Ovarian Cysts 

Ovarian cysts are small, fluid-filled sacs, similar to blisters, found on the ovaries. Most of the time they are harmless and disappear on their own. When these cysts grow large however, they may cause feelings of pressure, fullness or discomfort.

Ovarian cysts are very common among women during their reproductive years. Women can have one or many cysts, which can vary in size from as small as a pea to the size of a grapefruit.

Cause

As part of a woman’s reproductive cycle, the ovaries produce eggs each month which are released during ovulation. Every woman who is having periods and not using hormones will have ‘normal’ cysts in the ovary each month as the eggs are developing. Ovarian cysts form when the sac containing the developing egg fills with fluid. A normal ovulating sac can be as large as five centimetres, but most are smaller. Sometimes after the egg it released, a small blood vessel can burst in the sac, containing a cyst that persists for weeks or months.

Sometimes ovarian tissue begins to develop abnormally, forming cysts.

Pain in the abdominal area can be caused by cysts which are large in size, are bleeding, twisted or have burst.

Symptoms

While a woman with ovarian cysts often has no symptoms, symptoms can include:

• A dull ache or a sense of fullness or pressure in the abdomen
• Pain during intercourse
• Irregular or unusually painful periods

How do I know if I have them?

Ovarian cysts are usually diagnosed by an ultrasound, during which the doctor is able to check the size and location of any cysts, as well as determine if they are hollow, solid or contain abnormal structures.

Many women have an ultrasound to investigate abdominal pain. Most ovarian cysts seen on ultrasounds are the normal monthly swelling associated with a growing egg.

While most cysts are benign (not cancerous), sometimes they can 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.

Management/Treatment

If you have a cyst your doctor may decide to "wait and see" if it shrinks on its own. If a cyst does not go away after several menstrual periods, or if it gets larger or more painful, your doctor may want to perform other procedures to look at and remove the cyst.

To investigate this further, your doctor may perform a laparoscopy. This procedure is done under general anaesthetic and allows the doctor to closely examine all of your reproductive organs. A small incision is made near the navel, and a small telescope is inserted into the abdomen. If the cyst is found to be small and benign it can now be removed by sucking out the fluid.

If the cyst is too large to remove this way, or if it looks suspicious of cancer on the ultrasound, the doctor may perform a procedure called a laparotomy. This procedure involves making bigger incisions in the stomach under a general anaesthetic. It is important to remember that most cysts are not cancerous and are relatively harmless if treated properly.

If you have a cyst but have not yet gone through menopause, you may not need any treatment unless the cyst is very big or causing pain. After menopause however, the risk of ovarian cancer increases significantly, and surgery to remove the entire ovary is usually recommended.

If you frequently develop cysts, your doctor may prescribe the oral contraceptive pill to prevent you from ovulating. This will stop follicles from developing and new cysts from forming. Sometimes taking the oral contraceptive pill will make existing cysts smaller.

Pregnancy/Fertility

Most ovarian cysts that are related to ovulation will not have any affect on fertility. However, there is a separate condition called Polycystic Ovary Syndrome (PCOS) where lots of very tiny cysts are seen in the ovaries. Women with this condition often have a hormonal imbalance that leads to irregular or infrequent periods. They may need assistance to help their cycles become more regular if they wish to become pregnant.

Page last updated Mon, 12 Jun 2006 09:07

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