Overview
Ovarian cysts develop as fluid pockets in the ovaries or on their surface. Women have two ovaries on either side of the uterus that release eggs every month. The released eggs go to the uterus through the fallopian tubes.
Most ovarian cysts disappear naturally on their own and are not noticeable. However, some cysts burst, and this could lead to serious health problems.
Associated Anatomy
Ovarian cysts could form in one or both ovaries present on either side of the uterus.
Types of Ovarian Cysts
There are different types of ovarian cysts.
Functional Cysts
These cysts usually form over the ordinary course of a woman's menstrual cycle.
Endometriotic Cysts
These cysts form when endometrial tissue attaches to the ovaries and forms cysts.
Malignant Cysts
Most cysts are benign. However, a few may turn malignant or cancerous. The existence of malignant cysts indicates ovarian cancer. Regular pelvic tests or biopsies can help identify malignant cysts quickly and start treatment.
Benign Neoplastic Cysts
Although rare, these cysts grow abnormally. Rather than a follicle, neoplastic cysts form out of germ cells. These cysts do not disappear on their own and need external intervention to being removed.
Ovarian Cyst Causes
There are no known exact causes for ovarian cysts. However, the formation of cysts can be attributed to these reasons:
- Hormonal Problems - Hormone imbalances can be caused by drugs or medicines that help women ovulate.
- Pregnancy - Cysts may form during early pregnancy to help support the pregnancy to term. They may disappear naturally during the curse of pregnancy or will need to be removed after delivery.
- Endometriosis - For women with endometriosis, an endometriosis tissue might attach to the ovaries, and a cyst called endometrioma could form.
- Pelvic Infections - Severe infections in any part of the pelvis could spread to the ovaries and cause the formation of cysts.
- Cancer - Ovarian cancer may also cause cysts in the ovaries.
Ovarian Cyst Symptoms
Small ovarian cysts generally do not have any symptoms since they usually dissolve by themselves. However, if ovarian cysts do not dissolve, they may cause the following symptoms:
- Pelvic pain before and during periods.
- Pain in the lower back
- Breast tenderness
- Nausea
- Pain during intercourse
- Pain during bowel movements
- Painful cramps during periods
- Bloated feeling
- Clotted blood during periods
Stages of Ovarian Cysts
There are no specific stages for ovarian cysts. An ovarian cyst forms naturally as a regular part of the menstruation cycle and disappears naturally during the cycle. However, sometimes, cysts do not dissolve but become bigger. The bigger cysts cause discomfort to the affected women. However, the cysts can be treated accordingly with proper diagnosis and treatment.
Ovarian Cysts Diagnosis
Doctors, typically gynaecologists, need to perform multiple tests to analyze the symptoms and diagnose ovarian cysts. The tests used to conclude the affliction are:
- Pregnancy Test: A positive pregnancy test without actual pregnancy can indicate cysts - usually corpus luteum cysts.
- Pelvic Ultrasound: Pelvic ultrasounds use sonic waves to get a clear picture of the ovaries and the uterus. Cysts can be seen clearly in the ultrasound. They can help doctors determine the cysts' shape, size, and consistency for proper treatment.
- Blood Tests: In the case of solid or semi-solid cysts, there may be the presence of a protein called CA 125. It is a cancer antigen and is present in the case of cancerous cells.
Therefore, blood tests can help doctors identify cancer and begin treatment accordingly.
Ovarian Cyst Treatment
Most small cysts usually go away on their own. However, doctors may prescribe birth control pills to stop ovulation for 2-3 cycles. This prevents further cysts from forming, and slowly existing cysts reduce and disappear. However, cysts do not disappear on their own and need external help in some cases. Subsequently, the surgery type also depends on the size of the cysts and how they appear in the ultrasound scans.
Laparoscopy
If the cysts are smaller, doctors would recommend laparoscopy. First, through a small cut near the belly button, a tool with a camera is inserted for doctors to view the cyst. Then, another small tool is used to remove the cyst. The procedure is not overly complicated, and the patient might be discharged on the same day.
Laparotomy
If cysts are huge or are cancerous, doctors might suggest laparotomy. Here, the doctor makes a more significant cut on the abdomen. Then, a biopsy is done to determine if the cysts are cancerous. IF it is cancerous, a hysterectomy is performed to remove the affected ovaries and, if needed, the entire uterus.
Risk Factors for Ovarian Cysts
Ovarian cysts can form at any age. However, they are more common during peak reproductive years. Risk factors for ovarian cysts include:
- Treatment for Infertility - Infertility treatments involve the introduction of many hormones to create the ovulation cycle in the body. Hyperstimulation of eggs in the ovaries could cause cysts to form.
- Pregnancy - Before the formation of the umbilical cord, a woman's body might form cysts in the ovaries to help support early pregnancy.
- Tubal Ligation - Tubal ligation is the procedure of tying up the fallopian tubes. It essentially means female sterilization. The process permanently prevents pregnancy in women. The procedure might cause cysts to form in the ovaries.
- Hypothyroidism - Hypothyroidism is thyroid imbalance that causes changes in hormone levels in the body. These hormones could cause cysts to form in the ovaries.
- PCOS - It is a condition that causes lots of small cyst to develop in ovaries as a result of altered hormonal levels.
Ovarian Cyst Prevention
Primary Prevention
Ovarian cysts occur naturally. There is no clear, identifiable way to prevent cysts. The only way to prevent the rapid progression of growth of cysts is to have regular pelvic examinations. Another simple way to identify ovarian cysts is to pay attention to your periods. Any changes in menstruation or sudden increase in painful cramps need to be communicated to the doctors immediately.
Secondary Prevention
There are no secondary ways to prevent ovarian cysts.
Possible Complication of Ovarian Cyst
- Ovarian Torsion: Ovarian torsion happens when cysts grow bigger and move, which causes the ovaries to twist. The torsion can cause sudden pain, nausea, and even lightheadedness.
- Ovarian Cyst Rupture: It commonly occurs in corpus luteal cyst. Outcome is evaluated based on associated symptoms.
Few Specific Conditions
- Torsion of Ovary: Ovarian torsion can be easily managed laparoscopically
- Dermoid: Dermoid cyst contains multiple types of tissue, it can be easily performed laparoscopically and most of the ovarian tissue can be preserved.
Although most cysts are harmless and go away on their own, an early diagnosis and careful track of any cyst is required so that it doesn't grow and cause complications.
Epidemiology of Ovarian Cysts
Most ovarian cysts resolve naturally on their own, even before being detected. However, globally, it is theorized that at least 7% of the female population has had ovarian cysts in their lifetime.
Expected Prognosis of Ovarian Cysts
Functional cysts that form during a woman's menstrual cycle resolve independently. Other cysts or benign tumors can be removed surgically with laparoscopy or laparotomy. Usually, ovarian cysts do not cause long-term complications for affected women.
Natural Progression of Ovarian Cysts
Ovarian cysts form due to fluid buildup in the follicles. If they do not dissolve on their own, they grow and remain in the follicles. The growth of the cysts causes pain to the affected women and may affect the ability to conceive.
Pathophysiology of Ovarian Cysts
Ovarian cysts affect the ovaries and, consequently, the reproductive organs in a woman's body. Cysts form in the ovaries due to fluid buildup in follicles. If they do not reduce on their own, they may grow and cause issues during menstruation.