One of the biggest fears for women is suffering from ovarian cysts. Definitely, when a woman finds out that she has an ovarian cyst, she enters into an internal duel: how is it possible? Will they have to operate? Will it hurt? Is it benign or malignant? We will try to answer all those questions that come to mind once a cyst is diagnosed in this article with the help of obstetrician-gynecologist.

Ovarian cysts: what are they and how do they form?

  • Women have two ovaries located on each side of the uterus. Ovarian cysts are due to membranous sacs or bags filled with a liquid or solid substance that forms either on or within the affected ovary. Generally, ovarian cysts do not cause symptoms and may disappear after a few months. Ovarian cysts, sometimes reported as ovarian tumors or adnexal tumors, are often found incidentally in women who do not have symptoms and are diagnosed on a routine medical examination or by ultrasound (sonography) performed as part of the gynecological medical consultation. These cysts can be physiological (related to ovulation) or neoplastic (abnormal tumor growth).
  • While the vast majority of ovarian cysts are benign, some are malignant. They appear mainly in reproductive age (15-45 years) and the most frequent causes at this time are those of functional origin (harmless and non-cancerous). In premenarchal and postmenopausal women they should be immediately studied due to an increased risk of malignancy.

Symptoms that you have an ovarian cyst

When a woman suffers from one or more ovarian cysts, she may experience the following symptoms:
  • Irregular menstruation.
  • Pelvic or abdominal pain.
  • Swelling or heaviness in the abdomen.
  • Pain when having sexual intercourse.
  • Irregular bowel movements.
If you notice any of these symptoms, followed by fever or vomiting, it is important to consult a specialist such as a gynecologist, to find out how to treat the cyst and prevent it from becoming a bigger problem.

Types of ovarian cysts: malignant or benign?

There are different ovarian cysts, however, most occur due to an abnormality in the development of the menstrual cycle itself, specifically in ovulation. If they are mild, they are known as functional cysts. These are usually harmless, benign (not cancerous), and go away after a few months. However, this type of cyst is divided into two other subtypes:
  • Follicular cyst: occurs when the follicle does not release the egg and it continues to grow. Follicular cysts have no symptoms and disappear in one to three months.
  • Corpus luteum cyst: The follicle that releases the egg and begins to produce estrogen and progesterone is known as a corpus luteum cyst. Sometimes, this fluid accumulates inside the follicle, causing the "corpus luteum" to expand, thus forming the cyst. These types of cysts also usually disappear after a few weeks, although they can bleed and cause pain.
Now, cysts that are not related to functional ones include:
  • Dermoid cysts: also known as teratomas, are cysts that are formed by embryonic cells. They are not usually cancerous, but may contain tissue.
  • Cystadenomas: These are cysts that form on the surface of an ovary.
  • Endometriomas: These cysts can be formed by endometriosis.
These types of cysts mentioned above can expand, causing the ovary to shift out of position and increasing the possibility of a painful torsion of the ovary appearing.

How do I know if I have an ovarian cyst? Diagnosis

In addition to undergoing a regular clinical health assessment, you will need to suspect that you have an ovarian cyst if you have symptoms such as those described above. The way to diagnose it is as follows:
  • Pelvic ultrasound (pelvic ultrasonography) is the imaging study of choice to evaluate for ovarian cysts and is therefore the step of choice after taking the history, performing the physical examination, and obtaining blood tests.
  • Pelvic ultrasound can be performed transabdominally or transvaginally. The latter provides clearer images in most patients.
Simple cysts with or without hemorrhage larger or smaller than 3 centimeters are considered functional; however, those that measure more than 5 centimeters in diameter are recommended to be removed if they persist or cause symptoms, since they can lead to malignant tumors.

Treatment for ovarian cysts

Once there is a diagnosis of an ovarian cyst, once each particular case has been analyzed, the treatments may include:
  • Wait: as we have mentioned before, mild ovarian cysts usually do not show symptoms and disappear in a few months, so in many cases, the patient can wait and return for another exam to find out if the cyst has disappeared or remains.
  • Medications: One of the primary treatments is medications. The specialist could recommend the intake of hormonal contraceptives that help prevent the recurrence of ovarian cysts.
  • Surgery: if the cyst is large or continues to grow and persists for more than two or three months causing pain, that is when the doctor resorts to extracting it. An ovarian cystectomy (removal without removing the ovary) or an oophorectomy (removing the affected ovary) may be performed.
Reading this article should not leave you with goose bumps, as we have said, on some occasions there is nothing to worry about since the cyst could disappear in a while. However, you shouldn't relax either if you think you're suffering from one. See a specialist and find out what type of cyst you have and how to treat it.