An ovarian cyst is usually a fluid-filled sac that forms on or near the ovary. These cysts are common in women throughout their lives. Most ovarian cysts are benign, meaning they are not cancerous.
Types of cysts
In most cases, a cyst will be what is called a functional or simple cyst. There are a few types of functional cysts:
- Follicular cyst: This type of cyst is 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 6-8 weeks without treatment.
- Corpus luteum cyst: A corpus luteum cyst develops when the sac containing the egg doesn’t dissolve after ovulation. Instead, it fills with blood. They usually resolve in a few weeks without treatment. In some cases, this type of cyst can grow to almost 4 inches in diameter, filling with so much blood that it twists the ovary, causing internal bleeding and sudden sharp pain. If this happens, you may need surgery to treat the rotated ovary.
Beyond functional cysts, there are other types of cysts:
- Ovarian teratomas: This type of cyst is filled with tissues from the body, like skin and hair. These cysts can start to form in your body before you are even born, and then become cyst-like during your childbearing years. These types of cysts are usually benign, but occasionally they do become cancerous.
- Endometrioma: This is an estrogen-dependent cyst that forms because of endometriosis, during your childbearing years. This type of cyst is often associated with subfertility or infertility. Your obstetrician may suggest treatment with surgery or assisted reproductive techniques.
- Cystadenoma: This fluid-filled cyst is usually benign but can grow to be very large. They are more common in women in their 30s through 50s.
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. If there are symptoms, according to the National Women’s Health and Information Center, 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
- Menstrual irregularities
- Breast tenderness
- A dull ache that radiates to your lower back and thighs
- Pressure on your rectum or bladder
- Pain before your period begins and right before it ends
The following are 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 is a cyst diagnosed?
During a physical exam, your provider may do a bimanual exam, with one hand on your abdomen and one hand inside your body, to determine whether they can feel an enlargement or if you feel any pain that could point to a cyst. An ultrasound may be ordered to confirm and get more information about the potential cyst, such as whether it is fluid-filled.
How will my doctors know if I’m at risk of having a cancerous cyst?
During an ultrasound, your health care provider will look at the shape, size, location, and mass of your cyst. Cysts that are irregularly shaped, have irregular borders, and are solid inside may be suspect for malignancy (cancer). Most women who have cysts are of childbearing age, and for the most part, their cysts will be non-cancerous. But the risks greatly increase for a cyst to be cancerous if the woman is postmenopausal. A blood test for CA-125, a protein, may also be used to determine the risk of cancer.
What is the treatment for an ovarian cyst?
If you have an ovarian cyst, most times your doctor will go with a “watchful waiting” approach, according to the American College of Obstetricians and Gynecologists. This means they will have you back in a few weeks to do a repeat ultrasound to see if there are any changes in your cyst, including whether the cyst is growing or causing you pain.
Your doctor may decide to try to remove your cyst if it is causing you pain, is not going away after several menstrual cycles, or they suspect your cyst is malignant. They may also decide to remove your cyst if you are postmenopausal.
There are two types of surgery to remove cysts:
- A laparoscopy is done for removal of small, non-cancerous cysts. This type of surgery is minimally invasive, often called “belly button surgery” because they may make a small incision near your navel. They will insert a scope and take out your cyst.
- Open surgery is a type of surgery that 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 to remove your cyst.
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 bottom line
In the vast majority of cases, cysts are not problematic. However, they can be painful. Some will go away on their own with only watchful waiting, while others may need any medical intervention like medication or surgery. You and your doctor can decide which course of treatment will help your specific cyst.
This is an update of an article originally written by HealthCentral contributor Merely Me.
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Robin Elise Weiss, Ph.D., LCCE, CLC, AdvCD(DONA) is a childbirth educator, doula, founder of Childbirth.org, and the award-winning pregnancy and parenting author of “The Complete Illustrated Guide to Pregnancy” and more than 10 other books. Between her nine children, teaching childbirth classes, and attending births for more than two decades, she has built up an impressive and practical knowledge base. You can follow Robin on Twitter @RobinPregnancy, Instagram, and Facebook.