What are ovarian cysts?
Ovarian cysts are sacs of fluid that develop in or on the ovaries.
Ovaries are part of the female reproductive system. As part of the menstrual cycle, the ovaries release an egg, or ovum, around every 28 days. This process is known as ovulation. The ovaries also produce the female sex hormones estrogen and progesterone.
Ovarian cysts are fluid-filled sacs that can develop in or on a person's ovaries. The cysts are usually benign, which means they are not cancerous and often clear up without treatment.
Ovarian cysts are relatively common in people who have regular periods because small cysts can develop naturally as part of the menstrual cycle.
The ovarian cysts that develop due to regular ovulation during the menstrual cycle are known as functional ovarian cysts.
Ovarian cysts are typically not cancerous and cause no symptoms. Someone may only discover they have ovarian cysts by chance during a routine pelvic examination.
Cysts and cancer
Ovarian cysts are less likely to form after a person goes through menopause. Menopause marks the phase of a person's life when they stop having periods. However, if cysts do form post menopause, they have a higher chance of becoming cancerous.
Pathological ovarian cysts
Sometimes, ovarian cysts can develop as a result of abnormal and excessive cell growth. These are known as pathological ovarian cysts.
Pathological ovarian cysts can sometimes be malignant, which means they have the potential to cause ovarian cancer. People who have gone through menopause have a higher chance of developing pathological cysts.
Certain underlying conditions, such as endometriosis, can also cause pathological ovarian cysts to develop. Endometriosis is a condition where the cells that line the womb start to appear outside the womb, such as in the ovaries and fallopian tubes.
Ovarian cancer occurs when cells in the ovaries grow and multiply in an uncontrolled way to form a tumor. If not treated, these tumor cells can spread to nearby tissues and other places in the body.
Epithelial ovarian tumor
Different types of ovarian cancer can develop depending on which part of the ovaries the cancer started in. An epithelial ovarian tumor is the most common type of ovarian cancer and starts in the cells on the outer surface of the ovaries.
Symptoms of ovarian cysts and ovarian cancer
Ovarian cysts may cause abdominal discomfort.
People with ovarian cysts usually experience few or no symptoms. The early stages of ovarian cancer may also cause no or only minor symptoms.
However, if an ovarian cyst is very large, ruptures, or is blocking blood supply to the ovaries, it may cause symptoms similar to later-stage ovarian cancer, such as:
- pelvic pain, such as a dull or sharp pain in the lower abdomen
- abdominal discomfort, such as bloating and heaviness
- feeling full quickly and after having small amounts of food
- loss of appetite
- trouble emptying the bladder or the bowels
- frequent or urgent need to urinate
- pain during sex
- abnormal periods, such as very heavy, very light, or irregular periods
- fever or vomiting
Anyone who has these symptoms should see a doctor. If a person with ovarian cysts starts to experience severe, unusual, or recurring symptoms, they should see a doctor as soon as possible.
To diagnose ovarian cysts, a doctor may perform a type of ultrasound scan, such as:
- Transvaginal ultrasound. An internal examination, which involves inserting an ultrasound probe inside a person's vagina to get a picture of the ovaries.
- Transabdominal ultrasound. A doctor scans the person's lower abdomen to get a picture of the pelvic area.
If the doctor discovers an ovarian cyst during the ultrasound, they may request additional ultrasound scans to continue monitoring the cyst.
If a doctor suspects that the cyst is cancerous, they may also recommend a cancer antigen 125 (CA 125) blood test. High levels of CA 125 in the blood can be a sign of ovarian cancer.
However, not everyone with high CA 125 levels has ovarian cancer. Other conditions can also produce high levels of CA 125, including:
- pelvic infections
- menstrual periods
A doctor will assess a cyst to decide if it needs treating.
Most ovarian cysts go away on their own without medical treatment. However, a person may need treatment depending on:
- the size and appearance of the cyst
- their symptoms
- whether they have been through menopause
Doctors may suggest one of the following treatment approaches:
The doctor may recommend simply keeping an eye on the cyst and waiting to see how it progresses without treatment. This may include regular pelvic ultrasounds to see if the cyst changes in size or appearance.
A doctor may sometimes recommend the birth control pill for a person with ovarian cysts. Taking the birth control pill may not reduce the size of the cyst, but may help prevent it from getting worse.
A doctor may recommend operating and removing a cyst that:
- is very large or is growing
- is persistent and remains after medication
- is getting in the way of a woman's desire to bear children
- seems unusual
- is causing symptoms, such as pain
- may be malignant
Depending on the type of cyst, surgical options include:
- Cystectomy. This procedure involves removing the cyst but not the ovary
- Oophorectomy. This procedure involves removing the ovary along with the cyst but leaving the other ovary intact.
- Total hysterectomy. This procedure involves removing the malignant cysts by removing the uterus, ovaries, and fallopian tubes. The person may need to have chemotherapy or radiation therapy afterward.
Ovarian cysts are relatively common and can form naturally during a person's menstrual cycle. Most ovarian cysts are harmless, noncancerous, and usually, do not require treatment.
Ovarian cysts that form after a person has been through menopause have a slightly higher chance of becoming ovarian cancer. Anyone who has ovarian cysts and starts to experience severe, persistent, or unusual symptoms should see a doctor as soon as possible.
The usual treatment approach for ovarian cysts is watchful waiting. If a cyst is causing bothersome symptoms, becomes cancerous, or is getting in the way of becoming pregnant or carrying a child, a doctor may recommend surgical removal.