Ovarian Cyst Treatments
A cyst is a fluid-filled sac. Cysts develop in various places in the body. Depending on the type of cyst, the fluid within the cyst can range from thin and watery to thick and paste-like. Some cysts have a thicker solid outer part with some fluid within.
Cysts on the ovary are very common. The vast majority of ovarian cysts are non-cancerous (benign) but some are cancerous (malignant), or may become cancerous over time. Ovarian cysts can vary in size – from less than the size of a pea to the size of a large melon (occasionally even larger). There are various types, ∂which include the following:
Functional ovarian cysts
These are the most common type. They form in some women of childbearing age (women who still have periods) when there is a functional fault with ovulation. They are very common. There are two types:
- Follicular cysts. A follicle (see in ‘Ovulation’, above) can sometimes enlarge and fill with fluid. They can occur commonly in women who are receiving infertility treatment.
- Corpus luteum cysts. These occur when the corpus luteum (see in ‘Ovulation’, above) fills with fluid or blood to form a cyst. A blood-filled cyst is sometimes called a haemorrhagic cyst.
Both of these cysts can grow up to about 6 cm across. They usually do not need treatment, as they normally go away on their own within a few months.
Dermoid cysts (sometimes called benign mature cystic teratomas)
Dermoid cysts tend to occur in younger women. These cysts can grow quite large – up to 15 cm across. These cysts often contain odd contents such as hair, parts of teeth or bone, fatty tissue, etc. This is because these cysts develop from cells which make eggs in the ovary. An egg has the potential to develop into any type of cell. So, these cysts can make different types of tissue. In about 1 in 10 cases a dermoid cyst develops in both ovaries. Dermoid cysts can run in families.
These develop from cells, which cover the outer part of the ovary. There are different types. For example, serous cystadenomas fill with a thin fluid and mucinous cystadenomas fill with a thick mucous-type fluid. These types of cysts are often attached to an ovary by a stalk rather than growing within the ovary itself. Some grow very large. They are usually benign but some are cancerous.
Many women who have endometriosis develop one or more cysts on their ovaries. Endometriosis is a condition where endometrial tissue (the tissue that lines the womb (uterus)) is found outside the uterus. It sometimes forms cysts which fill with blood. The old blood within these cysts looks like chocolate and so these cysts are sometimes called chocolate cysts. They are benign.
Polycystic ovary syndrome (PCOS)
Polycystic means many cysts. If you have PCOS you develop many tiny benign cysts in your ovaries. The cysts develop due to a problem with ovulation, caused by a hormonal imbalance. PCOS is associated with period problems, reduced fertility, hair growth, obesity, and acne. See leaflet called Polycystic Ovary Syndrome for more detail on PCOS.
There are also other rare types of ovarian cysts. There are also various types of benign ovarian tumors, which are solid and not cystic (do not have fluid in the middle).
Symptoms and Problems related to Ovarian Cysts
- Abdominal bloating or swelling
- Painful bowel movements
- Pelvic pain before or during the menstrual cycle
- Painful intercourse
- Pain in the lower back or thighs
- Breast tenderness
- Nausea and vomiting
What is the treatment for ovarian cysts?
Dr. Ahdoot will advise on the best course of action. This depends on factors such as:
- Your age.
- Whether you are past the menopause.
- The appearance and size of your cyst from the ultrasound scan.
- Whether you have any symptoms.
Many small ovarian cysts will resolve and disappear over a few months. You may be advised to have a repeat ultrasound scan after a few months or so. If the cyst goes away then no further action is needed.
Removal of an ovarian cyst may be advised, especially if you have symptoms or if the cyst is large. Sometimes Dr. Ahdoot may want to remove it to determine exactly which type of cyst it is and to make sure there are no cancer cells in it. Most smaller cysts can be removed by ‘keyhole’ (laparoscopic) surgery. Some cysts require a more traditional style of operation.
The type of operation depends on factors such as the type of cyst, your age, and whether cancer is suspected or ruled out. In some cases, just the cyst is removed and the ovary tissue preserved. In some cases, the ovary is also removed, and sometimes other nearby structures such as the womb (uterus) and the other ovary. Dr. Ahdoot will advise on the options for your individual situation.