Ovarian Cysts - All you need to know

What is an ovarian cyst ?

An ovarian cyst is a sac filled with fluid that forms on or within an ovary. Many cysts are normal and form as part of the menstrual cycle, such as follicular and luteal cysts, which typically disappear on their own. However, certain types of ovarian cysts can persist and lead to complications or symptoms.

Common Symptoms and Red Flags

While most ovarian cysts are small, benign, and asymptomatic, some can cause:

• Lower abdominal or pelvic pain: This may range from a dull ache to a sharp, severe pain, especially if the cyst twists (ovarian torsion) or bursts.

• Bloating or a sense of fullness: Swelling or discomfort in the lower abdomen.

• Pain during intercourse: Some women experience pain only during sexual activity.

• Sudden, severe pain: This is a red flag that could indicate a burst cyst or ovarian torsion, both of which require immediate medical attention.

Different Types of Ovarian Cysts

1. Functional Cysts

• Follicular Cysts: These form when a follicle doesn’t release an egg and fills with fluid instead. They usually resolve within a few menstrual cycles.

• Corpus Luteum Cysts: After an egg is released, the follicle may fill with fluid or blood, forming this type of cyst. They typically disappear without intervention.

2. Dermoid Cysts

• Also known as benign mature cystic teratomas, these cysts often contain odd materials like hair, teeth, or fat. They can grow large and usually occur in younger women, commonly affecting both ovaries in about 10% of cases.

3. Cystadenomas

• These cysts develop from cells on the surface of the ovary and can grow significantly large. While they are mostly benign, some may turn cancerous. They are often attached to the ovary by a stalk rather than embedded within it.

4. Endometriomas

• Women with endometriosis may develop these cysts, which contain old blood and are referred to as "chocolate cysts" due to their appearance. They are benign but can cause severe pain and fertility issues.

5. Polycystic Ovaries

• Women with Polycystic Ovary Syndrome (PCOS) may have multiple small cysts caused by hormonal imbalances. PCOS is associated with infertility, irregular periods, excessive hair growth, acne, and obesity.

Serious Complications (Red Flags)

Although most cysts are benign, certain risks include:

• Ovarian torsion: When a large cyst causes the ovary to twist, cutting off its blood supply. This leads to intense pain and requires emergency surgery.

• Cyst rupture: If a cyst bursts, it can lead to severe, sudden pain and internal bleeding, warranting urgent medical attention.

• Cancer risk: While rare, some cysts may be linked to ovarian cancer, especially in postmenopausal women. A CA-125 blood test and ultrasound can help assess the likelihood of malignancy.

Diagnosis and Treatment

• Ultrasound: A primary tool used to diagnose ovarian cysts, either abdominally or through a vaginal probe.

• CA-125 test: A blood test that helps rule out ovarian cancer if levels are normal.

• Surgical intervention: If a cyst is large, symptomatic, or has the potential for cancer, surgery may be required. In most cases, keyhole (laparoscopic) surgery is performed. In more severe cases, the ovary or nearby organs may need removal.

Key Considerations

• Fertility: While most ovarian cysts don’t affect fertility, some can, especially if surgery involves removing ovarian tissue or if a cyst damages the ovary. PCOS and endometriosis-related cysts are particularly linked to fertility issues.

Seeking Help

If you have been diagnosed with an ovarian cyst/ cysts, make sure you book an appointment with your GP and speak to your Gynaecologist. You can book an appointment with Dr Kohli if you are looking for answers and treatment options regarding ovarian cysts