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Ovarian cysts
Revised: October 21, 2004
An ovarian cyst is any collection of fluid within the ovary. Some of
these, called functional cysts, are part of the normal process of
menstruation. Any ovarian follicle that is larger than about 2
centimeters is termed an ovarian cyst:
Types
Specific types of cyst include graafian follicles (which may rupture at mid-cycle and cause
mittelschmerz) or corpus luteum cysts (which may rupture about the
time of menstruation, and take up to three months to disappear
entirely). These follicles are normally formed during any normal
menstrual cycle and are degraded quickly. Failure to degrade results
in the formation of cysts.
Other cysts are pathological, such as those found in polycystic ovary
syndrome, or those associated with tumors.
Symptoms and signs
Usually ovarian cysts present without symptoms and are found during a
regular physical exam or seen by chance on an ultrasound performed
for other reasons. Sometimes the following symptoms may be present:
- Lower abdominal or pelvic pain
- Pelvic pain with a menstrual period that lasts for a long
time
- Pelvic pain after strenuous exercise or sexual intercourse
- Nausea and vomiting
- Vaginal spotting or painful bleeding
- Infertility
Complications include hemorrhage into a cyst, infection, or
torsion around a cyst.
Diagnosis
The vast preponderance of ovarian cysts in women of pre-menopausal age
are benign; those occurring in post-menopausal women may indicate more
serious disease and should be investigated through ultrasonography,
especially in cases where other family members have had ovarian
cancer. Such cysts may require surgical biopsy.
Treatment
Functional ovarian cysts are the most common type of ovarian
cyst. They usually go away by themselves and seldom require
treatment. But cysts that grow larger or last longer than a few
months may be something else and should be removed.
Oral contraceptives may be helpful in regulating the menstrual
cycle and preventing the formation of the follicles that can turn
into cysts. Analgesics are useful in treating the discomfort if
present.
Laparoscopy surgery or laparotomy is usually reserved for cases
that are suspicious of cancer or cases that present complications.
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