Ovarian cysts

WHAT IS OVARIAN CYST?

Ovarian cysts are quite common in women during their childbearing years. An ovarian cyst is a fluid-filled sac which develops on the ovaries. Most cysts result from the changes in hormone levels that occur during the menstrual cycle and the production and release of eggs from the ovaries.

A woman can develop one cyst or many cysts.

Ovarian cysts can vary in size-from as small as a pea to as big as a water melon.

There are different types of ovarian cysts, and each type causes a variety of symptoms. All cysts, especially if they are of significant size, can bleed, rupture (burst), and twist and cause pain. Most cysts are benign (not cancerous). A few cysts, though, may turn out to be malignant (cancerous). For this reason, all cysts should be checked by a doctor

Functional Cysts

The most common type of ovarian cyst is called a functional cyst. It develops from tissue that changes in the normal process of ovulation. There are two types of functional cysts-follicle and corpus luteum. Both of these cysts usually have no symptoms or minor ones when they occur. They disappear within a few months.

Dermoid Cysts

Dermoid cysts are made up of different kinds of tissue, such as skin, hair, fat, and teeth. They may be found on both ovaries. Dermoid cysts are often small and may not cause symptoms. They can, however, become large and cause symptoms.

Cystadenomas

Cystadenomas are cysts that develop from cells on the outer surface of the ovary. They are usually benign, but they can create problems. Cystadenomas can grow very large and interfere with abdominal organs and cause pain.

Endometriomas

Endometriomas are cysts that form when endometrial tissue grows in the ovaries. This tissue then responds to monthly changes in hormones. The tissue bleeds monthly, which may cause it to form a gradually growing cyst on the ovary. An endometrioma is also known as a ‘chocolate cyst’ because it is filled with dark, reddish-brown blood. An endometrioma is often linked to a condition known as endometriosis. It can be painful, especially during the menstrual period or during sexual intercourse.

Multiple Cysts

Women who do not ovulate regularly can develop multiple cysts. This is a disorder in which the ovaries are enlarged and contain many small cysts. It can be linked to a condition called polycystic ovary syndrome (PCOS). This condition causes irregular menstrual periods, infertility, and increased body hair.

CAN CYSTS BE CANCER?

Some cysts may be cancer although this is not the most common. The risk of ovarian cancer increases as a woman gets older. The vast majority of ovarian cancer cysts are encountered in women that are older than 50. Although ovarian cancer often has no symptoms in its early stages, women should be aware of it’s warning signs. Although many of these signs will prove non-related to any pathology, they should be promptly reported to the doctor.

Signs and symptoms that have to be taken notice are:

• Enlargement or swelling of the abdomen
• Nausea or heartburn that doesn't go away
• Loss of appetite
• Pelvic pain

If ovarian cysts are found early, many of the problems caused by them can be treated.

SYMPTOMS

Most ovarian cysts are small and do not cause symptoms. Many go away on their own. Some may cause symptoms because of twisting, bleeding, and rupture. They may cause a dull ache in the abdomen and pain during sexual intercourse.

DIAGNOSIS

An ovarian cyst is often found during a routine pelvic exam. Other tests may be required to confirm the diagnosis. These tests usually include a pelvic ultrasound, a laparoscopy and some blood tests. Some of these tests provide further information about the cyst that is helpful in planning treatment. Some may be used only if there is a high risk of problems.

Pelvic Ultrasound

This examination apart from confirming the clinical suspicion will also provide useful information about the size and the nature of the cyst.

Blood tests

These tests can investigate for the presence of some substances in the woman’s blood that are found often when cancer may be present. One such test measures CA 125, which may be used to detect a risk for ovarian cancer.

Laparoscopy

With this surgical procedure it is possible apart from seeing the cyst directly inside the woman’s body it is also possible to remove it at the same time

TREATMENT

If cysts do not cause any symptoms, and have features of functional cysts, they can be monitored for 4-6 months before other measures are taken. Most functional cysts go away on their own over one or two menstrual cycles. If cysts are large or cause symptoms, treatment may be necessary to start earlier.

The type of treatment depends on several factors:

• The woman’s age
• Size and characteristics of the cyst
• The symptoms
• Fertility requirements of the woman.

Birth control pills may help to treat functional ovarian cysts. They contain hormones which stop ovulation and prevents follicles developing into cysts. In other cases surgery may be required. In young women with benign cysts, laparoscopic surgery can be applied to remove them, while leaving the ovary intact. In some other occasions an incision on the tummy is required, in order to perform a more extended operation.