Ovarian Cysts: Symptoms, Causes, Treatment and Medical Help

Ovarian cysts are fluid-filled sacs or pockets that in most cases occur within or on the solicitous surface of an ovary. The ovaries are two organs in one -- each about the size and shape of an almond - situated on each extent side of a woman's uterus.

Eggs (ova) grow and mature in the ovaries and are released in menstrual periods during a woman's childbearing days.

Ovarian cysts are very common in women. Many women have ovarian cysts at some time during their lives. Most ovarian cysts do little or no discomfort. Ovarian cysts are harmless. Ovarian cysts disappear without treatment within a couple of months.

However, ovarian cysts, specifically those that have ruptured, sometimes cause serious symptoms which can be life-threatening. The best way to protect you from ovarian cysts is to know the symptoms and genres of ovarian cysts that may cause a substantial problem, and to schedule regular pelvic examinations.

Signs and Symptoms of ovarian cysts

There are no significant symptoms that help you in identifying, whether you have an ovarian cyst. In fact, you'll likely to have no symptoms at all. Or if you do, the symptoms may be similar to those of other conditions, like that of endometriosis, pelvic inflammatory disease, ectopic pregnancy or ovarian cancer. Even appendicitis and diverticulitis can produce symptoms that mimic a ruptured ovarian cyst.

Therefore, it's ultimately important to be watchful of any symptoms or changes in your body and to know which symptoms can cause serious problems.

If you are experiencing the following signs and symptoms, then you may have ovarian cyst:

Menstrual irregularities
Pelvic pain -- a constant or intermittent dull ache that may radiate to your lower back and thighs
Pelvic pain shortly before your period begins or just before it ends
Pelvic pain during intercourse (dyspareunia)
Nausea, vomiting or breast tenderness similar to that experienced during pregnancy
Fullness or heaviness in your abdomen
Pressure on your rectum or bladder -- difficulty emptying your bladder completely

If you have the following signs and symptoms, then you should take precaution and ask your doctor for help.

Sudden, severe abdominal or pelvic pain
Pain accompanied by fever or vomiting

Causes of ovarian cysts

Normally, your ovaries grow cyst-like structures called follicles each month. Follicles generate the hormones estrogen and progesterone and release an egg when you ovulate.

Sometimes, a normal monthly follicle just keeps growing. When that happens, it becomes known as a functional cyst. This means it started during the normal function of your menstrual cycle.

There are two types of functional cysts:

Follicular cyst: Around the midpoint of your menstrual cycle, your brain's pituitary gland releases LH i.e. luteinizing hormone (LH), which signals the follicle holding your egg to release it. When everything goes according to plan, your egg bursts out of its follicle and begins its journey down the fallopian tube in search of fertilization. A follicular cyst begins when the LH surge doesn't occur. The result is a follicle that doesn't rupture or release its egg. Instead it grows and turns into a cyst. Follicular cysts are usually harmless, rarely cause pain and often disappear on their own within two or three menstrual cycles.
Corpus luteum cyst: When LH does surge and your egg is released, the ruptured follicle begins producing large quantities of estrogen and progesterone in preparation for conception. This changed follicle is now called the corpus luteum. Sometimes, however, the escape opening of the egg seals off and fluid accumulates inside the follicle, causing the corpus luteum to expand into a cyst. Although this cyst usually disappears on its own in a few weeks, it can grow to almost 4 inches in diameter and has the potential to bleed into itself or twist the ovary, causing pelvic or abdominal pain. If it fills with blood, the cyst may rupture, causing internal bleeding and sudden, sharp pain. The fertility drug clomiphene citrate (Clomid, Serophene), used to induce ovulation, increases the risk of a corpus luteum cyst developing after ovulation. These cysts don't prevent or threaten a resulting pregnancy.

When to seek medical advice

If you are experience severe or spasmodic pain in your lower abdomen, accompanied by fever and vomiting, ask your physician for help. These signs and symptoms -- or signs and symptoms of shock such as cold, clammy skin, rapid breathing, and lightheadedness or weakness indicate an emergency and require immediate medical attention.

Screening and diagnosis

A cyst on your ovary may be found during a pelvic examination, during which your doctor feels (palpates) your ovaries. If a cyst is suspected, doctors often advise further testing to determine its type and whether you need treatment.

Typically, doctors address several questions to determine a diagnosis and to aid in management decisions:

Shape: Is your cyst irregularly shaped?
Size: What size is it?
Composition: Is it filled with fluid, solid or mixed? Fluid-filled cysts aren't likely to be cancerous. Those that are solid or mixed -- filled with fluid and solid -- may require further evaluation to determine if cancer is present.

To identify the type of cyst, your doctor may perform the following examinations:

Pregnancy test: A positive pregnancy test may suggest that your cyst is a corpus luteum cyst, which can develop when the ruptured follicle that released your egg reseals and fills with fluid.
Pelvic ultrasound: In this painless procedure, a wand-like device (transducer) is used to send and receive high-frequency sound waves (ultrasound) through your pelvic area, creating an image of your uterus and ovaries on a video screen. This image can then be photographed and analyzed by your doctor to confirm the presence of a cyst, help identify its location and determine whether it's solid, filled with fluid or mixed.
Laparoscopy: Using a laparoscope -- a slim, lighted instrument inserted into your abdomen through a small incision -- your doctor can see your ovaries and remove the ovarian cyst.
CA 125 blood test: Blood levels of a protein called cancer antigen 125 (CA 125) often are elevated in women with ovarian cancer. If you develop an ovarian cyst that is partially solid and you are at high risk of ovarian cancer, your doctor may test the level of CA 125 in your blood to determine whether your cyst could be cancerous. Elevated CA 125 levels can also indicate noncancerous conditions such as endometriosis, uterine fibroids and pelvic inflammatory disease.

Treatments for ovarian cysts

Treatment of ovarian cysts depends on your age, the type and size of your cyst, and your symptoms. Your doctor may suggest the following treatments remedy:

Watchful waiting: You can wait and be re-examined in one to three months if you're in your reproductive years, you have no symptoms and an ultrasound shows you have a simple, fluid-filled cyst. Your doctor may recommend that you get follow-up pelvic ultrasounds at regular intervals to see if your cyst has changed in size. Watchful waiting, with regular monitoring and ultrasound, is also a common treatment option recommended for postmenopausal women if a cyst is filled with fluid and less than 2 inches in diameter.
Birth control pills: Your doctor may recommend birth control pills to reduce the chance of new cysts developing in future menstrual cycles. Oral contraceptives offer the added benefit of significantly reducing your risk of ovarian cancer -- the risk decreases the longer you take birth control pills.
Surgery: Your doctor may suggest removal of a cyst if it is large, doesn't look like a functional cyst, is growing or persists through two or three menstrual cycles. Cysts that cause pain or other symptoms may need to be removed. Some cysts can be removed without removing the ovary in a procedure known as a cystectomy. Your doctor may also suggest removal of the one affected ovary and leaving the other intact in a procedure known as oophorectomy. Both procedures may allow you to maintain your fertility if you're still in your childbearing years. Leaving at least one ovary intact also has the benefit of maintaining a source of estrogen production. If a cystic mass is cancerous, however, your doctor will advise a hysterectomy to remove both ovaries and your uterus. After menopause, the risk of a newly found cystic ovarian mass being cancerous increases. As a result, doctors more commonly recommend surgery when a cystic mass develops on the ovaries after menopause.

Prevention to avoid ovarian cysts

Although there's no marked way to prevent the spread of ovarian cysts, regular pelvic examinations are a way to help protect that alterations in your ovaries are diagnosed as early as possible. Also, you need to be careful to changes in your monthly cycle, and also signs that may accompany menstruation that aren't characteristic for you or that persists over more than a few cycles. Be sure to clearly speak to your doctor about any concern that relates to menstruation.

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