Ovarian Cysts

Ovarian cysts, small masses that develop on one or both of the ovaries, are a common women’s health issue. If you have an ovarian cyst or experience symptoms that could indicate this condition, talk with your healthcare provider about the facts. We understand the fear that patients may feel when faced with the unknown. With compassion and clear communication, we do our best to clarify the details of concerns such as ovarian cysts.

What Is an Ovarian Cyst?

An ovarian cyst is a sac that develops either on or inside the ovary. This sac may have fluid inside of it, or it may be full-tissue through and through.

Ovarian Cyst Symptoms

In most cases, an ovarian cyst does not present symptoms. Many women discover they have an ovarian cyst when they obtain their routine well woman’s checkup.

On the rare occasions when symptoms do develop, they may include:

• A dull or sharp pain that comes and goes.
• Swelling on the side of the abdomen where the cyst has developed.
• Bloating and a sense of abdominal pressure.

A cyst may cause the ovary to twist. This can cause pain, as well as nausea and vomiting. A cyst may also rupture, causing severe pain.

Is an Ovarian Cyst Serious?

Most ovarian cysts are benign (non-cancerous), and many do not require treatment. Research suggests that a benign ovarian cyst is not likely to become cancerous. The development of benign ovarian cysts also does not raise a woman’s risk for ovarian cancer.

The instance of a ruptured ovarian cyst is not uncommon. Many of these sacs burst at some point, resulting in little to no pathology whatsoever. If you develop sudden, intense pain, or you experience pain alongside vomiting, vaginal bleeding, and/or fever, contact your healthcare provider for a full exam and diagnostic testing that will provide observation of your ovaries.

Ovarian Cyst Diagnosis

Whether you present symptoms or your health care provider finds an indication for ovarian cysts during your pelvic exam, additional diagnostic testing may be necessary. These include:

• Ultrasound imaging. This test provides observation of the location, size, shape, and characteristics of the cyst. Ultrasound will tell us if the cyst is solid, fluid-filled, or a mixture of the two. Imaging may be performed abdominally, or via a vaginal transducer, a small instrument inserted through the vagina.
• Pregnancy test, when appropriate.
• Blood tests for hormone levels and, in some cases, for cancer antigen 125. A higher than normal CA-125 in premenopausal women does not necessarily confirm ovarian cancer. Other diseases or illnesses can affect this test and will therefore require further follow-up.

Ovarian Cyst Treatment

When ovarian cysts are asymptomatic and there is no suspicion of cancer, a wait and watch approach may be necessary. This means that ultrasound imaging or other diagnostics taken at appropriate intervals, will help your doctor observe the size and structural characteristics of the cyst. If cysts cause intermittent pain, medication may be necessary. Patients who are prone to ovarian cysts may be prescribed hormonal birth control pills to manage ovulation and, thus, reduce the risk of new cyst formation. Your healthcare provider will develop a management or treatment plan based on your medical history, symptoms, and other factors important to your case.

In some cases, surgery is necessary to remove an ovarian cyst that is large, or that appears abnormal on ultrasound or another diagnostic testing.

What Does Surgery Involve?

There are two surgical methods of removing ovarian cysts. These include:

• Laparoscopy, in which a short incision is made near the belly-button and the cyst is observed and/or removed using small instruments.
• Laparotomy may be an option for larger cysts, or for cysts indicating abnormality which suggests cancer. This procedure is considered an “open” surgery due to a larger incision made along the abdomen.

Ovarian Cysts and Pregnancy

Having an ovarian cyst typically does not indicate that you will have difficulty becoming pregnant. The exception would be the presence of a primary condition such as polycystic ovary syndrome (several cysts on the ovaries) or endometriosis. Each of these reproductive issues is usually symptomatic, allowing your health care provider to diagnose and treat appropriately.

Sometimes, ovarian cysts develop during pregnancy. The general protocol in such instances is to monitor the cyst to assess labor and delivery risk.