What's the deal with ovarian cysts?

Dear Bumpy and Concerned and Reader, 

Ovarian cysts are sacs filled with fluids that can be found in or on the ovaries. More often than not they’re benign—non-cancerous—however, in some cases, they can be cancerous. Unfortunately, there are currently no ways to prevent ovarian cysts, so having an annual pelvic exam can help to find and diagnose cysts early. The cause of the cyst can vary, and as such, they result in different types of ovarian cysts that can have different impacts on your body. 

There are two main categories of cysts—functional and non-functional. Functional cysts form due to your menstrual cycle, while non-functional cysts grow without hormones and their exact cause is unknown. Both types of cysts typically disappear on their own within two to three menstrual cycles. However, these cysts may become twisted or rupture, causing more serious conditions. Some of those conditions can include:

• Functional ovarian cysts
  • Follicular cysts – A cyst forms when a follicle that typically releases an egg fails to rupture and instead continues to grow. 
  • Corpus luteum cyst – After a follicle releases its egg, the opening can become blocked and fluid can build up inside the corpus luteum, which is a temporary mass of cells that forms during ovulation, causing a cyst. 
• Non-functional ovarian cysts
  • Hemorrhagic ovarian cysts – This occurs when a corpus luteum cyst ruptures, which may cause vaginal bleeding and pelvic pain.Ovarian cystadenomas – Sometimes referred to as a tumor, ovarian cystadenomas are non-cancerous. They are fluid-filled growths that grow to more than 10 cm in size on the surface of the ovary. 
  • Ovarian dermoid cysts – Dermoid cysts are something that individuals can be born with. They form from cells that produce human eggs. They may contain skin, oil glands, hair, or teeth and often require surgical removal, as they may not resolve on their own. 
  • Endometriomas – Also known as endometroid cysts, occurs when tissue that is similar to the uterine lining attaches to the ovary and is therefore unable to shed during menstruation, causing pelvic pain. 
  • Polycystic ovaries – In individuals with polycystic ovary syndrome (PCOS), numerous, small cysts may grow on the ovaries due to a hormone imbalance. These individuals tend to have difficulty ovulating, due to the large number of follicles available for use, along with irregular periods, hormone imbalances, and fertility issues. 
  • Malignant ovarian cysts – This condition is a type of cancer that increases in risk with age. 

In terms of the symptoms, Bumpy, some people may never feel symptoms, and cysts may disappear on their own without treatment. Others may feel bloating, a sense of fullness, pain with urination, irregular or heavy periods, or pelvic pain on the side with the cyst. Consider speaking with a health care provider if you experience any severe symptoms (e.g., sharp, severe pain, severe abdominal cramping, nausea or vomiting, lightheadedness, or a rapid heart rate). They may perform a pelvic exam and conduct additional testing such as an ultrasound, a pregnancy test, cancer antigen 125 blood test (CA 125), imaging tests, or a computed tomography (CT) scan. Concerned, given that you’ve been diagnosed with a cyst and are still in pain after several months, you may consider speaking with a health care provider to learn about treatments that may be available. 

If you have a cyst or have further complications, there are treatments available based on your age, type and size of the cyst, and what symptoms you may be experiencing. A health care provider may recommend monitoring for symptoms, such as pelvic pain or pressure, and performing a repeat ultrasound about six weeks after the initial diagnosis. If the cyst does not enlarge or rupture, an ultrasound will be performed in intervals until the health care provider believes that the cyst isn’t growing further. A health care provider may also prescribe birth control pills, which may help prevent new ovarian cysts from developing since birth control pills stop ovulation. It may be recommended that the cyst(s) itself or the ovary or ovaries with the cyst(s) be surgically removed if any of the following occur: 

• They’re concerned the cyst is cancerous 
• The cyst is large and causing pain 
• Your CA 125 levels increase 
• The cyst(s) grows or changes in appearance during the monitoring period 

Although less common, complications with cysts may arise. Cysts can rupture, which may cause severe bleeding or intense pain. Additionally, when a cyst becomes heavy, it may cause the ovary to twist out of place and cut off blood flow to the organ, also known as ovarian torsion. This can cause severe pelvic pain, vomiting, and nausea. 

Ovarian cysts may also influence fertility or make it more difficult to get pregnant. However, Reader, in your case, you may be in the clear since it’s typically non-functional cysts that influence fertility. With PCOS specifically, hormone imbalances prevent ovulation and without the release of an egg, pregnancy cannot occur. Endometriomas may also affect the function of the uterus, fallopian tubes, and ovaries, which can impact fertility. It’s important to note that while treatment may be available to help alleviate symptoms of these diagnoses, surgical removal of the cyst or ovary—also called an oophorectomy—as a course of treatment can also impact fertility. Speaking with a health care provider about your concerns so you can track the progression of your diagnosis may be your best bet when it comes to ensuring the future of your fertility. 

Hope this information was helpful and wishing the best for all of you.