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What Your Gynec Says About Ovarian Cyst?

An ovarian cyst is a fluid-filled collection that develops in a woman’s ovary. They are very common and do not usually lead to any symptoms. Ovarian cysts affect women of all ages. They occur most often, however, during a woman’s childbearing years. In most cases, they are harmless and usually disappear without the need for treatment. However, if the cyst is large or causing symptoms, it may need to be surgically removed.

Types of ovarian cyst

There are a number of different types of ovarian cyst. The two main types are:

1. Functional ovarian cysts develop as part of the menstrual cycle and are harmless and short-lived. They are also the most common type. These include –

  • Follicle Cysts – When the follicle doesn’t break open to release egg, the fluid inside the follicle can form a cyst on the ovary.

  • Corpus Luteum Cysts – When the follicle sac doesn’t dissolve after releasing an egg and the opening of the follicle seals, additional fluid can develop inside the sac and this accumulation of fluid forms a cyst.

2. Pathological ovarian cysts occur as a result of abnormal cell growth (most pathological ovarian cysts are not cancerous) and are much less common. These include:

  • Dermoid cysts– These are sac-like growths on the ovaries that can contain hair, fat, and other tissue.

  • Cystadenomas– These are non-cancerous growths that can develop on the outer surface of ovaries.

  • Endometriomas– The endometrial tissues that normally grow inside the uterus can develop outside the uterus and attach to the ovaries, resulting in a cyst.

  • Polycystic ovary syndrome (PCOS)– The ovaries contain a large number of small cysts due to hormonal imbalance.

Symptoms

These can appear as the cyst grows. They include –

  • Abdominal bloating or swelling

  • Painful bowel movements

  • Pelvic pain before or during the menstrual cycle

  • Painful intercourse

  • Pain in the lower back or thighs

  • Breast tenderness

  • Nausea and vomiting

There are severe symptoms of an ovarian cyst that require immediate medical attention. These include:

  • Severe or sharp pelvic pain

  • Fever

  • Faintness or dizziness

  • Rapid breathing

These symptoms can indicate a ruptured cyst or an ovarian torsion. Both complications can have serious consequences if not treated early.

ovarian-cyst-1Diagnosis

We can detect an ovarian cyst during a routine pelvic examination. The various imaging modalities can help determine the size, location, shape, and composition (solid or fluid-filled) of a cyst which include:

  • Ultrasound

  • CT scan

  • MRI

If the cyst doesn’t disappear or increases in size, then some additional tests should be done to determine other causes. These include –

  • Pregnancy test – To rule any pregnancy

  • Hormone level test – To check for hormone-related issues

  • CA 125 Blood test – To screen for ovarian cancer

Treatment

If a cyst does not disappear on its own or if it grows larger, then it requires treatment to shrink or remove the cyst.

  • Birth Control Pills – In case of recurrent ovarian cysts, oral contraceptives can be given to stop ovulation and prevent the development of new cysts.

  • Laparoscopy – We can surgically remove the cyst or perform ovarian drilling in case of PCOS with laparoscopy.

  • Laparotomy– In case of large cyst, we can surgically remove the cyst through a big incision in the abdomen. The cyst will be sent for biopsy and in case of the cancerous cyst, a hysterectomy needs to be performed to remove the ovaries and uterus.

Prevention

Ovarian cysts cannot be prevented. But routine gynecological examinations can detect ovarian cysts early. Benign ovarian cysts do not become cancerous. The symptoms of ovarian cancer can mimic symptoms of an ovarian cyst. So, it is very important to visit the gynecologist for correct diagnosis.

Prognosis

The prognosis for ovarian cysts in premenopausal women is good and most cysts disappear within a few months. However, recurrent ovarian cysts can occur in premenopausal women and women with hormonal imbalances. Some cysts like PCOS or endometriomas can decrease the fertility and these can be easily treated with timely laparoscopic surgeries. The postmenopausal women (aged between 50­–70) with ovarian cysts have a higher risk of ovarian cancer, so should be removed immediately.

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