Ovarian cysts are fluid filled sacks found in the ovary or on the surface of the ovary. They are usually formed during ovulation (when the ovary releases an egg). About 7% of women would have an symptomatic ovarian cyst at some point in their lives. Ovarian cyst occurs commonly in pre-menopausal women, however, it can also occur in post-menopausal women.
Symptoms of Ovarian Cyst
Most ovarian cysts are symptomless. However, if there is an increase in size of the cyst, torsion in the stalk of the cyst there can be associated symptoms such as;
- Pressure, bloating and swelling in the lower abdomen on the side of the cyst.
- Pain; this pain may be sharp or dull and may come and go. The pain can however be severe and sudden if there is a rupture of the cyst.
- Nausea and vomiting; usually results when there is twisting of the cysts
- Menstrual irregularities
Other symptoms that can result include;
- Pelvic pain
- Dull ache in the lower back and thighs
- Problems emptying the bladder or bowel completely
- Pain during sex
- Unexplained weight gain
- Pain during your period
- Unusual vaginal bleeding
- Breast tenderness
- Increased frequency of urination
Causes of ovarian cyst include;
Ovulation; it is normal for a woman to have ovarian cysts when she is ovulating. They are known as functional cysts. Each egg forms inside the ovary in a structure known as a follicle. The follicle contains fluid that protects the egg as it grows and it bursts when the egg is released. However, sometimes a follicle doesn’t release an egg, or it doesn’t discharge its fluid and shrink after the egg is released. If this happens, the follicle can swell and become a cyst.
Hormonal imbalance; once there is an imbalance in the amount of the hormones that regulate the menstrual cycle it can lead to an ovarian cyst. It can also be due to ovulation stimulating drugs such as clomid.
Endometriosis; this is a condition in which uterine tissue grows outside the uterus (womb). This tissue also shed blood as the woman is menstruating. The endometriosis tissue may attach to the ovary and form a cyst due to reoccurring bleeding into the mass. These cysts can be painful during sex and during your period.
Pregnancy; an ovarian cyst normally develops in early pregnancy to help support the pregnancy until the placenta forms. Sometimes, the cyst stays on the ovary until later in the pregnancy and may need to be removed.
Severe pelvic infections; genital tract infections can spread to the ovaries and fallopian tubes and cause cysts to form on the ovaries.
Polycystic ovarian syndrome; it is an imbalance in the hormones of a woman. It leads to excessive formation of cysts in the ovary.
Treatments for Ovarian Cyst
- Most functional cysts are not cancerous and they usually resolve within months.
- Pathological cysts are cysts that don’t result due to hormonal changes in normal menstrual cycle. They are usually non-cancerous.
- Only about 5-10% of people require surgery to remove their cyst and only about 13-21% of these are cancerous.
- Treatment modalities can be in 2 ways;
- Medical; your doctor can prescribe certain medications that can reduce the frequency of ovulation such as pills, vaginal rings, patches.
- Surgery; the cyst alone is removed or the whole ovary is removed. The surgical procedure is done via laparoscopy (done for small cysts) or open surgery (done for large cysts). Surgeons prefer open surgery when there is an increase in the chances of the cyst being malignant. This is so that the surgeons can removed and examine other surrounding structures.
Indications for Surgery
- Post-menopausal women
- Severe pain
- Continuous increase in size of the cyst
- Suspected malignant transformation.
Note that the chance of an ovarian cyst being malignant is higher in post-menopausal women.