Here’s What You Should Know About Ovarian Cysts

You may have heard about ovarian cysts from a friend or maybe you’ve even had them yourself. But do you know what causes them, possible treatment options or when they can be dangerous?

Ovarian cysts are common in women, and they often occur during ovulation, when your ovary releases an egg during your menstrual cycle. An ovarian cyst is a fluid-filled sac that forms on or inside your ovary. Often, there are no signs or symptoms, and they typically go away on their own in a few months without any treatment.

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But sometimes, the cysts grow large or twist. When these changes happen, you might notice pelvic pain, pelvic pressure or fullness, usually on the side of the cyst. “The pain may be mild and dull, or severe and sharp depending on the cyst,” said Rachael Smith, DO, a gynecologist at University Women’s Institute in Phoenix.

Not all ovarian cysts trigger the same types of pain. Some cause constant pain. While others, particularly those with ovarian torsion where the cyst twists, cause intermittent pain. And in some instances, the cyst ruptures and releases fluid into the pelvis. This fluid irritates the pelvis and can cause severe pelvic or abdominal pain.

You might also notice pain radiating to your lower back, abdominal bloating, pain during sexual intercourse or problems emptying your bladder or bowel.

What causes ovarian cysts?

Dr. Smith said there are many different types of ovarian cysts and thus, many different causes for them. Most of them are noncancerous. Here are some of the most common types of ovarian cysts:

• Functional cysts or follicular cysts, which form when a follicle doesn’t open to release an egg but keeps growing instead
• Corpus luteum cysts, which occur when the follicle opens and then doesn’t shrink after it releases the egg
• Dermoid cysts, also called teratomas, which contain cells typically found in the skin
• Endometriomas, which develop in women who have endometriosis, or a condition where tissue grows outside the uterus
• Hemorrhagic cysts, which fill with blood
• Cystadenomas, which develop from the cells that cover the outer part of the ovary
• Tubo-ovarian abscesses, which can occur when you have an infection in your genital tract
• Para-tubal cysts or para-ovarian cysts, which seem like ovarian cysts but develop next to the ovary or fallopian tube

Although women can still ovulate after menopause, it is much less frequent, and they are not likely to develop cysts when an ovary releases an egg. But they may still have cysts that developed before menopause and never go away. Cancer can also cause ovarian cysts, but that’s rare—women have only a 1.3% lifetime risk of ovarian cancer, and not all of those cancers stem from ovarian cysts.

How are ovarian cysts diagnosed?

Your health care provider might be able to feel a large ovarian cyst during a pelvic exam. But most of the time, they are diagnosed with a pelvic ultrasound. In rare cases, your doctor might recommend a CT scan or MRI.

How do you treat ovarian cysts?

According to the U.S. Department of Health & Human Services’ Office on Women’s Health, about 8% of premenopausal women develop ovarian cysts that need treatment. If treatment is needed, there are several treatment options available  :

• Expectant management. If you have no symptoms or mild symptoms and your cyst appears benign, your doctor will probably recommend taking an oral contraceptive to help prevent further cysts from developing.
• Surveillance. Your ovarian cyst may appear benign, but if you’re experiencing symptoms or your physician is concerned by the size of the cyst, they may want to watch for changes in symptoms and perform a follow-up ultrasound in two to three months to measure the cyst and see if it is growing. If you have an ovarian cyst that ruptures, your health care provider will monitor you closely. In most cases, the fluid reabsorbs into your body over time, so your body heals itself and you don’t require surgery.
• Surgery. There are a few situations where you might need surgery to remove an ovarian cyst. Sometimes a cyst ruptures, causing sharp pain or internal bleeding. Cysts can also cause the ovary to twist on itself and slow or stop blood flow to the ovary, which can cause the death of the ovary. Cysts may also be very large. Or your doctor may suspect that a cyst is cancerous. If you need surgery, your surgeons can usually use laparoscopic or minimally invasive techniques, which reduce pain and recovery time.

Can you become pregnant if you’ve had ovarian cysts?

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Most ovarian cysts don’t affect your fertility. The exception is endometriosis-related cysts called endometriomas—they may need to be removed if you want to get pregnant. Another condition, called polycystic ovary syndrome (PCOS), is linked with infertility because it makes ovulation more difficult.

The bottom line

Ovarian cysts are common and often go away on their own without treatment. Birth control pills can help keep them from recurring. In rare cases, you might need surgery to treat ovarian cysts. Connect with a women’s health expert to learn more about ovarian cysts and other conditions that can cause pelvic pain.