Understanding ovarian cysts

August 20, 2010 By Danielle Luciano, M.D.

Ovarian cysts are common—especially during the childbearing years—and are rarely a reason to panic. Most ovarian cysts are benign and are a result of a normal menstrual cycle. There's only a slim chance that ovarian cysts may be cancerous, as a woman's lifetime risk of ovarian cancer is 1:70. If the cysts are found early, treatment—if necessary—is easier and less invasive.
There are many different types of cysts, including:

• Functional cysts, the most common, are essentially a byproduct of ovulation. There are two types—a follicular cyst (before ovulation) which becomes a corpus luteum cyst after ovulation.
• Polycystic ovarian syndrome (PCO), is marked by the growth of tiny, benign cysts on both ovaries. PCO is usually the result of a hormonal imbalance.
• Dermoid cysts are benign cysts containing skin, hair, teeth or bone. Although they develop from cells that normally produce an egg, they are not pregnancy-related.
• Endometriomas, often called chocolate cysts, result from endometriosis—a benign disease in which patches of tissue from the uterine lining grow outside the uterus.
• Cystadenomas are usually benign cysts that develop from ovarian tissue, and may be filled with may be a watery fluid or gelatinous material.
Treatment depends on the cyst type, size and location, symptoms, woman's age and childbearing plans and other factors. A wait-and-see approach is often best for functional cysts since they tend to go away on their own. Alternatively, birth control pills may help “shrink” cysts and prevent new ones. Surgery may be required for large or painful cysts. Ovarian cysts in a postmenopausal woman may be treated more aggressively because the cyst is more likely to become cancerous.
Fortunately, cysts can usually be removed without disturbing the ovary, however in some cases, one or both ovaries must also be removed. In severe cases, it may be necessary to remove the fallopian tubes and possibly the uterus.

Could you have an ovarian cyst?
Most ovarian cysts don't cause symptoms until they become very large, bleed, rupture or twist. Call your doctor if you experience any of these symptoms:

• abdominal pain or pressure
• painful intercourse
• unusual vaginal bleeding
• unexplained weight gain or abdominal bloating
• menstrual irregularities—longer, shorter, absent or irregular cycles
• infertility problems
• nausea, vomiting or breast tenderness
• pressure on the rectum or bladder
• a constant dull ache in your pelvis that may radiate to the lower back and thighs
Because your outlook is best when an ovarian cyst is discovered early, visit your doctor for your annual checkup. Don't wait for symptoms to strike.

Danielle Luciano, M.D., is an obstetrician/gynecologist at The Hospital of Central Connecticut.