Overview: What is an ovarian cyst?
An ovarian cyst is a fluid-filled cavity in your ovaries. The term “cyst” does not indicate whether the change is benign or malignant. Most cysts are harmless. They result, for example, from an excess of certain sex hormones during puberty or menopause. Since they do not cause any discomfort and often disappear on their own, you usually do not need to have them treated.
However, if the ovarian cyst persists over a long period of time, your doctor should investigate the cause to rule out conditions such as endometriosis or ovarian cancer.
Ovarian cyst: causes and risk factors
Most ovarian cysts are related to ovulation and the maturation of eggs in the ovaries. Medicine calls them “functional cysts.” They can occur in one or both ovaries. The most common functional cysts are
- Follicular cysts
- Corpus luteum cysts (cysts of the corpus luteum)
- Lutein cysts
- Small pearly cysts due to PCO
- Endometriosis cysts
Every month, an egg matures in a follicle (vesicle) in the ovary of a fertile woman. If ovulation does not occur, for example during menopause, the follicle can fill with fluid and develop into a cyst that can grow up to 15 centimeters in size .
Corpus luteum cysts
A corpus luteum cyst is an enlarged corpus luteum. It is formed after ovulation from the remains of the follicle and produces mainly the sex hormone progesterone and a little of the female sex hormone estrogen. Sometimes blood collects in the corpus luteum and it enlarges into a cyst.
Lutein cysts usually develop in both ovaries when the production of certain hormones is increased. Cause can be
- Multiple pregnancies due to elevated pregnancy hormone (HCG).
- Hormone treatments for female infertility
- certain hormone-producing diseases, for example tumors
- Developmental disorders of the placenta
Lutein cysts usually regress on their own when their causes are removed – for example, after childbirth or when hormone treatment is discontinued.
Cysts due to polycystic ovary syndrome (PCO)
Many small cysts are a symptom of polycystic ovary syndrome (PCO). PCO is a hormonal disorder: due to a hormonal imbalance, the maturation of the follicles is impeded. Instead, the follicles develop into small cysts that line up like pearls around the edges of the ovaries, causing the ovary to swell.
If you have endometriosis, tissue from your uterine lining settles in other parts of your abdomen, in other organs, and sometimes in your ovary. During menstruation, these small islands of uterine lining bleed. Since menstrual blood cannot drain in the ovaries, cysts form there. Endometriosis cysts contain dark brown, thickened blood breakdown products, which is why we call them chocolate cysts .
Special form retention cysts
Retention cysts occur when glandular fluid accumulates. This backwater (retention) causes a gland to grow into a cyst. Retention cysts include, for example, the so-called dermoid cysts. They are malformations derived from the germ cells, which may contain hair, sebum, cartilage or bone tissue, and teeth. Dermoid cysts are harmless changes that account for about one-third of all benign neoplasms on the ovaries. They form mainly before puberty or in young women. In very rare cases, a dermoid cyst can degenerate into a malignant tumor. However, this usually occurs in women over the age of 40.
Symptoms: Usually the cyst behaves inconspicuously
The majority of ovarian cysts only reach a size of one to three centimeters and regress within a few months. Whether one should speak of a cyst at all below 3cm is questionable, since normal eggs can reach this size before ovulation. In exceptional cases, however, cysts can grow to 30 cm in diameter.
Small ovarian cysts do not cause any symptoms. Your gynecologist usually notices them by chance during an ultrasound examination. If a cyst reaches a size that exceeds a few centimeters, it can affect neighboring organs. Then the following symptoms may occur:
- You feel dull or pulling pain in your lower abdomen.
- You have a more frequent urge to urinate.
- You suffer from a voiding disorder of the bowel.
- You experience pain during sexual intercourse.
- Your back hurts.
- Your cycle is irregular.
It can become painful if your ovarian cyst bursts. As a rule, the so-called rupture is not dangerous. Sometimes, however, vessels can be damaged so that this leads to bleeding into the abdominal cavity occurs. Then you have to stop the bleeding by surgery.
If you feel severe unbearable pain in the lower abdomen and other symptoms such as diarrhea and severe nausea, this may indicate that the cyst has turned on its axis. One stem rotation can interrupt the blood supply to the ovary. In this case, you will need surgery.
A corpus luteum cy st can cause cycle disorders, then, for example, menstruation stops.
Ovarian cyst: diagnosis by us
During your annual gynecological checkup, a gynecologist will palpate your uterus, fallopian tubes and ovaries. They can palpate large cysts during this examination. Smaller cysts show up on ultrasound examination. The examination may also already give an indication of what type of cyst it is. If not, further investigation is necessary:
The blood shows certain hormone and inflammation levels, as well as possible tumor markers.
Computed tomography and laparoscopy
Further examinations such as a computer tomography or an abdominal endoscopy are rarely necessary. In most cases, they are intended to clarify whether the changes in the tissue of the ovary could be a malignant tumor. While cysts are benign in most cases, they are sometimes not easily distinguished from a tumor.
Ovarian cyst: prevention, early detection, prognosis
Preventing ovarian cysts is difficult. They are formed under the influence of sex hormones. Theoretically, drugs could inhibit their production. However, this would cause side effects and is not suitable for women who, for example, want to have children. Moreover, in most cases the cysts are harmless and regress on their own.
With polycystic ovary syndrome (PCOS), you can take action yourself: Its causes are not yet fully understood. A healthy diet, adequate exercise and a reasonable weight can reduce risk factors and symptoms. However, the cause of endometriosis is not yet known, which is why you cannot prevent the disease.
Early detection of ovarian cysts is possible in the course of gynecological screening.
Course and prognosis of ovarian cysts
If you have an ovarian cyst, your prognosis is very good. It usually disappears on its own after a few months. Serious complications are very rare. The cyst may burst, causing pain. However, this so-called rupture is usually harmless. In individual cases, however, this can cause bleeding into the abdominal cavity, which we have to stop with surgery.
In rare cases, it happens that a larger cyst rotates on its own axis. This so-called stalk rotation can interrupt the blood supply to the ovary. In this case, we need to reverse the ovary in surgery and surgically remove the cyst to preserve the ovary.