By Gerald F. Joseph, Jr, MD
President, The American College of Obstetricians and Gynecologists
Many women have ovarian cysts—fluid- or tissue-filled growths that form on the ovary. Ovarian cysts areusually noncancerous and most remain small in size, cause mild symptoms if any at all, or simply go away on their own. However, they can become a problem and require treatment if they grow too large or cause pain.
Ovarian cysts can develop in women of all ages, but because most cysts occur as a side effect of ovulation, reproductive-age women are especially susceptible. Each month, an egg matures in a woman’s ovary within a sac called a follicle. When the mature egg is released from the follicle, ovulation occurs. Functional cysts develop when the follicle does not open to release the egg or when the follicle seals off after the egg is released. They often go away in six to eight weeks.
Some ovarian cysts are not related to ovulation. Dermoid cysts are made from cells that can develop into different types of tissue such as hair, skin, and teeth. Endometriomas form when the cells that usually line the uterus migrate to the ovaries and continue to bleed with each menstrual cycle. Cystadenomas develop from the cells on the outside of the ovary and are filled with fluid.
Cysts do not cause symptoms in most women, but some women experience a dull or sharp ache during certain activities. Pain may also occur if large cysts cause the ovaries to twist. Additionally, if a cyst bleeds or bursts, prompt medical attention may be needed.
In rare instances, ovarian cysts may be cancerous. As with noncancerous cysts, the symptoms of ovarian cancer may be vague or nonexistent. Some women with ovarian cancer have reported symptoms such as unexplained bloating, pelvic or abdominal pain, back pain, increased abdominal size, difficulty eating, unexplained weight loss, urinary incontinence, frequent urination, constipation, fatigue, and indigestion. Tell your doctor if you have been experiencing any of these symptoms on a regular basis.
Ovarian cysts are often discovered during routine pelvic exams. If your doctor observes an enlarged ovary, further tests—such as a vaginal ultrasound, blood test, or laparoscopy which uses a lighted scope to view the inside of the pelvic cavity—may be ordered to confirm the diagnosis.
Treatment options for ovarian cysts vary depending on the type and size of cyst, severity of symptoms, family history, age, and other factors. Your doctor may decide to monitor the cyst for changes or increasing size with regular ultrasound exams. Birth control pills stop ovulation which can be helpful in preventing new functional cysts. Surgery to remove a cyst or the entire ovary is also available, though it may not be the best option for women who still want to have children. Your doctor can review your options based on your specific case. ?
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