It began for me with changes to my menstrual cycle. I am always fairly regular give or take a few days in getting my period on time. But this time two weeks went by with no visit from "aunt flow" and I was becoming worried. The obvious thing which comes to mind when your period is late is to wonder if you are pregnant. So I went off to the gynecologist where they promptly gave me a pregnancy test which turned out to be negative.
I was also experiencing some pressure in my abdomen especially on my bladder and so my doctor decided to do an ultrasound to see what was going on down there. When the doctor looked at the results he told me that I had a cyst on my right ovary. Of course the first words out of my mouth were, "Does this mean I have ovarian cancer?" and his reply was to re-assure me that this was a "simple cyst" and should go away within a couple of cycles at most. I must have still looked worried as the nurse chimed in, "Oh yeah I get these kind of cysts all the time, nothing to worry about."
I was asked to come back in four weeks for another ultrasound and by then the cyst had resolved. I was relieved. And on day 55 of my cycle my period did return.
I think a lot of women are like me and become anxious when they hear the words "ovarian cyst" but the reality is that the vast majority of ovarian cysts are benign and not cancerous.
What exactly is an ovarian cyst? A cyst is basically a fluid filled sac which forms on the ovary. In most cases the cyst will be what is called a "functional" or "simple" cyst such as the one I had. One type of functional cyst is called a follicular cyst. Follicular cysts are created when the follicle which is supposed to release your egg during ovulation fails to do so. Fluid then fills up the unruptured follicle until a cyst develops. Follicular cysts usually resolve within several months.
Corpus Luteum cysts are another type of functional cyst which develops when the sac containing the egg does not dissolve after ovulation. Instead it fills with blood.. Corpus Luteum cysts usually resolve in a few weeks. Corpeus Luteum cysts do have the potential to grow to almost 4 inches in diameter, filling up with so much blood that it twists the ovary causing internal bleeding and sudden sharp pain.
What are the symptoms of having an ovarian cyst? Many ovarian cysts don't cause any symptoms at all. You may have one and not even know it. The National Women's Health and Information Center tells us that if there are symptoms they may include:
- Pressure, pain, or swelling of the abdomen
- Pain during sex
- Abnormal bleeding
- Nausea or vomiting
- Pelvic Pain
- Weight gain
- Problems passing urine completely
The Mayo Clinic adds the following symptoms to this list:
- Menstrual irregularities
- Breast tenderness
- A dull ache which radiates to your lower back and thighs
- Pressure on your rectum or bladder
- Pain before your period begins and right before it ends.
Warning signs that you should see a doctor immediately:
- Cold, clammy skin
- Rapid breathing
- Lightheadedness and weakness like you are going to pass out
- Pain with fever and vomiting
- Sudden, sharp, intense pain in your abdomen or pelvic area
How do they tell if you are at risk for having a cancerous cyst?
If they do an ultrasound they are going to look at the shape, size, location, and mass of your cyst. Cysts which are irregularly shaped, have irregular borders, and are solid inside may be suspect for malignancy. Most women who have cysts are of child bearing age and for the most part these cysts will be non-cancerous. But the risks greatly increase for a cyst to be cancerous if the woman is postmenopausal (in her fifties on up).
What is the treatment for an ovarian cyst?
If you have an ovarian cyst, most times they are going to tell you that they are going to wait and see what happens. This means that they will have you back in some weeks to do a repeat ultrasound to see if there are any changes in your cyst as in: Is the cyst growing or causing you pain? This is what they did in my case and by the time I came back, my cyst had gone away.
They may decide to try to remove your cyst if the cyst is causing you pain, is not going away after several cycles or if they suspect your cyst is malignant. They may also decide to remove it if you are postmenopausal.
If you have surgery there are two types:
- A laparoscopy is done for removal of small non-cancerous cysts. This type of surgery is called belly button surgery because they make a small incision near your navel. They will insert a scope and take out your cyst that way. I have personally had a laparoscopy but not for cyst removal. I had mine as exploratory surgery for infertility. I can tell you that the surgery was not bad at all and it left with no scar.
- A laparotomy is a type of surgery which is more invasive than a laparoscopy. This is done if your cyst is deemed to be large in size and possibly cancerous. An incision is made into the stomach in order to remove your cyst. They will remove the cyst and see if it is cancerous. If it is cancerous they may need to also remove your ovary and possibly your uterus. Of course this is the worst case scenario and as stated previously, most cysts are not cancerous.
Another strategy some doctors may use for women who keep developing functional cysts is to give them birth control pills. Birth control pills will stop you from ovulating and if you don't ovulate you are far less likely to develop any new cysts.
The main thing I hope you get out of this article is that if you are having any symptoms of an ovarian cyst, to schedule an appointment with your doctor right away. Most likely there won't be anything to worry about. But if there is a problem with your cyst then it is far better to catch these things early so that you can get the best benefit from treatment. It is always wise to see your doctor if you have concerns about your gynecological health and the sooner the better.
How about you? Have you ever had an ovarian cyst? What treatment plan did your doctor follow? Tell us about your experience. You could help someone else by sharing your personal story.