(1) Dear Alice,

What are ovarian cysts? What do they feel like, and where would one feel the symptoms?

— Bumpy

(2) Dear Alice,

I just found out that I have a small cyst on my left ovary. I was wondering what causes these? Any risks with them? The doctor told me that they usually pass during a monthly period but I've been having this pain for several months already. Any advice? I haven't seen my GYN about this yet.

Thanks,
Concerned

Dear Bumpy and Concerned,

Generally speaking they are fluid-filled sacs (picture a blister) that are located within the ovary. These cysts can be malignant (cancerous), but most are benign (non-cancerous) and quite common in women with regular periods. In fact, most women develop cysts at some point during their cycle — which eventually disappear on their own without any treatment. There are multiple types of ovarian cysts and symptoms may or may not appear (more on that in a bit). Possible causes include hormonal issues, pregnancy, or a pelvic infection. In addition, ovarian cysts can also result from conditions such as polycystic ovarian syndrome (PCOS) and endometriosis.

The most common type of cyst is a functional cyst that forms during the menstrual cycle. Functional cysts are typically benign and are broken into two types:

  • Follicular cysts: In the middle of a woman’s menstrual cycle, an egg usually bursts out of its follicle within the ovary and travels down the fallopian tube to await the possibility of fertilization. Typically, the follicle will rupture and release the egg, but if it doesn’t, it may continue to grow into a follicular cyst. These cysts often have no symptoms and go away in one to three months.
  • Corpus luteum cysts: After the follicle breaks open and releases the egg, the empty sac shrinks into a ball of cells, known as the corpus luteum. Sometimes, the corpus luteum doesn’t shrink, and instead, the opening from which the egg escapes seals shut and fluid fills the follicle. This causes the corpus luteum to expand into a cyst. These cysts typically go away after a few weeks, though they can become very large (up to four inches wide) and potentially painful.

There are also some less common types of cysts that aren’t related to the menstrual cycle:

  • Dermoid cysts: These cysts, which are mostly benign, form from cells that produce human eggs and therefore may contain tissue, such as hair, skin, or teeth.
  • Cystadenomas: This type of cyst, which develops from ovarian tissue, may be filled with a watery fluid or mucous material.
  • Endometriomas: Among those with endometriosis, cysts may result from the tissue attaching to the ovary that may also affect fertility. 

Most ovarian cysts are small and don’t cause pain. However, if a cyst does cause symptoms they may include pressure, bloating, swelling, or pain in the lower abdomen on the side where the cyst is located. It’s not common, but complications (such as rupturing) can occur, with potential to cause severe pain and lead to internal bleeding. It’s also good to note that though ovarian cysts can happen to anyone with ovaries, they tend to be less common after menopause. If they are found after menopause, it's more likely that they may be cancerous. Because of this, regular pelvic exams are a good idea for all women. If a cyst is found during a pelvic exam, a health care provider may assess its size and composition to determine next steps. S/he may also perform tests or procedures, such as a pregnancy test, pelvic ultrasound, laparoscopy, or blood test, to identify the type of cyst. Treatment for an ovarian cyst depends on the individual’s age, the type of cyst, and the types of symptoms. As such, treatment recommendations can range from waiting and monitoring, taking birth control pills to reduce the chance of new cysts developing, or, in more extreme cases, surgery.

If you’d like to learn more about ovarian cysts, or if you think you may have an ovarian cyst, consider making an appointment to talk with your health care provider to address any lingering questions or concerns you have.

Alice!

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