Ovarian cysts

What are the ovaries?

The ovaries are a pair of small, almond-shaped organs located on either side of the uterus in the female reproductive system. The ovaries are key organs in the female reproductive system. They have two main roles:

  • Egg production: Ovaries release eggs each month during ovulation, essential for reproduction.
  • Hormone production: They produce hormones like oestrogen and progesterone, which regulate the menstrual cycle and support pregnancy.

 

What are ovarian cysts?

Ovarian cysts are fluid-filled sacs that develop on or inside the ovaries. They are common, especially in women of reproductive age, and are usually benign (non-cancerous). Most ovarian cysts cause no symptoms and resolve on their own, but some may lead to complications that require medical attention.

 

Types of ovarian cysts

 Common types of ovarian cysts include:

  • Functional cysts:  These develop as part of the menstrual cycle and are normally harmless and short-lived.  These are the most common type of ovarian cysts.
  • Follicular cysts: Occur when a follicle (the sac that contains an egg) doesn’t release an egg and continues to grow. These are the most common type of cysts and usually resolve on their own.
  • Corpus luteum cysts: Develop after the follicle releases the egg but fails to shrink. Instead, it seals off and fills with fluid. These cysts also often resolve without treatment.
  • Pathological cysts: Abnormal growths that develop on or within the ovaries and are not related to the normal menstrual cycle. Unlike functional cysts, which are usually harmless and often resolve on their own. Pathological cysts can be benign (non-cancerous) or less commonly malignant (cancerous) and may require medical intervention.
  • Dermoid cysts: Also known as teratomas, these cysts contain tissues such as hair, skin, or teeth. They are typically benign but may require removal if they grow large. 
  • Endometriomas: Ovarian cysts can sometimes be caused by an underlying condition, such as endometriosis, where tissue similar to the lining of the uterus grows outside it, often on the ovaries. These cysts can be painful and may affect fertility.
  • Cystadenomas: These cysts develop from the surface of the ovary and can be filled with a watery or mucous material. While usually benign, they can grow large and cause discomfort.
  • Malignant ovarian cysts: Less common than benign cysts. Also known as cancerous ovarian cysts or ovarian cancer, occur when abnormal cells in or on the ovaries grow uncontrollably and form a tumour. These cysts are more common if you have been through menopause.
  • Polycystic ovarian syndrome (PCOS): A condition where multiple small cysts form on the ovaries, often associated with hormonal imbalances, irregular periods, and fertility issues

 

Symptoms of ovarian cysts

Ovarian cysts are common, are usually harmless and most go away without treatment after a few months.  They do not usually cause symptoms and are often found during a pelvic examination or a pelvic ultrasound scan. Symptoms may occur if they become twisted, ruptured or very large and block the blood supply to the ovaries:

  • Pelvic pain or discomfort, ranging from a dull, heavy sensation to sudden severe and sharp pain, often on one side
  • Bloating or a feeling of fullness in the abdomen
  • Pain during intercourse
  • Changes in menstrual periods, such as irregular, heavier or lighter bleeding
  • Frequent urination or difficulty emptying the bladder
  • Constipation
  • Nausea or vomiting, particularly if the cyst causes ovarian torsion
  • Difficulty getting pregnant. However, fertility is normally not affected by ovarian cysts.

 

If you experience sudden, severe abdominal or pelvic pain, it is important to seek immediate medical attention, as this could indicate a ruptured cyst or ovarian torsion, both of which require urgent care.

 

Diagnosing ovarian cysts

Ovarian cysts are typically diagnosed through a combination of:

  • Pelvic examination: A physical examination to check for any lumps or abnormalities in the pelvic area.
  • Ultrasound: The most common imaging test used to visualise the cyst, assess its size, shape, and whether it is filled with fluid, solid, or mixed.
  • Blood tests: A CA-125 blood test may be performed if there is a concern about ovarian cancer, particularly in postmenopausal women. However, elevated CA-125 levels can occur with non-cancerous conditions as well.
  • CT scan or MRI: These imaging tests provide more detailed information if further evaluation is needed.

 

Treatment

The treatment for ovarian cysts depends on several factors, including the cyst’s size, type, and symptoms, as well as your age and overall health:

  • Watchful waiting:  Many cysts, especially functional cysts causing no symptoms, resolve on their own within a few weeks or months. Regular ultrasound monitoring may be recommended to ensure the cyst is shrinking.
  • Medication – Oral contraception: May be prescribed to stop ovulation and prevent the formation of new cysts in future menstrual cycles, but it does not shrink existing cysts.
  • Surgery
  • Laparoscopy: A minimally invasive surgery to remove the cyst if it is large, causing symptoms, or suspected to be cancerous. The procedure involves small incisions and a camera to guide the removal. Some cysts can be removed without removing the ovary (cystectomy). In some cases, the ovary is removed with the cyst (oophorectomy).
  • Laparotomy: A more extensive surgery that may be required for larger cysts or if cancer is suspected. It involves a larger incision and may include the removal of the ovary if necessary.
  • Radical hysterectomy: If an ovarian cyst is found to be malignant, surgery may be needed to remove the uterus, cervix, fallopian tubes and ovaries

 

Risks and complications

While most ovarian cysts are benign, complications can arise:

  • Ruptured cyst: A cyst that ruptures can cause severe pain and internal bleeding, requiring immediate medical attention.
  • Ovarian torsion: A large cyst can cause the ovary to twist, cutting off its blood supply, which is a medical emergency.
  • Fertility issues: Cysts related to conditions like endometriosis or PCOS can affect fertility and may require specialised treatment.

 

Prevention and monitoring

While you cannot prevent ovarian cysts entirely, certain measures can reduce your risk and help with early detection:

  • Regular pelvic examinations: Routine check-ups can help detect cysts early, allowing for prompt management.
  • Manage risk factors: Addressing underlying conditions like endometriosis or PCOS can help reduce the likelihood of developing cysts.
  • Oral contraception: Hormonal birth control may be recommended to prevent the formation of new cysts.

 

Why choose Birmingham Gynaecology Clinic?

At Birmingham Gynaecology Clinic, we provide expert care for women with ovarian cysts. Our team is here to guide you through diagnosis, treatment, and follow-up care, ensuring the best possible outcomes for your health.

 

Contact us

If you are experiencing symptoms or have concerns about ovarian cysts, please contact us today to schedule a consultation.

 

 

 

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