At some point in their lives, most women develop ovarian cysts – small, fluid-filled sacs that typically form during ovulation and are located in or on the ovary.
Most of the time, these cysts are harmless, painless, and go away on their own without requiring treatment. However, it becomes a problem if it doesn’t go away or it gets bigger.
While most ovarian cysts are symptom-free, if you experience bloating or swelling of the abdomen, constipation or pain during bowel movements, irregular menstrual periods, and abdominal or pelvic pain before or during your menstrual cycle, it may be time to schedule a medical exam.
Severe cases can be accompanied by nausea and vomiting. In such a scenario, your doctor may order an emergency pelvic ultrasound to rule out ovarian cancer.
Types of ovarian cysts
Dr. Cindy Pang, an obstetrician and gynecologist at Mount Elizabeth Novena Hospital, says there are different types of cysts.
Functional cysts occur as part of the menstrual cycle. These can sometimes cause problems in women in the reproductive age group. During the first half of the cycle, the follicle containing the developing egg can grow up to 2 cm before ovulation. After ovulation, the corpus luteal cyst or egg shell persists until the next menstrual cycle begins. If everything is in order, this process will continue monthly. However, some patients may have hormonal problems that cause the follicle to enlarge, or bleeding into the corpus luteal cyst may occur. This can lead to the formation of water cysts and blood cysts.
Benign pathological cysts can also form due to processes unrelated to ovulation. For example, the cells on the ovaries can develop into a dermoid cyst that contains hair, sebum, and other tissues. Another example is the endometriotic cyst, which is a blood-filled cyst as the lining of the uterus grows on the ovary. These can increase in size and grow regardless of the menstrual cycle.
And then there are cancer cysts. The lifetime risk of a woman developing ovarian cancer is one in 74 – or about 1.3 percent. It can affect women of any age, but those who are older, have previously had breast cancer, or have a family history of ovarian cancer may be at a higher risk of developing the disease. The ultrasound usually reveals eerie features like solid areas in the cyst and increases the blood supply.
The symptoms of cysts can be vague. A slowly growing cyst can cause symptoms such as bloating or swelling of the abdomen, constipation, or pain during bowel movements. There may be irregular menstrual periods and abdominal or pelvic pain before or during your menstrual cycle.
If the cyst is leaking or twisting on the blood supply, medically known as ovarian cyst torsion, the presentation can be sudden with severe abdominal pain with nausea and vomiting. This is known as an ovarian cyst accident. Surgical intervention is usually required in an emergency, as delaying it can damage the ovary and surrounding tissues, which can affect fertility.
When should a cystectomy be considered?
“If the ovarian cyst is left untreated, it can continue to grow, which can put the patient at increased risk of an ovarian cyst accident,” says Dr. Pang. “A cystectomy removes cysts from your ovaries or their surface while leaving the ovary intact. It can be performed as an open operation or as a keyhole operation (laparoscopy). “
If you need help in the Southern Cal area, the Gynecologic Oncology Institute focuses on both complex ovarian benign cysts, including endometriosis endometriomas, and cancer ovarian tumors. Even for larger cyst and cancer cases, we use minimally invasive surgery to ensure your fast recovery.