Ovarian Cysts

Ovarian cysts are fluid-filled sacs that develop on or inside the ovaries. Most ovarian cysts are harmless, cause little or no discomfort, and disappear without treatment within a few months. However, some cysts can grow large, cause symptoms, or be indicators of other conditions. There are different types of ovarian cysts, including functional cysts (which form during the normal menstrual cycle), endometriomas (associated with endometriosis), dermoid cysts (containing tissue such as hair, skin, or teeth), and cystadenomas (filled with watery or mucous material). While most ovarian cysts are benign, some can be cancerous, making proper evaluation important.

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What Causes It?

Normal menstrual cycle function - The most common type of ovarian cysts (functional cysts) form during the menstrual cycle. Follicular cysts occur when the follicle that normally releases an egg doesn't open, and corpus luteum cysts form when the follicle seals after releasing the egg and fills with fluid.

Endometriosis - When tissue similar to the uterine lining grows outside the uterus, it can attach to the ovary and form a growth (endometrioma).

Polycystic ovary syndrome (PCOS) - This hormonal disorder causes the ovaries to enlarge with multiple small cysts.

Pregnancy - The corpus luteum, which produces hormones to support pregnancy until the placenta forms, can sometimes fill with fluid and form a cyst.

Pelvic infections - Severe pelvic infections can spread to the ovaries and fallopian tubes, causing cysts to form.

Previous ovarian cysts - Having had ovarian cysts increases the likelihood of developing more.

Hormonal imbalances - Conditions that affect hormone levels can increase the risk of developing ovarian cysts.

Early menstruation or menopause - Starting menstruation at an early age or experiencing menopause late may increase risk.

Smoking - Some research suggests smoking may increase the risk of certain types of functional ovarian cysts.

Fertility treatments - Medications used to induce ovulation can sometimes lead to the development of multiple follicular cysts.

Signs & Symptoms

No symptoms - Many ovarian cysts cause no symptoms and are discovered during pelvic examinations or imaging studies done for other reasons.

Pelvic pain - Ranging from dull and aching to sharp and severe, often on the side of the cyst.

Abdominal bloating or swelling - Particularly with larger cysts.

Pain during intercourse - Discomfort during sex, especially with deep penetration.

Pain during bowel movements or urination - When cysts press on the bladder or rectum.

Irregular menstrual periods - Changes in cycle length, timing, or intensity.

Abnormal bleeding - Including spotting or bleeding between periods.

Breast tenderness - Due to hormonal changes related to the cyst.

Nausea and vomiting - Particularly if a cyst is twisting (torsion) or rupturing.

Fullness or heaviness in the abdomen - Especially with larger cysts.

Pressure on the bladder or rectum - Leading to frequent urination or difficulty emptying the bladder completely.

Sudden, severe pain - Which may indicate cyst rupture, torsion, or bleeding within a cyst, requiring immediate medical attention.

How We Diagnose

Our specialists use advanced diagnostic methods to accurately identify and assess your condition

Pelvic Examination

During a routine pelvic exam, your doctor may detect an enlarged ovary that suggests the presence of a cyst. However, many cysts are too small to be felt during an examination.

Ultrasound

This imaging test uses sound waves to create an image of the ovaries and uterus. Transvaginal ultrasound, where the ultrasound wand is inserted into the vagina, provides the clearest images of the ovaries and can determine the size, location, shape, and composition of an ovarian cyst, helping to differentiate between various types.

Blood Tests

Tests may include hormone levels to check for hormonal imbalances, pregnancy testing (as the corpus luteum can form cysts during pregnancy), and CA-125 blood testing. CA-125 is a protein that may be elevated in women with ovarian cancer, though it can also be elevated with benign conditions like endometriosis or during menstruation.

CT Scan or MRI

These advanced imaging tests may be used when more detailed information is needed beyond what ultrasound can provide, such as when planning for surgery or when there are concerns about possible cancer.

Laparoscopy

This minimally invasive surgical procedure allows your doctor to see the ovaries directly and, if necessary, remove or biopsy a cyst. A thin, lighted instrument is inserted through a small incision in the abdomen to visualize the ovaries and pelvic organs.

Treatment Options

Personalized treatment plans tailored to your specific needs and condition

Watchful Waiting

For small, simple cysts that appear benign on ultrasound, your doctor may recommend monitoring with follow-up pelvic ultrasounds at regular intervals to check if the cyst changes in size or appearance. Many functional cysts resolve on their own within a few menstrual cycles.

Hormonal Contraceptives

Birth control pills, patches, or vaginal rings may be prescribed to prevent ovulation, reducing the formation of new functional cysts and decreasing the risk of recurrence. However, they won't shrink existing cysts.

Pain Management

Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage discomfort associated with ovarian cysts. For more severe pain, prescription medications may be necessary.

Surgical Treatment

Surgery may be recommended for cysts that are large, don't resolve with time, appear suspicious on imaging, or are causing severe symptoms. Options include laparoscopy (minimally invasive surgery through small incisions) for smaller cysts or laparotomy (open surgery) for larger cysts or when cancer is suspected. Cystectomy removes just the cyst while preserving the ovary, while oophorectomy removes the entire affected ovary.

Home Remedies

Heat Therapy

Applying a heating pad, hot water bottle, or warm compress to the lower abdomen can help relieve pain caused by ovarian cysts. The heat increases blood flow to the area and relaxes tense muscles. Use for 15-20 minutes at a time as needed for pain relief.

Over-the-Counter Pain Relievers

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help manage pain and reduce inflammation associated with ovarian cysts. Always follow package directions for dosage and frequency.

Relaxation Techniques

Stress can exacerbate pain perception and may affect hormonal balance. Practices like deep breathing, meditation, progressive muscle relaxation, or gentle yoga can help manage stress and potentially reduce discomfort.

Dietary Adjustments

Some women find that reducing inflammatory foods (processed foods, sugar, alcohol) and increasing anti-inflammatory foods (fruits, vegetables, omega-3 rich foods like fish) helps reduce pelvic pain. Staying well-hydrated and maintaining a balanced diet supports overall health and may help manage symptoms.

Gentle Exercise

Regular, moderate physical activity like walking, swimming, or cycling can increase blood flow, reduce pain, and improve mood through the release of endorphins (natural pain relievers). Avoid high-impact activities or exercises that cause pain.

Prevention Tips

Attend regular gynecological check-ups to monitor reproductive health and detect any issues early.

Consider hormonal contraceptives if you have a history of recurrent functional cysts, as they can prevent ovulation and reduce the formation of new cysts.

Be aware of your body and note any changes in your menstrual cycle or new pelvic symptoms.

Maintain a healthy weight through balanced nutrition and regular physical activity, as obesity may be linked to hormonal imbalances that can increase cyst risk.

Manage stress through relaxation techniques, adequate sleep, and supportive social connections, as chronic stress can affect hormonal balance.

If you have conditions like PCOS or endometriosis, work with your healthcare provider to manage these effectively, potentially reducing associated cyst formation.

Seek prompt medical attention for severe pelvic pain, as early intervention for complications like ovarian torsion or rupture is important.

Consider keeping a symptom diary to track patterns in pain or menstrual irregularities, which can help your doctor with diagnosis and treatment planning.

Avoid tobacco products, as some research suggests smoking may increase the risk of certain types of functional cysts.

If fertility treatments are needed, work closely with your doctor to monitor ovarian response and minimize the risk of ovarian hyperstimulation syndrome.

Surgical Solutions

Advanced surgical procedures performed by our expert specialists

Laparoscopic Ovarian Cystectomy

A minimally invasive procedure that removes the cyst while preserving the ovary. Small incisions are made in the abdomen, and a camera and surgical instruments are inserted to carefully separate the cyst from the ovarian tissue. This approach is typically used for benign cysts and helps preserve fertility with a shorter recovery time than open surgery.

Laparoscopic Oophorectomy

Minimally invasive surgical removal of the entire ovary, which may be necessary if the cyst is very large, if the ovary is severely damaged, or if there are concerns about malignancy. This procedure can often be performed through small incisions, resulting in less pain and faster recovery than open surgery.

Laparotomy with Cystectomy or Oophorectomy

An open surgical procedure requiring a larger abdominal incision, used for very large cysts, suspected cancer, or when the cyst can't be removed safely via laparoscopy. During the surgery, the cyst may be sent for immediate pathological examination (frozen section) to determine if cancer is present and guide the extent of surgery needed.

Transvaginal Aspiration

A procedure where a needle is inserted through the vagina under ultrasound guidance to drain fluid from the cyst. This is not commonly used for treatment as it has a high recurrence rate and doesn't allow for tissue diagnosis, but may be used in specific situations such as in women with one ovary who want to preserve fertility, or to relieve symptoms temporarily when surgery isn't possible.

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