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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