grow inside the uterus can develop outside the uterus and attach to the ovaries. These are also colloquially called chocolate cysts, and may affect people with severe endometriosis.
- Cystadenomas: These growths can develop on the outer surface of the ovaries.
Some people develop a condition called polycystic ovary syndrome (PCOS), in which the ovaries form many small cysts. PCOS can cause the ovaries to enlarge. If left untreated, polycystic ovaries can result in infertility.
Often times, ovarian cysts don’t cause any symptoms. However, symptoms can appear if the cyst grows. Symptoms may include:
- abdominal bloating or swelling
- painful bowel movements
- pelvic pain before or during the menstrual cycle
- painful intercourse
- pain in the lower back or thighs
- breast tenderness
- nausea and vomiting
How do you know if an ovarian cyst has burst?
Both complications are rare, but can have serious consequences if not treated early.
An ultrasound is an imaging test that uses high-frequency sound waves to produce an image of your internal organs. Ultrasound tests help determine the size, location, shape, and composition (solid or fluid-filled) of a cyst.
Other imaging tools that may be used to diagnose ovarian cysts include:
- CT scan: A CT scan uses a body imaging device to create cross-sectional images of internal organs.
- MRI: An MRI uses magnetic fields to produce in-depth images of internal organs.
Because most cysts disappear after a few weeks or months, the doctor may not immediately recommend a treatment plan.
Instead, they may repeat the ultrasound test in a few weeks or months to check your condition. In certain cases, no further monitoring will be needed, especially if you previously had a follicular cyst or corpus luteum cyst.
If there aren’t any improvements to your condition or the cyst increases in size, the doctor may request additional tests to determine other causes of your symptoms.
That said, if treatment is necessary, the kind of treatment will depend on the type of the cyst. Some larger cysts, endometromas, or cancerous cysts usually need to be removed surgically.
Options for surgery include:
- Laparoscopy: A doctor performs a laparoscopy by making several tiny incisions near your navel and inserting a small instrument into your abdomen to remove the cyst.
- Laparotomy: In this procedure, a doctor can surgically remove the cyst through a large incision in your abdomen. This is known as laparotomy. They can then do a biopsy if they are concerned about cancer.
In a rare case, a doctor may detect a cancerous cystic ovarian mass during a routine examination.
Ovarian torsion is another rare complication of ovarian cysts. It occurs when a large cyst causes an ovary to twist or move from its original position. Blood supply to the ovary is cut off. If not treated, ovarian torsion can cause damage or death to the ovarian tissue.
Ruptured cysts rarely cause intense pain and internal bleeding. This complication increases your risk of an infection and can be life threatening if left untreated.
If you have recurring ovarian cysts, a doctor can prescribe oral contraceptives to stop ovulation and prevent the development of new cysts.
Oral contraceptives can also help reduce your risk of ovarian cancer. The risk of ovarian cancer is higher in postmenopausal females.
In addition, in a study on rats,
Routine gynecologic examinations can also help a doctor detect ovarian cysts early.
Alert a doctor to symptoms that may indicate a problem, such as:
- changes to your menstrual cycle
- ongoing pelvic pain
- loss of appetite
- unexplained weight loss
- abdominal fullness
The outlook for premenopausal people with ovarian cysts is good. Most cysts disappear within a few months. However, premenopausal people and people with hormone imbalances such as PCOS can also experience recurring ovarian cysts.
If left untreated, some cysts can decrease fertility. This really depends on the type of cyst. Ovulatory cysts indicate regular menstrual cycles, but endometriomas suggest endometriosis, which can harm fertility. Dermoid cysts can cause pain and make sexual intercourse more painful, affecting conception.
To improve fertility, a doctor can remove or shrink the cyst. However, laproscipic removal of some types of cysts
Depending on cyst size and type, a “wait and see” approach may be appropriate with ovarian cysts.
A doctor may recommend surgery to remove and examine any cyst or growth that develops on the ovaries after menopause. This is because the chance of developing a cancerous cyst or ovarian cancer increases after menopause. However, ovarian cysts don’t increase the chance of getting ovarian cancer.