Ovarian Cysts

Patient Education Materials

Women’s Health

Ovarian Cysts

A cyst (SIST) is a growth containing fluid, blood, tissue, or a combination of these. It may occur anywhere in your body. A cyst on an ovary is called an ovarian (oh-VAIRee-an) cyst. Some ovarian cysts cause no symptoms. Many go away on their own. They are so common that it is not known how many women have them.

Most ovarian cysts are harmless, but they can cause pain and make you uncomfortable. However, a small number of ovarian cysts are cancerous (malignant). The risk of cancer goes up as a woman gets older.

The ovary is the part of a woman’s body that produces eggs. Women who do not release eggs (ovulate) regularly are more likely to develop ovarian cysts.

Experts think that non-cancerous cysts do not affect the way a woman’s body works or her ability to become pregnant.

Symptoms of an ovarian cyst

Call your doctor right away if you have sharp pain in the lower belly. This may mean that a cyst is about to break open (rupture) or already has broken.

Other symptoms may include:

  • Dull ache in the pelvic area, usually on one side or the other
  • Feeling of heaviness or pressure in your pelvis
  • Changes in your menstrual period
  • Frequent urination
  • Nausea or diarrhea
  • Pain during sex

Call your doctor if you have 2 or more of these symptoms.

What causes an ovarian cyst?

No one knows exactly what causes an ovarian cyst. Some experts think that common ovarian cysts come from a hormonal imbalance. If a woman has a hormonal imbalance, her body will not make eggs (ovulate). In most cases, this imbalance does not last long. The doctor may want to just watch you until the cyst goes away.

Types of ovarian cysts

There are 3 major types of ovarian cysts: functional, benign neoplasms, and malignant.

Functional Cysts

Functional cysts are common in women who have not gone through menopause.

One type of functional cyst, called a follicle cyst, happens when a woman does not ovulate. The cyst is filled with watery fluid. It usually goes away on its own. No treatment is needed.

Another type of functional cyst, called a hemorrhagic (hem-or-AJ-ick) cyst, happens when an egg breaks free from the ovary to begin its journey to the fallopian tubes. Sometimes, after the egg breaks free, the tissue that is left closes and bleeds within itself. This blood-filled cyst usually goes away on its own. Treatment might not be needed. In some cases, this cyst may break and cause heavy bleeding in the belly.

Benign Neoplasms

Benign (bee-NINE) means not cancerous. Neoplasm (NEE-oh-plazm) means a growth or tumor. The most common benign neoplasm of the ovary is the dermoid cyst. This unusual cyst is made up of hair and fatty tissue. No one knows exactly how or why these cysts form. Some experts think they may form from an immature egg, which can make different body tissues.

Most women with dermoid cysts have no symptoms. The cysts may be found during a routine pelvic exam. These cysts must be removed by surgery.

Endometriosis (END-oh-mee-tree-OH-sis) is another common and benign condition. It may be caused by many cysts in a woman’s pelvic area. Or there may be one large blood filled cyst within the ovary.

There are other kinds of benign neoplasms of the ovary, but they are less common.

Malignant Cysts

Malignant (cancerous) cysts are more common in women who have gone through menopause. Women who have gone through menopause usually do not get functional cysts. The danger with malignant ovarian cysts — for all women — is that they rarely cause any symptoms until they are very large.

Diagnosis of ovarian cysts

If you think you have an ovarian cyst, call your doctor right away. He or she will perform a pelvic exam. Many cysts can be felt during a pelvic exam, if they are large enough. You may need further testing.

One test is ultrasound. This painless test uses sound waves to measure the size of the cyst and see if it is filled with fluid, tissue, or blood.

Another test, a type of ultrasound, is called a Doppler flow. This test measures the amount of blood flowing to the ovary. Because malignant tumors need more blood, there is more blood flow if the cyst is cancerous.

A blood test, called CA 125, measures certain substances that are released by a cancerous cyst. The results of this test are not always clear. Women with conditions  like uterine fibroids, endometriosis, or liver disease also have elevated levels of these substances. The best use for the CA 125 test is to see if a particular treatment is working for a woman who has ovarian cancer. The test also can be used to screen women with a family history of ovarian cancer who may be at high risk to develop the disease.

Routine screening is not recommended for every woman.

Treatment of ovarian cysts

The treatment for an ovarian cyst is based on the type of cyst. Different types of cysts often have similar symptoms. They may look the same with ultrasound. For that reason, your doctor may watch the cyst for several weeks to see if it disappears on its own.

Sometimes, the doctor may prescribe low-dose birth control pills. These pills stop your body from releasing eggs. That allows time for the cyst to go away on its own before the body resumes its regular cycle. If the cyst does not go away, or if it grows larger, then the doctor considers surgery.

A cystectomy (sis-TECK-toe-me) is one surgical procedure that may be used to remove the cyst from the normal ovarian tissue. If the cyst cannot be removed, then the entire ovary is removed.

These procedures can be done by laparoscopy (lap-ah-RAW-sko-pee). Two or 3 small cuts are made in the wall of the lower belly (abdomen). The doctor then uses a lighted scope and small instruments to remove the cyst.

A laparotomy (lap-ah-RAW-toe-me) is more like standard surgery. A large cut is made in the abdomen, below the belly button. If cancer is suspected, the doctor may do a laparotomy to check other areas in the pelvis and abdomen for possible cancer.