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,

Ovarian cysts are sacs filled with fluids that can be in or on the ovary. Most frequently, they're benign but rarely, they’re cancerous. They’re common among those with ovaries, and many people have cysts in their lifetime without even realizing it. The cause of the cyst can vary, and as such, they result in different types of ovarian cysts. Some of these causes may be related to the menstrual cycle, pregnancy, or embryonic tissue. Ovarian cysts can also be associated with health conditions such as polycystic ovary syndrome (PCOS) and endometriosis. In terms of the symptoms, some people may never feel symptoms and they disappear on their own without treatment. Others may feel bloating, a fullness, or even pelvic pain on the side of the cyst. Ready to know more? Keep on reading!

Functional cysts are the most common type of cyst, and they form during the menstrual cycle. During the menstrual cycle, the ovary develops a follicle (a fluid-filled sac) to hold the egg and then release it into the fallopian tubes for fertilization. Functional cysts occur when the follicle doesn’t behave in its typical fashion. For many people, these cysts go away on their own in a few months and don’t cause many, if any, symptoms. They're generally benign and there are two different types:

  • Follicular cysts: Usually, the follicle bursts and releases the egg. If this doesn’t occur, the follicle may continue to grow, developing into a follicular cyst.
  • Corpus luteum cysts: Typically, after the follicle ruptures, the empty sac shrinks into a ball of cells called the corpus luteum. However, if the empty sac doesn’t shrink, it may instead seal shut and fill with fluid, forming a cyst.

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

  • Dermoid cysts: Mostly benign, dermoid cysts form from cells that produce human eggs. These can grow to be quite large and can be found with tissues such as hair or teeth inside.
  • Cystadenomas: These cysts form from ovarian tissue and can also be quite large, filling with water or mucous on the surface of the ovary.
  • Endometriomas: Common in those who have endometriosis, these cysts form when endometrial tissue (part of the lining of the uterus) attaches to the ovary. This may affect fertility.

Many people who have cysts don’t experience symptoms. However, those who do experience symptoms may notice pressure, bloating, swelling, pelvic pain on the side where the cyst is located, pain during menstruation, and pain during sex.

A cyst can often be diagnosed through a pelvic exam performed by a health care provider. Some additional tests may include an ultrasound, a pregnancy test, a hormone test, or a blood test. If a cyst is found, the treatments can range based on how old you are, the type and size of the cyst, and what (if any) symptoms you may be experiencing. Some of these include monitoring the cyst to note any changes in size or symptoms, taking birth control pills to stop ovulation and reduce the likelihood of functional cysts forming, and surgery if it’s large, causing pain, or appears to be cancerous. There currently isn’t a way to prevent ovarian cysts, so having routine pelvic exams can help ensure that any cysts are diagnosed early. Concerned, given that you've been told you have a cyst and it's causing pain, you may find it helpful to see a specialist such as a gynecologist for further evaluation.

Although rare, there are some complications that can result from ovarian cysts. First, cysts can rupture, which may cause severe bleeding or intense pain. Additionally, they may also twist, which is called ovarian torsion. When a cyst becomes heavy, it may cause the ovary to twist out of place and cut off blood flow to the organ. This can cause severe pelvic pain, vomiting, and nausea. If you have an ovarian cyst and experience these symptoms, it’s critical to seek medical care right away to help maintain the organ. For more information about cysts and the menstrual cycle, you may want to review the related Q&As or the Go Ask Alice! Sexual & Reproductive Health archives. 

Alice!

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