Ovarian cyst | NHS inform

An ovarian cyst is a fluid-filled sac that develops on an ovary. They’re very common and do not usually cause any symptoms.

Most ovarian cysts are generally harmless and disappear without treatment in a few months.

Small cysts are normal in the ovary. There may only be a problem is there are a large number of cysts, they’re persistent, or become particularly large.

Ovarian cysts may affect both ovaries at the same time, or they may only affect one.

What are ovaries?

The ovaries are part of the female reproductive system. They are 2 small, bean-shaped organs, one each side of the womb (uterus).

The ovaries have 2 main functions. They are:

• to release an egg around every 28 days as part of the menstrual cycle
• to release the female sex hormones, oestrogen and progesterone

Types of ovarian cyst

The 2 main types of ovarian are:

• functional ovarian cysts (most common) – develop as part of the menstrual cycle and are usually harmless and short-lived
• pathological ovarian cysts (much less common) – occur due to abnormal cell growth

Ovarian cysts can sometimes also be caused by an underlying condition, such as endometriosis.

The vast majority of ovarian cysts are non-cancerous (benign). But a small number are cancerous (malignant).

Signs and symptoms

Most cysts are found by chance during a scan. They’re unlikely to cause any symptoms unless they’re large or abnormal.

An ovarian cyst will usually only cause symptoms if it splits (ruptures), is very large, or it blocks the blood supply to the ovaries.

Urgent advice:

Contact your GP practice if:

• you have sudden, severe pelvic pain

If your GP is closed, phone 111.

Non-urgent advice:

Contact your GP practice if:

You’re worried about your symptoms or you regularly have:

• pelvic pain – this can range from a dull, heavy sensation to a sudden, severe and sharp pain
• pain during sex
• difficulty having a poo
• a frequent need to urinate
• heavy periods, irregular periods or lighter periods than normal
• bloating and a swollen tummy
• feeling very full after only eating a little
• difficulty getting pregnant

If your GP practice is closed, phone 111.

Useful information for your doctor

It can be helpful to keep a note of your period dates and symptoms using a calendar, a diary or an app. You can then discuss this with your doctor who can decide if any tests or treatments might be needed.

If you’re seeing your doctor, there are some useful pieces of information to think about beforehand:

• the first day of your last period (when it started)
• how many days your period usually lasts
• what was the shortest time between your periods (from the first day of one period to the first day of the next)
• what was the longest time between your periods (from the first day of one period to the first day of the next)
• how often you need to change your period products on a heavy day
• if you are over 25, when you had your last smear test

Diagnosing ovarian cysts

If your GP thinks you may have an ovarian cyst, you may be referred for an ultrasound scan. This is carried out by using a probe placed inside your vagina.

As this is a very intimate examination, the doctor who performs it will have another person (chaperone) present. You can ask for a female doctor to carry it out. If there isn’t a female doctor available, you can ask if there’s a female health professional who could carry out the examination.

If a cyst is identified during the ultrasound scan, you may need to have this monitored with a repeat ultrasound scan in a few weeks. Or your doctor may refer you to a gynaecologist, who specialises in female reproductive health.

Your doctor may also arrange blood tests to check for any other conditions.

Treatment

In most cases, ovarian cysts disappear in a few months without treatment. A follow-up ultrasound scan may be used to confirm this.

Treatment will depend on:

• size and appearance of the cysts
• whether you have any symptoms
• whether you’re post-menopausal (due to the slightly higher risk of ovarian cancer)

If you’re post-menopausal, you’ll usually have regular ultrasound scans and blood tests over the course of a year to monitor the cyst.

Large cysts, those causing symptoms, and those that could be cancerous, may need to be surgically removed.

Your care team can talk with you about what to expect, and answer any questions you have.

Types of surgery

There are 2 types of surgery used to remove ovarian cysts:

• laparoscopy
• laparotomy

These are usually carried out under general anaesthetic.

Laparoscopy

Most cysts can be removed using laparoscopy. This is a type of keyhole surgery. Small cuts are made in your tummy and gas is blown into the pelvis to allow the surgeon to access your ovaries.

A laparoscopy is a procedure where a camera (a laparoscope) is inserted into the pelvis via a small cut near the belly button so the surgeon can see your internal organs. The surgeon then removes the cyst through the small cuts in your skin.

After the cyst has been removed, the cuts will be closed using dissolvable stitches.

A laparoscopy is preferred because it causes less pain and has a quicker recovery time. You’ll usually be able to go home on the same day or the following day.

Laparotomy

If your cyst is particularly large, or there is a chance it could be cancerous, a laparotomy may be recommended.

During a laparotomy, a single, larger cut is made in your tummy to give the surgeon better access to the cyst.

The whole cyst and ovary may be removed and sent to a laboratory to check whether it’s cancerous. Stitches or staples will be used to close the incision.

You may need to stay in hospital for a few days after the procedure.

After the surgery

After the ovarian cyst has been removed, you’ll feel pain in your tummy. This should improve in a day or two.

If you have had a laparoscopy, you’ll probably need to take things easy for 2 weeks. Recovery after a laparotomy will usually take longer, possibly around 6 to 8 weeks.

If the cyst has been sent for testing, the results should come back in a few weeks. Your doctor will discuss with you whether you need any further treatment.

Contact your GP if you notice the following symptoms after surgery, as they may indicate an infection:

• heavy bleeding
• severe pain or swelling in your abdomen
• a high temperature (fever)
• dark or smelly vaginal discharge

Your fertility after surgery

If you have not been through the menopause, your surgeon will try to preserve as much of your reproductive system as they can.

Make sure you discuss your fertility concerns with your surgeon before your operation.

It’s often possible to just remove the cyst and leave both ovaries intact, which means your fertility should be largely unaffected.

If one of your ovaries needs to be removed, the remaining ovary will still release hormones and eggs as usual. Your fertility shouldn’t be significantly affected. But you may find it slightly harder to get pregnant.

Occasionally, it may be necessary to remove both ovaries. This will trigger an early menopause. You’ll no longer produce any eggs and will not be able to get pregnant.

It may still be possible to have a baby by having a donated egg implanted into your womb. You can speak to your doctor for more information about this.

If you’ve been through the menopause, both ovaries may be removed because they no longer produce eggs.

Source:
Scottish Government – Opens in new browser window

Last updated:


03 March 2023

How can we improve this page?

Help us improve NHS inform

Don’t include personal information e.g. name, location or any personal health conditions.

Email Address



e. g. [email protected]

Message



Maximum of 500 characters

Vaginal discharge link, color, and more

Ovarian cancer can cause vaginal discharge, but so can many other factors and conditions.

Ovarian cancer is a group of diseases that originate in the ovaries or related areas of the fallopian tubes and peritoneum and cause abnormal cells in the body to grow out of control.

The ovaries are in the pelvis on either side of the uterus, and they make specific hormones and produce eggs for reproduction. The fallopian tubes are a pair of long, slim tubes on each side of the uterus that eggs pass through from the ovaries to the uterus. The peritoneum is the lining around organs in the abdomen.

Ovarian cancer often causes symptoms such as constipation, bloating, and abdominal, back, or pelvic pain. Vaginal discharge associated with ovarian cancer is most common in stromal or germ cell tumors. Ovarian cancer treatment is often more effective when a doctor diagnoses it in the early stages.

In this article, we look at whether ovarian cancer can cause vaginal discharge. We also discuss the characteristics of abnormal vaginal discharge and other symptoms of ovarian cancer.

Ovarian cancer can cause vaginal discharge. However, several other factors can also cause this symptom, so a person should not assume they have ovarian cancer if they notice vaginal discharge.

Vaginal discharge is a common symptom of certain types of ovarian cancer, especially at the start of cancer, but not all. Epithelial ovarian cancer, the most common type, rarely causes vaginal discharge or bleeding, but germ cell and stromal cancers can.

If cancer lacks oxygen, some cells may die off and infect the tumor, causing a foul-smelling vaginal discharge.

A person who experiences continuous discharge should speak to a doctor.

The vaginal discharge ovarian cancer can cause is often clear, white, or colored with blood.

Normal discharge is usually milky white or thin and clear and typically has no odor. It may also be clear or brown at different stages of a person’s menstrual cycle.

Learn more about what the color of vaginal discharge might mean.

Vaginal discharge is a mucus-like fluid that the small glands in the cervix and vagina secrete. This fluid leaks from the vagina daily to remove debris and old cells, keeping the vagina and reproductive tract clean.

The amount, color, and consistency of vaginal discharge can vary from one person to another.

A person’s discharge is typically normal if it is:

• without odor
• thick and sticky
• white or clear
• wet and slippery

Vaginal discharge may be a symptom of infection if it is:

• foul-smelling, such as with a fishy odor
• yellow, green, or frothy
• thick and white like cottage cheese

An infection may also be present if the vaginal discharge occurs with bleeding, pelvic pain, or blisters and sores.

Causes

Besides certain types of ovarian cancer, various factors may cause abnormal vaginal discharge.

Factors that may cause abnormal vaginal discharge during childhood include:

• chemicals from soaps or bubble baths
• an infection resulting from bacteria from the digestive tract
• a foreign object, such as a toy or toilet paper, in the vagina

Factors that may cause abnormal vaginal discharge during adulthood include:

• infections such as bacterial vaginosis, trichomoniasis, or a yeast infection
• sexually transmitted infections (STIs) such as chlamydia or gonorrhea

The growth of harmful bacteria may also result from a rise in acidity in the vagina, which kills protective bacteria called lactobacilli. This can occur because of vaginal infections due to:

• difficulty maintaining adequate hygiene
• using antibiotics
• frequent douching
• semen or menstrual blood
• diabetes
• pregnancy
• a foreign object, such as a tampon

In rare cases, people may have fistulas or abnormal openings between the intestine and the genital tract. These can cause vaginal discharge, which may also contain stool.

Fistulas may result from:

• Crohn’s disease
• damage to the vagina during childbirth
• tumors in the pelvis
• radiation therapy on the pelvis
• an injury during surgery on the pelvis

According to the Centers for Disease Control and Prevention (CDC), common symptoms of ovarian cancer include:

• pressure or pain in the pelvic area
• pain the back or abdomen
• abnormal vaginal bleeding, especially after menopause
• feeling full too quickly
• bloating
• a change in bathroom habits, such as frequently urinating or having constipation

Symptoms may also include:

• fatigue
• weight loss
• pain during vaginal sex
• difficulty breathing
• a buildup of fluid in the abdomen
• a buildup of fluid between the tissues that line the lungs and the chest

Learn more about early and advanced symptoms of ovarian cancer.

People who have symptoms of ovarian cancer, abnormal discharge, or both should immediately contact a doctor.

If a person has a yeast infection or thrush and no other symptoms of infection or ovarian cancer, they do not have to contact a doctor every time they experience discharge. This type of discharge is usually thick, white, and clumpy. Yeast infections may also cause itching and burning.

If a person consults a doctor about vaginal discharge, the doctor may ask some questions regarding:

• the smell and look of the discharge
• if other symptoms are present, such as itching
• whether a person has pain during sex or urination, or constant pain in the pelvis
• whether discharge occurs during menstruation or sex
• if the person uses any products that may irritate the vaginal area
• whether the person is taking antibiotics
• whether the person has diabetes

A doctor may also do a physical examination of the pelvis and other tests, such as inserting a cotton swab into the vagina or cervix to get a sample of the discharge. They will then examine the discharge and send a sample to the lab.

People looking for ovarian cancer support can call the American Cancer Society’s cancer helpline on 800-227-2345, chat with them online, or find local programs or services.

Organizations that provide support for people with ovarian cancer include:

• The National Ovarian Cancer Coalition
• Ovarian Cancer Research Alliance
• The National LGBT Cancer Project

Several organizations provide support specifically for People of Color with cancer, including:

• Black Women’s Health Imperative
• SHARE
• Latinas Contra Cancer

Ovarian cancer may cause discharge that is often white or clear or that contains blood. This symptom is common among certain types of ovarian cancer but not all. The most common type of ovarian cancer rarely has vaginal discharge or bleeding.

Discharge may be normal as part of a person’s menstrual cycle or indicate another issue, such as an infection. Abnormal discharge may be thick and lumpy, or frothy. It may be white, green, or yellow. Various factors could cause it, including:

• a yeast infection
• an STI
• an overgrowth of harmful bacteria
• difficulty maintaining adequate hygiene
• pregnancy

Other symptoms of ovarian cancer include:

• pelvic pain
• abnormal vaginal bleeding
• changes to bathroom habits
• bloating

A person should contact a doctor if they have abnormal vaginal discharge, ovarian cancer symptoms, or both. A doctor will likely ask questions, perform a pelvic exam, and test the discharge.

causes, psychosomatics, symptoms, how to treat, what is dangerous

In general, they are divided into three types:

• Functional.
• Endometrioid.
• Dermoid.

The latter type is also called cystic tumors – cystadenomas and teratomas. They are diagnosed in about 20% of cases. Inside such formations there can be various types of cells and tissues of the body – hair, muscle fibers, lipid tissues, teeth, cartilage and bone inclusions. The size of dermoid tumors reaches 15 cm and above. It is in this case that one of the symptoms is frequent urination, since a huge neoplasm presses, including on the bladder. Also very often the stomach increases in size, the patient suffers from constipation. The occurrence of this pathology is associated with various hormonal periods in a woman’s life.

In adulthood, there are two more types of benign tumors – paraovarian and mucinous. The first pathology is formed from a rudiment called paraovarium. Sometimes this cyst grows very large. The diagnosis is made in 15% of registered cases. Symptoms manifest themselves as pains of a pulling nature in the lower abdomen and lumbar region. Women mistakenly believe that this condition occurs from physical exertion.

The second cyst is multi-chambered, where the cavities are filled with mucus. Its dimensions are gigantic, up to 30 centimeters. In addition, the mucinous cyst grows almost at lightning speed. Among the symptoms, dyspepsia, a visually noticeable increase in the abdomen, frequent trips to the toilet for a small one are distinguished. These species are dangerous because they can degenerate into oncology.

Get a free consultation

Two types of cysts are functional:

• Follicular. Such neoplasms are classified as hormone-dependent, so they are most often diagnosed during puberty or the decline of reproductive function. These cysts do not grow beyond 8 cm in diameter, but usually most of them are half the size. These formations live for several cycles, after which they disappear on their own. Women generally do not even notice their condition, because it does not worsen and everything is asymptomatic. But it happens that the disease goes in a different scenario – with unpleasant sensations, in particular, during menstruation, long periods. Discomfort may increase with sudden movements, as well as after sexual contact. There are discharges between cycles or after intercourse. Similar symptoms appear if the cyst grows up to 10 cm.
• Luteal. These formations are otherwise called cysts of the corpus luteum. They are also prone to self-disappearance, and therefore are classified as functional. A hormone-dependent cyst appears if the corpus luteum does not disappear in time due to an imbalance in blood flow. This may be preceded by inflammation of the ovaries, severe stress, taking hormonal contraceptives, inadequate exercise, deficiency or excess weight. Such cysts often disappear without a trace after about 3 months, showing almost no symptoms.

Endometrial cysts are referred to as pseudocysts. They are formed from the cells of the layer lining the uterus. However, sometimes the endometrium goes to the wrong place – this happens during sexual intercourse during regular periods, atypical width of the fallopian tubes, physical activity not recommended for women, and impaired blood outflow due to various reasons. The size of ovarian cysts of this type can vary from one to ten centimeters. An alternative name for this neoplasm is a chocolate cyst. It is given taking into account the characteristic bloody tint, since the sac is filled with blood that did not come out naturally.

Separately, it is worth mentioning polycystic, that is, the multiple formation of benign tumors in the ovaries. This disease very often manifests itself outwardly: due to a jump in the level of production of male hormones, a woman’s hairiness increases, her voice coarsens, the figure becomes masculine. An unpleasant situation leads to a violation of insulin production, which has an extremely negative effect on ovarian function. As a result, immature follicles turn into cysts.

Primary polycystosis occurs in adolescence, and secondary – in adulthood, especially in women with obesity and increased insulin resistance.

Attention! If hyperthermia is noted in the evening, unusual fatigue, drowsiness, loss of appetite are permanently felt – you should immediately make an appointment with the doctor to check for the presence of a malignant tumor, into which the cyst may have degenerated

Treatment of cysts and operations in Israel are quite successful. The staff of the Sourasky Clinic (Ichilov) are doctors with vast experience gained over years of practice and study of the theoretical base, because our country has long become a center of medical tourism. Also important is modern high-tech diagnostic equipment. For example, in the Sourasky Medical Center it is one of the best in the world. In our clinic, highly qualified narrow specialists work on it, coping with any challenges in their profession.

Diagnostic measures to detect ovarian pathologies are as follows:

• Ultrasound type of examination.
• Laboratory tests.
• Laparoscopy of the pelvic organs.
• Neoplasm puncture.

On ultrasound, the doctor will see the ovarian cyst with his own eyes, and with the help of a laparoscope, a benign tumor can not only be examined, but also tissue samples can be taken for subsequent histology (to determine the type of tumor, as well as exclude cancer).

Laboratory tests will show the rate of erythrocyte sedimentation and the number of leukocytes, that is, will determine whether inflammation is present. The level of hemoglobin will tell you what condition the woman’s body is in, whether she has anemia. A blood test will also demonstrate the presence or absence of tumor markers.

Taking a puncture is necessary to clarify the diagnosis – the composition and nature of the fluid will indicate the type of neoplasm

Therapeutic approach: drugs or surgery

Treatment of cysts can be conservative, operative or mixed. Growths that go away on their own usually require adjuvant therapy, such as hormonal drugs that block ovulation.

Minor internal bleeding also does not require surgery unless the woman is anemic. Non-steroidal anti-inflammatory drugs and hemostatic drugs are used.

Cyst torsion is a dangerous condition, but not always. Sometimes the issue can be resolved with conservative therapy. Painkillers are required. In all cases, vitamins and general strengthening medicines are prescribed.

Surgical intervention

The da Vinci robot is used very often in Israel, especially in operations involving the removal of cysts. Specialists of the Sourasky Clinic prefer minimally invasive surgical methods, resorting to abdominal operations very rarely. With the help of high-precision mechanisms and the professionalism of surgeons, the intervention is carried out with minimal damage, due to which the rehabilitation period is significantly reduced and facilitated.

If the formation is very large, then drug treatment is carried out before the operation, aimed at its possible reduction

The decision on the operation is taken collectively and the patient must be informed about this in order to obtain her consent. Indications for surgery are complications: purulent inflammatory processes, rupture or torsion of the cyst, significant internal bleeding, as well as the huge size of the neoplasm. Surgery is necessary if ovarian cancer is diagnosed or the cyst has not disappeared spontaneously within 3 months.

Surgical treatment in Israel mainly involves laparoscopy, in which the healthy tissues of the organ are preserved as much as possible. Laparoscopy involves, depending on the severity of the situation, the removal of exclusively cysts, without affecting the tissues of the ovary, or a complete resection of the organ (sometimes the tubes are additionally removed).

Postoperative rehabilitation lasts about a month until the body is fully restored

Treatment of functional ovarian cyst | “Best Clinic”

What is a functional ovarian cyst

A functional cyst is a tumor-like formation of the ovary with a diameter of more than 3 cm, which can appear only in women in the reproductive period and is directly related to the cyclic processes occurring in the ovaries.

There are 2 types of functional cysts:

• A follicular cyst is a large follicle that has not released an egg in the middle of the cycle, i.e. did not ovulate. If the diameter of this follicle is up to 30 mm, then
  this condition is called the persistence of the follicle, and if more than 30 mm – then the follicular cyst. In other words, the difference between these structures is only in
  sizes.
• A luteal cyst is a corpus luteum that is larger than normal, that is, more than 30 mm.

During the menstrual cycle, different structures are formed in the ovaries, which replace each other. So, immediately after the end of menstruation, several follicles begin to mature, among which, by about the 8-9th day, one stands out, which has the largest size. Such a follicle is called dominant. An egg matures in it, which in the middle of the cycle should exit into the abdominal cavity. This process is called ovulation. If it does not occur, then the dominant follicle may undergo reverse development (follicle atresia), or may develop further. In the latter case, the granulosa cells located on the periphery continue to secrete fluid, which leads to the formation of a follicular cyst.

The menstrual cycle in which the follicular cyst has formed is always anovulatory (no ovulation). The presence of a luteal cyst in all cases indicates that ovulation has occurred. Normally, a corpus luteum up to 3 cm in diameter is formed at the site of a burst follicle. If the size exceeds the specified one, then such a structure is called a corpus luteum cyst (luteal cyst).

Cysts of the corpus luteum may also occur in pregnant women. This temporary gland secretes progesterone, which is necessary to reduce the contractile activity of the uterus,
the correct formation of the placenta and the flow of other parts of the gestational process. Such cysts do not increase obstetric risks, do not require treatment and observation. It passes on its own in the second or third trimester of pregnancy or within 1.5-2 months after childbirth.

Thus, the follicular and luteal cysts are functional structures that appear at different phases of the menstrual cycle in some women. In contrast to the standard dominant follicle or corpus luteum, they are larger in size, which exceeds 3 cm in diameter.

Diagnosis and indications for treatment

Functional cysts may be asymptomatic. The follicular cyst in some patients can lead to a delay in menstruation due to the lack of ovulation. With large formations, a woman is sometimes disturbed by pain and discomfort in the lower abdomen. These symptoms may be aggravated by sexual contact, bumpy driving, or playing sports.

Usually, a tumor-like formation in the ovaries is first detected by a gynecologist when examining a woman on an armchair. In the area of ​​​​the appendages, the doctor palpates an enlarged rounded structure
soft elastic consistency, which is usually painless or sensitive.

The final diagnosis is established by ultrasound examination. This method allows not only to confirm the presence of a cyst, but also to distinguish the follicular structure from the luteal one, which cannot be done during palpation. The ultrasound report is encrypted using the ORADS system, according to which the doctor selects the optimal tactics for managing the patient.

Cysts of the corpus luteum in prognostic terms do not cause concern. Follicular formations with a diameter of more than 3 cm, which appear repeatedly, are an indication for advanced diagnostics, because indicate chronic anovulation. This condition is accompanied by infertility, and also increases oncological and metabolic risks. Such patients are assigned a detailed hormonal examination, according to the results of which the doctor establishes the final diagnosis.

Types of treatment

Uncomplicated functional cysts usually do not require specific treatment, because are a physiological state. However, those causes that lead to menstrual irregularities are subject to treatment. This can be corrective hormone therapy, anti-inflammatory treatment, and other help options.

Usually, without treatment, regression of a functional cyst occurs within 3-6 months, but observation for 1 year is acceptable. If during this time regression has not occurred, and the formation is large (more than 10 cm) and causes discomfort to the woman, then surgical treatment is performed. The operation is performed laparoscopically. This method of surgery is characterized by a gentle effect on tissues and a short recovery period.

With a long-term existence of a cyst, it is not possible to determine whether it is follicular or luteal. Therefore, such a formation is referred to as a simple cyst.

Symptoms and complications

Functional cysts in some patients may be asymptomatic, while in others they lead to menstrual irregularities.

As a rule, follicular and luteal cysts are benign (smooth). Very rarely, a rupture of the formation with intra-abdominal bleeding can occur. This complication is manifested by an acute attack of pain, which appears in the midst of complete well-being. The pain is localized in the lower abdomen, radiates to the rectum and leg on the side of the lesion. When conducting a bimanual examination, severe pain is determined.

The following factors can provoke a rupture of a functional cyst:

• bumpy ride;
• sexual contact;
• constipation and heavy physical exertion, which are accompanied by an increase in intra-abdominal stress.

Functional cyst rupture is treated with surgery only. During a laparoscopic operation, a bleeding rupture is sutured and the cyst capsule is removed, while the ovarian tissue is handled very carefully so as not to damage the follicular apparatus.

Management of functional ovarian cyst

Functional ovarian cysts usually do not require specific treatment. If such a formation is detected, dynamic control is required after 3 months. Usually during this time the cyst regresses, and the condition of the ovaries is restored.

In the presence of a recurrent follicular cyst, an examination is carried out, which is aimed at diagnosing the causes of anovulation. Further treatment is carried out by conservative methods in accordance with the established diagnosis. So, in case of thyroid pathology accompanied by hypothyroidism, thyroid hormones are prescribed, in case of hyperprolactinemia, agents that suppress the production of prolactin are used, etc.