By Dr Ananya Mandal, MD
Ovarian cysts are blister-like, fluid-filled sacs that develop on the ovary. The cysts are relatively common and in most cases do not give rise to any symptoms. They also usually resolve independently, without treatment. However, if the cysts are large or give rise to symptoms, they may need to be surgically removed.
Symptoms of large ovarian cysts:
A dragging sensation across the lower abdomen or pain on the side where the affected ovary is
If the cyst ruptures or bleeds, there may be pain in the pelvic area
Frequent urination due to the cysts pressing on the bladder
Bloated or full-feeling abdomen
Periods may become irregular, heavier or lighter
Hirsuitism or excessive hair growth
Types of ovarian cysts
There are several different types of ovarian cysts which include:
Functional ovarian cysts - These are the most common type of cyst and they develop as part of the menstrual cycle. Functional cysts may be further divided into the subtypes graafian (or follicular) cysts which develop during the first half of the menstrual cycle; the corpus luteum which forms during the second half of the cycle when the follicular cyst bursts but does not disintegrate; and the hemorrhagic or blood-filled cyst which forms when a blood vessel in a cyst breaks causing the cyst to fill with blood. In the majority of cases, hemorrhagic cysts resolve independently but may need to be surgically removed if they are persistent and painful.
Pathological ovarian cysts - These cysts arise due to cellular abnormality and examples include the dermoid cysts which are benign tumors containing pieces of hair, fat or bone and, endometrioid cysts or chocolate cysts that are caused by endometriosis.
Cysts that do not cause symptoms may go unnoticed and may not require treatment. A diagnosis of symptomatic cysts is made on a clinical examination of the pelvis and confirmed using medical imaging techniques such as ultrasound.
The size and symptoms of the cyst determine the treatment required. In most cases, the cyst disappears in a few weeks and this can be confirmed by a follow-up ultrasound scan. In women who have had their menopause, the risk of getting ovarian cancer is high and closer monitoring is required. Larger cysts are surgically removed which may involve removal of only the cyst or the whole ovary, depending on the size and type of cyst.
Other general treatments include:
Pain relievers such as paracetamol or ibuprofen
Oral contraceptive pills which help regulate the menstrual cycle and prevent the formation of follicles that can turn into cysts. These pills can also shrink existing cysts.
Reviewed by Sally Robertson, BSc