What Every Woman Should Know About Ovarian Cysts

Many women get an ovarian cyst of some type at some point in their life. Most are benign and do not cause any long-term harm.  Having ovarian cysts certainly does not mean ovarian cancer. In fact, according to the provider reference Up To Date, most ovarian cysts do not need to be removed through surgery, and are not caused by cancer.

Some women can have the cysts and not even know, while for others, they can cause health issues and complications. 

What causes an ovarian cyst?

An ovarian cyst is a sac full of fluid that develops on an ovary. They can be present in women of any age and while some cause pain and pressure, others go completely undetected. They can be very small, or as large as four inches or more. There are a several types of ovarian cysts and are categorized by cysts that occur in premenopausal and postmenopausal women.

Premenopausal

Functional Ovarian cysts: These cysts are caused by ovulation, the process where an egg is released from a follicle in your ovary every month. A follicle is a tiny sac that helps the egg grow and holds it in place. Functional cysts occur when the follicle that holds continues to grow without rupturing. These usually resolve on their own and rarely have any symptoms. According to the Department of Health and Human Services (DHHS), they usually go away between one and three months.

Dermoid cysts: These are also referred to as teratomas. They are the most common type of ovarian cyst found in women between the ages of 20 and 40. These cysts are made up of ovarian reproductive cells called germ cells. They can contain teeth, hair, or even fat. They are usually harmless, but in some cases (rarely) can be cancerous.

Polycystic ovarian syndrome (PCOS): Some women have a condition that causes their ovaries to produce a lot of cysts. Women with PCOS have a lot of very small cysts. While the cysts do not need to be removed, women with PCOS often need treatment for irregular menstruation and other symptoms such as unwanted hair, acne, and weight gain.

Endometriosis: This is another condition where women can develop cysts on their ovaries. These cysts are called endometriomas and are often painful, especially during menses.

Pregnancy: In some cases, the ovarian cyst that normally develops in the beginning of a pregnancy can persist. This cyst helps support the pregnancy until the placenta develops, and then it typically goes away.

Severe pelvic infections: Some infections can spread to the ovaries and fallopian tubes and cause pus-filled cysts to form.

Cancerous growths: This is an uncommon cause of ovarian cysts. Less than one percent of cancers cause ovarian cysts.

Postmenopausal women

In postmenopausal women, the most common causes of ovarian cysts are non-cancerous growths, and fluid collection inside the ovary. New growths that are found on or around the ovary in postmenopausal women are a little bit more likely to be caused by cancer.

The Symptoms

Ovarian cysts can be quite painful when they rupture. Sometimes women report feeling a sharp and sudden pain in their lower abdomen, specifically on one side. Other times, it can be a dull and constant pain. Crampy pain is not usually related to ovarian cysts, though. If you’re ever concerned, give your provider a call. Pelvic pain can be difficult to diagnose because there are so many organs from so many body systems packed into the same area. Is it an ovarian cyst? A bladder infection? Or simply constipation? Sometimes your provider will have you wait to see if the pain disappears. If it doesn’t, they may want you to come in for an exam.

Occasionally, ovarian cysts can cause a bit more of a problem. If they grow too large without rupturing, they can sometimes rotate around themselves and cause the blood supply to the ovary to be cut off. This could destroy the ovary. These are emergency situations that require surgical removal. Ovarian cysts can be diagnosed through a pelvic exam in some cases, but usually if there is any suspicion, providers will send you for an ultrasound to be sure.

The Connection Between Ovarian Cysts and Ovarian Cancer 

This is a common concern, but the majority of ovarian cysts are caused by things other than cancer.

Ovarian cancer is most common in people with:

• Family history of ovarian cancer or related cancers
• History of breast cancer or gastrointestinal cancer
• A cyst that has solid areas, multiple nodules, or many fluid-filled areas
• Ascites (fluid collection in the abdomen that is usually found during imaging tests)

Having these things does not mean that you have cancer, either. It just means that further testing may be necessary and that you could be monitored a little more closely. If you have a history of ovarian cysts, this does not mean you are more likely to develop ovarian cancer. However, according to the American Cancer Society, when cancerous cysts are present, they cause more deaths than any other gynecological cancer.

Treatment for Ovarian Cysts

Providers typically want to try watchful waiting to see if the symptoms evolve or disappear. They will make their next decisions based on what they observe. They will usually repeat a pelvic ultrasound in six to eight weeks. Sometimes, they will prescribe birth control pills to premenopausal women during this time to help decrease the cyst formation. In postmenopausal women, providers make their decision about whether or not to do watchful waiting based on a CA 125 blood test. Occasionally, surgical removal is warranted. 

After a cyst resolves, follow-up is not necessary unless symptoms continue or reoccur. Certain types of cysts such as functional ovarian cysts are more likely to reoccur and be a bit more bothersome in the long term than other types. If you are concerned, talk with your provider. For women who frequently get bothersome cysts, hormonal birth control can be quite effective in preventing them. It can always be frightening when someone tells you that you have something going on with your ovaries. It is important to get it checked out and educate yourself with the facts.