What are ovarian cysts. How do ovarian cysts form. What symptoms can ovarian cysts cause. How are ovarian cysts diagnosed. When should you seek medical attention for ovarian cysts.

Understanding Ovarian Cysts: Types and Formation

Ovarian cysts are fluid-filled sacs that develop on or inside the ovaries. While the term may sound alarming, it’s important to understand that most ovarian cysts are benign and often resolve on their own. There are two main types of functional ovarian cysts:

• Follicular cysts
• Corpus luteum cysts

Follicular cysts form when the follicle fails to rupture and release an egg during ovulation. Instead, the follicle continues to grow, forming a cyst. Corpus luteum cysts develop after ovulation when the ruptured follicle fails to dissolve properly and continues to accumulate fluid.

Are ovarian cysts common? Yes, ovarian cysts are quite common, especially in women of childbearing age. They are a normal part of the menstrual cycle and often indicate that the ovaries are functioning properly.

The Role of Hormones in Ovarian Cyst Formation

Hormones play a crucial role in the development of ovarian cysts. During the menstrual cycle, follicles in the ovaries produce estrogen as they prepare to release an egg. After ovulation, the corpus luteum produces progesterone. Imbalances or disruptions in these hormonal processes can contribute to cyst formation.

Can hormonal contraceptives affect ovarian cysts? Yes, oral contraceptives may be prescribed to help regulate hormonal cycles and reduce the likelihood of cyst formation. However, they are not a guaranteed prevention method.

Fertility Treatments and Ovarian Cysts

Women undergoing fertility treatments may be more prone to developing multiple ovarian cysts. This is because fertility drugs often stimulate the ovaries to produce multiple follicles. While these cysts typically resolve on their own, they require monitoring during treatment.

Recognizing the Symptoms of Ovarian Cysts

Many ovarian cysts are asymptomatic, meaning they cause no noticeable symptoms. However, when symptoms do occur, they can include:

• Pelvic pain or pressure
• Abdominal bloating or swelling
• Pain during intercourse
• Changes in bowel movements or urination
• Irregular menstrual cycles

When do ovarian cysts become painful? Ovarian cysts are more likely to cause pain if they grow large, rupture, bleed, or cause twisting of the ovary (torsion). These situations can lead to sudden, severe pelvic pain, often accompanied by nausea and vomiting.

Diagnosing Ovarian Cysts: Medical Examinations and Imaging

Ovarian cysts are often discovered during routine pelvic examinations or when investigating other gynecological concerns. The primary diagnostic tools for ovarian cysts include:

1. Pelvic examination
2. Ultrasound imaging
3. Blood tests

How accurate is ultrasound in detecting ovarian cysts? Ultrasound is highly effective in identifying and characterizing ovarian cysts. It can provide information about the size, location, and composition of the cyst, helping healthcare providers determine the appropriate course of action.

Follow-up and Monitoring

If an ovarian cyst is detected, your healthcare provider may recommend a follow-up examination after 6 to 8 weeks. This allows time to see if the cyst resolves on its own, which is often the case with functional cysts.

Potential Complications of Ovarian Cysts

While most ovarian cysts are harmless and resolve without intervention, there are potential complications to be aware of:

• Ovarian torsion
• Cyst rupture
• Internal bleeding
• Infertility (in rare cases)

What is ovarian torsion? Ovarian torsion occurs when a cyst causes the ovary to twist on its blood supply. This is a medical emergency that can lead to severe pain and potential loss of the affected ovary if not treated promptly.

Treatment Options for Ovarian Cysts

The treatment approach for ovarian cysts depends on various factors, including the size and type of the cyst, the woman’s age, and her symptoms. Treatment options may include:

1. Watchful waiting
2. Hormonal birth control
3. Pain management
4. Surgical intervention (in severe cases)

Is surgery always necessary for ovarian cysts? No, surgery is not always required for ovarian cysts. Many cysts resolve on their own within a few menstrual cycles. Surgery is typically reserved for large, persistent, or suspicious cysts, or in cases of severe symptoms or complications.

Minimally Invasive Surgical Techniques

When surgery is necessary, laparoscopy is often the preferred approach. This minimally invasive technique involves small incisions and a camera, allowing for shorter recovery times and less scarring compared to traditional open surgery.

Lifestyle Factors and Ovarian Cyst Prevention

While it’s not always possible to prevent ovarian cysts, certain lifestyle factors may help reduce the risk:

• Maintaining a healthy weight
• Regular exercise
• Managing stress
• Avoiding excessive caffeine and alcohol

Can diet affect ovarian cyst formation? While there’s no direct evidence linking specific foods to ovarian cyst prevention, a balanced diet rich in fruits, vegetables, and whole grains may support overall reproductive health.

When to Seek Medical Attention for Ovarian Cysts

While many ovarian cysts are harmless, there are situations where medical attention is necessary. Seek immediate care if you experience:

• Sudden, severe abdominal or pelvic pain
• Pain accompanied by fever or vomiting
• Signs of shock, such as cold, clammy skin or rapid breathing
• Dizziness or weakness

How can you differentiate between normal menstrual pain and cyst-related pain? Cyst-related pain is often more severe, persistent, and may be accompanied by other symptoms like bloating or changes in menstrual patterns. If you’re unsure, it’s always best to consult with a healthcare professional.

Regular Gynecological Check-ups

Regular gynecological examinations are crucial for early detection and monitoring of ovarian cysts. These check-ups allow healthcare providers to track any changes and address concerns promptly.

Ovarian Cysts in Different Life Stages

The prevalence and implications of ovarian cysts can vary depending on a woman’s life stage:

Adolescence and Young Adulthood

Functional ovarian cysts are common in young women as their menstrual cycles become established. Most of these cysts are harmless and resolve on their own. However, persistent pain or irregular bleeding should be evaluated by a healthcare provider.

Reproductive Years

Women in their reproductive years may experience ovarian cysts more frequently. While most are benign, cysts can sometimes interfere with fertility or cause complications during pregnancy. Regular check-ups are important for monitoring and management.

Perimenopause and Menopause

As women approach and enter menopause, the incidence of functional ovarian cysts typically decreases. However, any new cysts discovered after menopause should be carefully evaluated, as the risk of ovarian cancer increases with age.

Do ovarian cysts increase the risk of ovarian cancer? Most ovarian cysts are benign and do not increase cancer risk. However, certain types of cysts, especially in postmenopausal women, may require further investigation to rule out malignancy.

Psychological Impact of Ovarian Cysts

The diagnosis of ovarian cysts can have psychological effects on some women, including:

• Anxiety about potential complications
• Concerns about fertility
• Body image issues
• Fear of cancer (even when unwarranted)

How can women cope with the emotional aspects of an ovarian cyst diagnosis? Open communication with healthcare providers, seeking accurate information, and connecting with support groups can help alleviate anxiety and promote emotional well-being.

Patient Education and Empowerment

Educating patients about ovarian cysts, their typical progression, and management options can help reduce anxiety and empower women to make informed decisions about their health. Healthcare providers play a crucial role in providing clear, accurate information and addressing patient concerns.

Future Directions in Ovarian Cyst Research and Management

Ongoing research in the field of gynecology continues to improve our understanding and management of ovarian cysts. Some areas of focus include:

• Advanced imaging techniques for more accurate diagnosis
• Biomarkers for early detection of malignant changes
• Novel therapeutic approaches to prevent cyst formation
• Improved fertility preservation techniques for women with recurrent cysts

What advancements can we expect in ovarian cyst management? Future developments may include more targeted hormonal therapies, less invasive surgical techniques, and improved diagnostic tools to distinguish between benign and potentially malignant cysts.

The Role of Genetics in Ovarian Cyst Formation

Researchers are also exploring the genetic factors that may predispose some women to develop ovarian cysts more frequently. This knowledge could lead to personalized prevention and treatment strategies in the future.

In conclusion, while ovarian cysts are a common gynecological condition, understanding their types, causes, and potential complications is crucial for proper management and peace of mind. Regular check-ups, open communication with healthcare providers, and a healthy lifestyle can all contribute to optimal ovarian health. As research continues to advance, we can look forward to even better diagnostic and treatment options for women affected by ovarian cysts.

Ovarian cysts Information | Mount Sinai

Physiologic ovarian cysts; Functional ovarian cysts; Corpus luteum cysts; Follicular cysts

An ovarian cyst is a sac filled with fluid that forms on or inside an ovary.

This article is about cysts that form during your monthly menstrual cycle, called functional cysts. Functional cysts are not the same as cysts caused by cancer or other diseases. The formation of these cysts is a perfectly normal event and is a sign that the ovaries are working well.

External structures of the female reproductive anatomy include the labium minora and majora, the vagina and the clitoris. Internal structures include the uterus, ovaries, and cervix.

Typically, ovarian cysts are functional (not disease-related) and usually disappear on their own within 60 days. Oral contraceptives may be prescribed to help establish normal cycles.

The uterus is a hollow muscular organ located in the female pelvis between the bladder and rectum. The ovaries produce the eggs that travel through the fallopian tubes. Once the egg has left the ovary it can be fertilized and implant itself in the lining of the uterus. The main function of the uterus is to nourish the developing fetus prior to birth.

Causes

Each month during your menstrual cycle, a follicle (cyst) grows on your ovary. The follicle is where an egg is developing.

• The follicle makes the estrogen hormone. This hormone causes normal changes of the uterine lining as the uterus prepares for pregnancy.
• When the egg matures, it is released from the follicle. This is called ovulation.
• If the follicle fails to break open and release an egg, the fluid stays in the follicle and forms a cyst. This is called a follicular cyst.

Another type of cyst occurs after an egg has been released from a follicle. This is called a corpus luteum cyst. This type of cyst may contain a small amount of blood. This cyst makes progesterone and estrogen hormones.

Ovarian cysts are more common in the childbearing years between puberty and menopause. The condition is less common after menopause.

Taking fertility drugs often causes the development of multiple follicles (cysts) in the ovaries. These cysts most often go away after a woman’s period, or after a pregnancy.

Functional ovarian cysts are not the same as ovarian tumors or cysts due to hormone-related conditions such as polycystic ovary syndrome.

Symptoms

Ovarian cysts often cause no symptoms.

An ovarian cyst is more likely to cause pain if it:

• Becomes large
• Bleeds
• Breaks open
• Interferes with the blood supply to the ovary
• Is twisted or causes twisting (torsion) of the ovary

Symptoms of ovarian cysts can also include:

• Bloating or swelling in the abdomen
• Pain during bowel movements
• Pain in the pelvis shortly before or after beginning a menstrual period
• Pain with intercourse or pelvic pain during movement
• Pelvic pain — constant, dull aching
• Sudden and severe pelvic pain, often with nausea and vomiting (may be a sign of torsion or twisting of the ovary on its blood supply, or rupture of a cyst with internal bleeding)

Changes in menstrual periods are not common with follicular cysts. These are more common with corpus luteum cysts. Spotting or bleeding may occur with some cysts.

Exams and Tests

Your health care provider may find a cyst during a pelvic exam, or when you have an ultrasound test for another reason.

Ultrasound may be done to detect a cyst. Your provider may want to check you again in 6 to 8 weeks to make sure it is gone.

Other imaging tests that may be done when needed include:

• CT scan
• Doppler flow studies
• MRI

The following blood tests may be done:

• CA-125 test, to help establish a level of concern regarding the cyst if you have an abnormal ultrasound or are in menopause. Your provider may use this test value to plan further testing.
• Hormone levels (such as LH, FSH, estradiol, and testosterone).
• Pregnancy test (Serum hCG).

Treatment

Functional ovarian cysts often do not need treatment. They often go away on their own within 8 to 12 weeks.

If you have frequent ovarian cysts, your provider may prescribe birth control pills (oral contraceptives). These pills may reduce the risk of developing new cysts. Birth control pills do not decrease the size of current cysts.

You may need surgery to remove the cyst or ovary to make sure that it is not ovarian cancer. Surgery is more likely to be needed for:

• Complex ovarian cysts that do not go away
• Cysts that are causing symptoms and do not go away
• Cysts that are increasing in size
• Simple ovarian cysts that are larger than 10 centimeters
• Women who are near menopause or past menopause

Types of surgery for ovarian cysts include:

• Exploratory laparotomy
• Pelvic laparoscopy

You may need other treatments if you have polycystic ovary syndrome or another disorder that can cause cysts.

Outlook (Prognosis)

Cysts in women who are still having periods are more likely to go away. A complex cyst in a woman who is past menopause has a higher risk of being cancer. Cancer is very unlikely with a simple cyst.

Possible Complications

Complications have to do with the condition causing the cysts. Complications can occur with cysts that:

• Bleed.
• Break open.
• Show signs of changes that could be cancer.
• Twist, depending on size of the cyst. Bigger cysts carry a higher risk.

When to Contact a Medical Professional

Contact your provider if:

• You have symptoms of an ovarian cyst
• You have severe pain
• You have bleeding that is not normal for you

Also contact your provider if you have had following on most days for at least 2 weeks:

• Getting full quickly when eating
• Losing your appetite
• Losing weight without trying

These symptoms may indicate ovarian cancer. Studies which encourage women to seek care for possible ovarian cancer symptoms have not shown any benefit. Unfortunately, we do not have any proven means of screening for ovarian cancer.

Prevention

If you are not trying to get pregnant and you often get functional cysts, you can prevent them by taking birth control pills. These pills prevent follicles from growing.

Brown DL, Wall DJ. Ultrasound evaluation of the ovaries. In: Norton ME, Scoutt LM, Feldstein VA, eds. Callen’s Ultrasonography in Obstetrics and Gynecology. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 30.

Bulun SE. Physiology and pathology of the female reproductive axis. In Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 17.

Dolan MS, Hill CC, Valea FA. Benign gynecologic lesions: vulva, vagina, cervix, uterus, oviduct, ovary, ultrasound imaging of pelvic structures. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 18.

Last reviewed on: 1/10/2022

Reviewed by: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Complex Ovarian Cyst: Symptoms, Treatment, and More

What are ovarian cysts?

Ovarian cysts are sacs that form on or inside the ovary. A fluid-filled ovarian cyst is a simple cyst. A complex ovarian cyst contains solid material or blood.

Simple cysts

Simple cysts are common. They develop when your ovary fails to release an egg or when a follicle in your ovary continues to grow after an egg has been released. Because they form due to your normal menstrual cycle, they’re also called functional cysts. Functional cysts usually have no symptoms. They tend to resolve on their own within a few menstrual cycles.

Complex cysts

Complex cysts aren’t related to your normal menstrual cycle, and they’re less common. The following are three common types of complex ovarian cysts:

• Dermoid cysts are made up of cells you had since before you were born. Your body uses these cells to produce dermal tissue so they may contain fat, skin, hair, or even teeth.
• Cystadenomas contain ovarian tissue with fluid or mucus.
• Endometriomas form when cells from your uterine lining grow outside of your uterus and in or on your ovaries.

It’s rare, but ovarian cysts can be malignant. Most ovarian cysts are benign, especially those that develop before menopause.

It’s possible to have small ovarian cysts and not have any symptoms. Some of the more common symptoms of ovarian cysts include:

• bloating or pressure in your lower abdomen
• lower abdominal pain
• nausea and vomiting if the cyst is twisting an ovary
• frequent urination if the cyst is large enough to press on your bladder
• sudden, severe pain if the cyst ruptures

Seek immediate medical attention if you have a fever, vomiting, or severe abdominal pain.

If you have endometriomas, the symptoms may include:

• painful periods
• pain during intercourse
• painful urination and bowel movements during your period
• fatigue
• nausea
• diarrhea
• constipation
• fertility problems

It’s often not possible to determine the cause of an ovarian cyst.

Functional cysts occur due to a minor problem, usually involving hormones, in your normal menstrual cycle. Polycystic ovary syndrome (PCOS) is a condition that causes many small, simple ovarian cysts. The exact cause is unknown, but it involves a hormone imbalance.

Read more: What you should know about PCOS and pregnancy »

Endometriomas occur due to a condition called endometriosis, which causes cells from your uterine lining to grow outside of the uterus, including on your ovaries.

Cancerous cysts develop when mutated ovarian cells begin to grow and reproduce.

Ovarian cysts are quite common in women who ovulate. You’re less likely to develop cysts after menopause. If you do develop an ovarian cyst after menopause, it increases your risk for ovarian cancer.

About 8 percent of premenopausal women have a cyst that’s large enough to need treatment.

If you’re experiencing symptoms of a cyst, see your doctor. You’ll probably need a pelvic exam. If your doctor suspects you have a cyst, they may take a wait-and-see approach because most ovarian cysts clear up without treatment. You may also want to take a pregnancy test because pregnancy can cause similar abdominal symptoms.

Other diagnostic tests may include an ultrasound or a CT scan.

Ultrasound

An ultrasound uses sound waves to produce real-time images of your ovaries and the surrounding area. It’s fast, safe, and painless. If your doctor suspects an ovarian cyst, they’ll likely use a transvaginal ultrasound to help identify the cyst. For this type of ultrasound, you’ll lie on your back and put your feet in the stirrups. They’ll insert the transducer, which looks like a long rod, a few inches into your vagina to produce images of your ovaries and uterus. The transducer is smaller than the speculum your doctor uses for a Pap test. It only takes a few minutes. It may be slightly uncomfortable, but it doesn’t usually cause pain.

Ultrasound imaging can help determine the location, size, and shape of a cyst. It may also be able to tell if the ovarian cyst is simple or complex.

Ask your doctor if you should arrive with a full or empty bladder. You may need to have one ultrasound done while you have a full bladder and then empty it before having a second one. Alternatively, they may ask you to arrive at the ultrasound appointment with your bladder already empty.

Blood tests

You might also have a blood tests for cancer antigen 125 (CA 125), which is a protein that can be high in women who have ovarian cancer. CA 125 can also be high if you have endometriosis or you’re menstruating. Other blood tests can help determine if you have hormone imbalances.

Learn more: Cysts and ovarian cancer »

Over-the-counter pain relievers may be all you need for a simple cyst. If you have a lot of pain or discomfort, your doctor may be able to prescribe something stronger.

Complex ovarian cysts may need further treatment. Five to 10 percent of women need surgery to remove an ovarian cyst. Thirteen to 21 percent of these cysts turn out to be cancerous.

You may need the cyst removed if it’s growing too large, is painful, or is causing some other problem.

Your doctor can remove some cysts using a small, lighted instrument called a laparoscope.

Your doctor can insert it into your abdomen through a tiny incision. They’ll do this while you’re under anesthesia. Your doctor can remove large or complex cysts that appear to be cancerous with traditional surgery. They can then test the cyst to see if it contains cancerous cells.

If you frequently develop ovarian cysts, your doctor may recommend hormonal birth control. This can help prevent ovulation and lower the chances of developing more cysts.

Treatment for endometriosis can include hormone therapy, pain medications, and surgery.

Most simple ovarian cysts aren’t harmful.

Complex ovarian cysts, such as dermoids and cystadenomas, can grow too large. This can push your ovary out of place. It can also cause a painful condition called ovarian torsion, which means your ovary has become twisted. Cysts can also press against your bladder, causing frequent or urgent urination.

If a cyst ruptures it can cause:

• severe abdominal pain
• a fever
• dizziness
• weakness
• rapid breathing
• vomiting
• bleeding

If you have any of these symptoms, see your doctor.

Both endometriosis and PCOS can cause fertility problems. Most ovarian cysts aren’t cancerous, but complex ovarian cysts raise the risk of ovarian cancer.

The outlook is generally very good, especially for simple ovarian cysts. What you can expect with a complex ovarian cyst depends on the cause and treatment.

It’s unlikely that you’ll have any long-term health issues once you’ve recovered from surgical removal of a cyst.

Treatment for severe endometriosis can involve surgery and hormonal therapy. In some cases, it leaves scar tissue that can harm your internal organs. About 30 to 40 percent of women with unexplained infertility have endometriosis.

If you have ovarian cancer, your outlook depends on how far the cancer has spread. Treatment options include surgical removal of the ovary, chemotherapy, and radiation. The outlook is best when the doctor diagnoses and treats ovarian cancer in the early stages.

Ovarian cyst

What to do if you have an ovarian cyst?

Ovarian cyst – perhaps the most common female “pathology”. You should not immediately start to panic if, during the examination, the gynecologist discovers a cyst in you and sends you for an ultrasound scan. It is necessary to undergo an examination and observe its behavior. It can be either a harmless temporary “bubble” filled with liquid, or a dangerous neoplasm. Therefore, it is necessary to find out the exact cause of the increase in the size of the ovary.

Cyst of different cysts

A cyst is a cavity in the tissues of an organ in which some liquid accumulates. Because of this, the size of the ovary increases and its functions may be impaired (there are cysts up to 10-15 cm). But the diagnosis itself still does not say anything, because there are many varieties of this formation, depending on its nature, localization and behavior.

All ovarian cysts can be conditionally divided into 2 groups:

1. Functional (false)
This type of cyst is considered harmless. They are called functional because they are formed as a result of the natural function of the ovary – the formation of follicles with an egg inside. Normally, after the egg matures, the follicle should burst and let it come out. But for some reason (usually this is due to hormonal disorders), this does not happen and a cavity with liquid is formed at the site of the follicle – a functional cyst. As a rule, such a “late follicle” still resolves on its own after 2-4 months. But if it reaches 10 or more centimeters in diameter, causes pain, impaired ovarian function, then the question of conservative or surgical treatment may arise (in most cases this is laparoscopy).

The second type of functional cysts – luteal, most often appear in the inflammatory process. They are formed after the egg has left its follicle and the so-called corpus luteum (an endocrine gland that actively prepares for pregnancy and produces progesterone) begins to form in the ovary. If at this stage the process is disturbed, then the corpus luteum “swells up” and turns into a cystic formation.

If the functional cyst resolves without complications (ruptures, twisting, compression of neighboring tissues), then there is no reason for concern. A woman may not even notice that something has gone wrong in the ovary. But pulling and aching pains, familiar to almost everyone, may appear.

2. Pathological

These include endometriosis cysts. This is a focus of endometriosis, and normally there should not be endometrial cells in the ovary at all, it is a capsule filled with bloody contents. It can reach 5-10 cm in size. It leads to impaired ovarian function and infertility. It is treated at the initial stages with hormonal drugs. And if the therapy is ineffective, then it is better to have an operation in order to prevent complications (perforation of the walls, fusion of the ovary with neighboring organs).

Cystic tumors – a neoplasm that resembles a cyst in appearance. It is not so common – about 1-2 tumors out of 10 cases. The tumor can be benign or malignant. Alas, it is very difficult to predict the course of development of such events, and growing a tumor in oneself is life-threatening. Therefore, if your “cyst” has an irregular shape, grows, its structure is similar to a tumor neoplasm, then there is only one way out – an immediate operation.

How to detect a cyst yourself?

Both a functional cyst and a tumor (cystadenoma, mucinous cyst, cancer) may be asymptomatic or manifest as lower abdominal and lower back pain, irregular menstrual cycles, and bleeding. Unfortunately, women often do not notice these “annoying troubles” for a long time, attribute them to inflammation, which “will pass by itself” or say that they have a little cold in the ovaries.

Therefore, a cyst or tumor can be detected in time only during a gynecological examination or ultrasound. Literally 10-15 minutes of time spent every six months can save not only health, but also life. Do you regularly visit a doctor and do an ultrasound of the pelvic organs once a year? Then you have nothing to worry about. It is not the cyst itself that is terrible, but its consequences and complications, if measures are not taken in time.

You can make an appointment at the PROMED gynecology clinic by calling +7 (495) 211-08-03.

Ovarian cyst – causes and consequences, diagnosis and treatment of pathology

Ovarian cyst is a cavity formation, which is surrounded by a capsule. Its cavity contains contents. That may be, depending on the type of cyst, fluid, mucus, blood or bookmarks of internal organs. Nowadays, the diagnosis of ovarian cyst is quite often made. After clarifying its nature, it is determined with the type of treatment.

Ovarian cyst.

Causes and consequences

Most cavitary ovarian masses occur as a result of failures in the normal functioning of the uterine appendages. They are called functional cysts. Such tumors do not pose a threat to a woman’s life, but can lead to infertility.

In order to understand the mechanism of ovarian cyst formation and what are its consequences, it is necessary to understand the mechanism of functioning of the ovaries. The reproductive system of a woman is corrected by the pituitary gland and hypothalamus according to the feedback principle. They regulate the level of hormones produced by the ovary during different phases of the menstrual cycle. Every month, a dominant follicle matures in the ovary, in which there is an oocyte (ovum). It is immersed in follicular fluid. The diameter of a mature egg is in the range of twenty to twenty-eight millimeters.

On the fourteenth or fifteenth day of the cycle, that is, in its middle, the dominant follicle ruptures and the oocyte enters the abdominal cavity. The current of the follicular fluid brings the female germ cell to the fibrial part of the fallopian tube, where it is picked up by the fibria and forwarded into the fallopian tube. There it can be fertilized by sperm – male sex cells.

Sometimes, for unknown reasons, the follicle does not rupture. It accumulates follicular fluid, the cavity of the follicle expands and it turns into a follicular cyst. When a woman is diagnosed with an ovarian cyst, the consequences can be different. So, in the case when it is small in size and does not grow over time, then there will be no consequences.

If the follicular cyst increases in diameter, it begins to put pressure on intact ovarian tissue. This leads to dysfunction of the uterine appendages – new follicles do not develop in them. This leads to anovulation and infertility. It is also believed that in the presence of a follicular ovarian cyst, subsequent ovulation does not occur. Thus, multiple retention ovarian cysts are formed.

Much less often, a cyst of the ovarian corpus luteum turns into a cyst. The consequences here, too, can be different. As you know, the corpus luteum develops at the site of the ruptured follicle. It synthesizes the hormone progesterone, which maintains pregnancy if fertilization occurs. Sometimes fluid accumulates in it, and the corpus luteum transforms into an ovarian cyst. After treatment, the uterine appendages begin to function normally.

A normal cystic mass can bleed for many reasons. This forms a hemorrhagic ovarian cyst. After its rupture, signs of acute blood loss may appear. In this case, the woman will need emergency medical care. If a hemorrhagic ovarian cyst has ruptured, the consequences can be unpleasant, up to the development of peritonitis or hemorrhagic shock.

Ovarian dermoid cyst forms during the embryonic period of a female fetus. It occurs under the influence of teratogenic factors. In the cavity of the dermoid cyst, you can find teeth, eyes, hair and bookmarks of internal organs. If, as a result of development, the dermoid ovarian cyst does not increase in size, then there may be no consequences. But with its growth and large size, the volume formation presses on the follicular tissue and causes its transformation. This leads to dysfunction of the ovaries. The consequence of a dermoid ovarian cyst may be the lack of egg production and infertility.

A paraovarian cyst forms on the mesentery of the uterine appendages. It can reach enormous sizes. When a large paraovarian ovarian cyst is identified, the consequences can be unpredictable. It can compress the organs adjacent to the ovary, perforate or rupture. In this case, the woman needs surgical intervention.

Endometrioid ovarian cyst is a manifestation of internal genital endometriosis. It is formed during the migration of transformed endometrial cells into the uterine appendages. The endometrioid cyst “menstruates” during menstruation. Fluid and menstrual blood accumulate in its cavity. It turns into a “chocolate” cyst. If a woman has an endometrioid ovarian cyst, the consequences are not long in coming. It can break, and then endometriosis cells spread through the pelvic cavity, causing the formation of new heterotopias.

The consequence of the formation of multiple cysts is polycystic ovary syndrome. It is manifested by hormonal imbalance, metabolic disorders, algomenorrhea and infertility. With an increase in the level of male hormones in the body of a woman diagnosed with multiple ovarian cysts, consequences such as hirsutism occur. It is manifested by excessive male pattern hair.

In addition to functional ovarian cysts, there are also pathological cystic formations. These include cystadenoma. This is a benign ovarian cyst. Its consequences are the transformation into a malignant neoplasm.

Complications of an ovarian cyst

When should a woman suffering from an ovarian cyst urgently see a doctor to avoid consequences? An ovarian cyst, the consequences of which can be different, is manifested by common signs, in the event of which a woman needs to consult a gynecologist:

• hyperthermia and fever;
• the onset of sudden acute pain in the abdomen;
• sudden weakness, loss of consciousness, also dizziness;
• pallor of the skin and visible mucous membranes;
• nausea and vomiting;
• painful or irregular periods;
• increase in the volume of the abdomen and its asymmetry;
• palpation of a tumor-like formation in the abdomen.

In addition, it is recommended to undergo regular examination by a gynecologist for women over forty years of age, as well as in the presence of abdominal pain, problems with defecation.

Effect of ovarian cyst on pregnancy

In the presence of functional ovarian cysts, in most cases there are no problems with conception and pregnancy. It is known that in some cases, retention cysts of the ovary disappear on their own before sixteen weeks of pregnancy. However, if a woman knows that she has an ovarian cyst, the consequences of which can be a threat to the fetus, the tactics of monitoring should be discussed with the doctor. The ideal option would be to get rid of volumetric formation at the stage of pregnancy planning.

If an ovarian cyst is detected during pregnancy, the consequences may not be long in coming. When a cyst ruptures, it suppurates or torsion of the leg, compression by the pregnant uterus, signs of an “acute abdomen” or blood loss develop. These conditions threaten the woman’s life and lead to the death of the fetus. Whatever happens after the operation for a complicated ovarian cyst, surgery in this case cannot be avoided. If the ovarian cyst is asymptomatic, does not increase in size, then treatment should be discussed after childbirth.

If an ovarian cyst is detected during an ultrasound in the first trimester of pregnancy, multiple follow-up ultrasounds may be needed to avoid or prevent complications. Sometimes, when the consequences of an ovarian cyst can affect the course of pregnancy, it increases to ten centimeters in diameter, and surgery may be necessary during pregnancy. It is better to perform it in a planned manner, without waiting for the consequences of complications of the ovarian cyst.

Diagnosis of ovarian cyst

In order to make a diagnosis of “ovarian cyst”, and then decide on the tactics of observation and treatment, the following studies are needed:

• Ultrasound examination, which is the main diagnostic method. On ultrasound, it is possible to clarify the localization of the volumetric formation, its dimensions, wall thickness, echoscopic characteristics of the contents.
• Laparoscopy allows you to clarify the location and size of the cyst, visualize its surface and influence on the ovarian tissue. During laparoscopy, the cyst can be punctured and the contents sent for histological examination.
• Determining the level of hormones allows you to determine their concentration and balance.
• Oncomarker CA 125 is not strictly specific and highly informative, however, it is determined to clarify the nature of volumetric formation.
• A complete blood and urine test helps to identify signs of inflammation and blood loss.

Echoscopic picture of an ovarian cyst

Follicular ovarian cyst in most cases rounded, less often it resembles an egg. Its wall is thin, the inner surface is even and smooth. The internal contents have a homogeneous structure, it is anechoic. The diameter of the cysts can be in the range from three to ten centimeters.

The ovarian corpus luteum cyst is mostly round in shape, its wall is thick, from two to six millimeters, and the diameter varies from three to seven millimeters. Its contents may either be completely anechoic or have a reticulate or cobweb-like structure. Irregularly shaped partitions may be visualized in the cavity. In the contents of the cyst, hyperechoic inclusions, represented by blood clots, are sometimes detected.

The cause of thecalutein ovarian cysts may be hydatidiform mole or ovarian hyperstimulation syndrome. On scans, they are visible as unilateral or bilateral multi-chamber formations with a diameter of four to eight centimeters. Their wall is thin, and the contents are uniformly anechoic.

Endometrioid cysts on ultrasound appear as ovoid or round masses. They are located in the back of the uterus. In most cases, this is a two-way process. Their size can vary from one to eight centimeters. The internal contents of the cyst are filled with a highly or moderately echoic suspension, which does not move during percussion of the formation. The wall has a double contour.

Paraovarian ovarian cysts range in size from three to twelve centimeters. Their wall is thin, no more than one centimeter. The content of such a cyst is homogeneous, anechoic. In it, you can sometimes see a delicate fine suspension, which shifts during the percussion of the formation. The ovary is located separately from the cyst.

Teratomas can be up to twelve centimeters in size. Their internal echostructure is diverse. The formation may consist of a single hyperechoic component, which is represented by adipose tissue, and may contain dense cystic and hyperechoic components of various diameters, as well as a dense component, represented by hair or bone tissue, which gives an acoustic shadow. The cyst may contain multiple small-streaked inclusions or thin hyperechoic elongated structures represented by hair.

Treatment of ovarian cysts. Recovery after surgery

Some ovarian cysts are treated with medication. If the ovarian cyst after that does not regress within three months, then the woman is offered to perform surgery. The ideal option is to remove the cyst through laparoscopy. In this case, after the operation, the ovarian cyst does not recur and the woman’s fertility is not disturbed.

Sometimes it is necessary to resect part of the ovary along with the cyst. After such an operation, problems with conception are possible. In the case when a woman is in menopause, she can either have the ovary removed or the uterus removed along with the appendages. After such treatment, an ovarian cyst will not reappear, but the consequences will not be pleasant – a violation of hormonal homeostasis develops.

After laparoscopic surgery for an ovarian cyst, recovery is fast. A woman is advised to avoid sex for one month, reduce physical activity and regulate bowel function.