The ovaries are two small organs located on each side of the uterus. It is normal for a woman to develop small cysts (a fluid filled sac) and these cysts are harmless and typically resolve on their own without treatment.
Monthly Cycle
Each month your ovaries will produce an egg. This egg is in a sac called a follicle, which grows inside the ovary. On day 5 of your cycle the hormone estrogen signals the uterus to thicken it’s lining to prepare for possible pregnancy. On day 14, the egg is released from the ovary, which is called ovulation. After ovulation a women can get pregnant as the egg moves into the fallopian tube where it can be fertilized by sperm. After ovulation, the empty follicle becomes the corpus luteum, which remains until the next period. The corpus luteum makes hormones that cause the endometrium to grow.
Types of Ovarian Cysts
Ovarian cysts are quite common in women during their childbearing years. Most are caused by changes in hormone levels that occur during the menstrual cycle as well as from the production and release of eggs from the ovaries. Women can develop one cyst or many cysts and they can vary in size from a small pea to as big as a grapefruit. There are many different types of ovarian cysts and each type causes a variety of symptoms. All cysts can bleed, rupture and twist and cause pain. Most cysts are benign but a few may turn out to be malignant.
Functional cysts
The most common type of ovarian cyst is 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 have no symptoms and usually will 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 and are often small and may not cause symptoms. They can however become large and cause symptoms.
Cystadenomas
Cystadenomas are cysts that develop from the outer surface of the ovary. They are usually benign but can create problems because they 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 a gradually growing cyst on the ovary called an endometrioma. It is also known as a “chocolate cyst” because it is filled with dark, red-brown blood. An endometrioma is often found in women who have endometriosis. This is a condition that can be painful, especially during the menstrual period or during sexual intercourse.
Multiple cysts
Polycystic ovary syndrome is a condition that develops in women who do not ovulate regularly and can develop multiple cysts. This condition causes irregular menstrual periods, infertility, and increased body hair.
Symptoms caused by Ovarian Cysts
Most ovarian cyst are small and do not cause symptoms. Some go away on their own. Some may cause symptoms because of twisting, bleeding, and rupture. They may cause a dull ache and pain during sexual intercourse. Some cysts may be cancer. The risk of ovarian cancer increases as you get older.
Diagnosis
An ovarian cyst can often be detected on pelvic exam, by an ultrasound or if a laparoscopy, which is a procedure that allows a doctor to look directly inside the body cavity, is done. Blood tests to measure CA 125 may be used to detect possible risk of ovarian cancer.
Treatment
If your cyst is not causing any symptoms it may be monitored for 1-2 months. Most functional cysts go away on their own over one to two menstrual cycles.
If your cyst is large or causing symptoms, your doctor may suggest treatment with hormones or surgery.
The type of treatment depends on several factors including the size and type of cyst, your age, your symptoms and your desire to have children.
Hormonal therapy
Your doctor may prescribe oral contraceptives (birth control pills) to treat functional ovarian cysts. The hormones in birth control pills stop ovulation. This prevents follicles from developing and stops new cysts from forming. Birth control pills may not be right for every woman, especially if you smoke cigarettes and are over 35. Your doctor will help you decide if hormonal therapy is right for you.
Surgery
Your doctor may suggest surgery to remove the cyst. Sometimes a cyst can be removed while leaving the ovary called a cystectomy. In other cases, one or both of the ovaries may have to be removed. Your doctor may not know which procedure is needed until the surgery begins.
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