Ovarian cysts are fluid-filled sacs or pockets within or on the surface of an ovary. Women have two ovaries — each about the size and shape of an almond — located on each side of the uterus. Eggs (ova) develop and mature in the ovaries and are released in monthly cycles during your childbearing years.
Many women have ovarian cysts at some time during their lives. Most ovarian cysts present little or no discomfort and are harmless. The majority of ovarian cysts disappear without treatment within a few months.
However, ovarian cysts — especially those that have ruptured — sometimes produce serious symptoms. The best ways to protect your health are to know the symptoms that may signal a more significant problem, and to schedule regular pelvic examinations.
Ovarian Cysts Symptoms
Usually ovarian cysts do not produce symptoms and are found during a routine physical exam or are seen by chance on an ultrasound performed for other reasons. However, symptoms can be present, especially with large cysts. The following symptoms may be present:
- Lower abdominal or pelvic pain, which may start and stop and may be severe, sudden, and sharp
- Irregular menstrual periods
- Feeling of lower abdominal or pelvic pressure or fullness
- Long-term pelvic pain during menstrual period that may also be felt in the lower back
- Pelvic pain after strenuous exercise or sexual intercourse
- Pain or pressure with urination or bowel movements
- Nausea and vomiting
- Vaginal pain or spotty bleeding from the vagina
- Infertility
How are ovarian cysts diagnosed?
Sometimes ovarian cysts may be noticed by a health care practitioner during a bimanual examination of the pelvis. If a cyst is suspected based upon the symptoms of physical examination, imaging techniques are used. Most cysts are diagnosed by ultrasound, which is the best imaging technique for detecting ovarian cysts. Ultrasound is an imaging method that uses sound waves to produce an image of structures within the body. Ultrasound imaging is painless and causes no harm.
Cysts can also be detected with other imaging methods, such as CT scan or MRI scan (magnetic resonance imaging).
Treatments and drugs
Treatment depends on your age, the type and size of your cyst, and your symptoms. Your doctor may suggest:
Watchful waiting. In many cases you can wait and be re-examined to see if the cyst goes away on its own within a few months. This is typically an option — regardless of your age — if you have no symptoms and an ultrasound shows you have a small, fluid-filled cyst. Your doctor will likely recommend that you get follow-up pelvic ultrasounds at periodic intervals to see if your cyst has changed in size.
Birth control pills. Your doctor may recommend birth control pills to reduce the chance of new cysts developing in future menstrual cycles. Oral contraceptives offer the added benefit of significantly reducing your risk of ovarian cancer — the risk decreases the longer you take birth control pills.
Surgery. Your doctor may suggest removal of a cyst if it is large, doesn't look like a functional cyst, is growing, or persists through two or three menstrual cycles. Cysts that cause pain or other symptoms may be removed.
Some cysts can be removed without removing the ovary in a procedure known as a cystectomy. In some circumstances, your doctor may suggest removing the affected ovary and leaving the other intact in a procedure known as oophorectomy.
If a cystic mass is cancerous, however, your doctor will likely advise a hysterectomy to remove both ovaries and your uterus. Your doctor is also likely to recommend surgery when a cystic mass develops on the ovaries after menopause.
