Understanding Ovarian Cysts
What is an Ovarian Cyst?
An ovarian cyst is an abnormal, fluid-filled swelling inside one of the ovaries. These are the almond-shaped glands situated on either side of the uterus, immediately below the entrance to the Fallopian tubes. The ovaries contain follicles, one of which releases an egg during ovulation. The ovaries are also responsible for producing the female sex hormones, oestrogen and progesterone.
Most women will probably have had at least one ovarian cyst without knowing it. They can appear at any age, in any number, and on one or both ovaries. They often disappear on their own without any treatment.
What causes an Ovarian Cyst?
The most common cause of ovarian cysts is a minor upset during ovulation. The follicle, instead of bursting and releasing an egg, continues to grow and accumulates fluid. This causes a functional, or simple cyst, These cysts can grow quite large, sometimes to over 8cm.
Simple cysts can also be caused by endometriosis, a condition in which fragments of the uterine lining travel to other parts of the abdomen. These fragments bleed monthly, as the uterus does (during menstruation) but they can cause blood-filled cysts if they migrate up to the ovaries.
Another type of cyst, a dermoid cyst, accounts for about 10% of all ovarian cysts. Dermoid cysts range in size from just a few millimeters to 10cm or even more. They have a cell structure that is similar to skin and are thought to be made up of the same cells from which an embryo develops. It is quite common for a dermoid cyst to contain tissues of hair, teeth and bone.
Both simple and dermoid cysts are benign (harmless). However, in some cases an ovarian cyst can be malignant (cancerous) and will have to be surgically removed.
How is an Ovarian Cyst diagnosed and treated?
Since there are usually no symptoms, ovarian cysts are often discovered during a routine pelvic examination. However, abdominal pain, nausea, fever, and abnormally heavy periods can make a doctor suspect a cyst. If this is the case, the doctor will perform an internal examination, and then make a referral to a hospital for ultrasound scanning or a laparascopy (an examination of the abdominal cavity through a viewing tube). Both of these procedures can confirm the diagnosis, as well as determine the size and position of the cyst. They cannot tell whether the cyst is malignant or not.
If a cyst is diagnosed, it will usually be surgically removed, whether the doctor thinks it is malignant or not. This is done in a hospital under a general anaesthetic, and a stay of at least a couple of days is usually needed.
During the operation, a small piece of the cyst may be removed and sent to the laboratory. There, it is quickly examined to find out the nature of the cyst. If it is benign, only the cyst is removed, leaving the ovary in place. The other ovary is also examined, because cysts sometimes occur in both ovaries at the same time.
If the cyst is malignant, the cyst ovary and Fallopian tube are all removed. Again, the second ovary will be examined. If it is affected as well, the second ovary will usually be removed.
What can I do myself?
The pill reduces the risk of benign ovarian cysts by 90% and reduces the risk of ovarian cancer by 40%. Once a cyst is discovered, it is important to discuss the possibilities and options thoroughly with your doctor before going ahead with any treatment. Find out whether it will be necessary to have both ovaries removed if the cyst is malignant. This is very important if you are still of childbearing age and want to have a family.
If you are of premenopausal age, ask about hormone replacement therapy, because if both the ovaries are removed you will not produce female sex hormones and will start a premature menopause.
When should I see my doctor?
See your doctor immediately if you experience any pain or swelling in the lower abdomen, particularly if you also have some or all of the symptoms listed overleaf.
Are Ovarian Cysts dangerous?
A cancerous cyst that is untreated is dangerous, as the cancer can spread. If the cyst and one ovary are removed, fertility may be slightly reduced but the necessary sex hormones will continue to be produced. Removal of both ovaries results in infertility, and there may be a need for hormone replacement therapy. If the cyst is benign and only the cyst is removed, then there should be no further trouble and it should not affect fertility. There may be a need to be examined more often in the future, in case another cyst develops.
Symptoms of Ovarian Cysts
Ovarian cysts often cause no symptoms, especially when they are small, but signs which may indicate the presence of a cyst include:
- Abdominal swelling
- Pain during sexual intercourse
- Changes in the normal menstrual cycle, including irregular, painful or heavy periods.
- Frequent urination
- Difficulty conceiving
- Abdominal or pelvic pain, nausea and fever if the cyst twists or ruptures
Warning: Any pain or swelling in the lower abdomen should be seen by your doctor. Most ovarian cysts are benign, but delay in getting treatment may lead to problems. Consult your physician as early as possible to avoid complications.
Surgical procedure of removing a swelling ovarian cyst.
Tags: ovarian cyst surgery, ovarian cyst swelling, ovarian cysts
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