Ovarian Cysts: Causes, Treatment and Prevention

Ovarian cyst can be a scary word, but don’t panic just yet. This lesion takes the form of a fluid-filled follicle, and in selected types of cyst, various types of tissue are also present. It is one of the more common gynaecological pathologies. Find out what symptoms accompany this lesion and whether an ovarian cyst can rupture. Find out what the treatment of a cyst is.

Table of contents:

• What are ovarian cysts?
• Types of ovarian cysts
  • Follicular cysts
  • Corpus luteum cysts
  • Endometrial cysts
  • Dermoid cysts
  • Polycystic ovary syndrome (PCOS)
• Signs and symptoms of an ovarian cyst
• What causes an ovarian cysts?
• Diagnosing an ovarian cyst
• How treat ovarian cysts?
  • There are several ways to treat ovarian cysts:
• Ovarian cyst prevention

What are ovarian cysts?

Ovarian cysts are a fairly complex group of lesions. In the most general terms, they can be described as sphere-like formations with a fluid or solid content inside (for example, with fluid or blood). The cysts may occur singly or multiply on one or both ovaries. These lesions are most commonly found in women of reproductive age - it is the most common gynaecological pathology. It can be benign - for example, a persistent Graaf's follicle - or malignant - ovarian cancer.

Types of ovarian cysts

Most ovarian cysts are common and harmless - ‘functional’ cysts. Many go away on their own or get smaller within two or three menstrual cycles. Sometimes, if they're large, they may disrupt the normal menstrual cycles, delaying bleeding and causing heavier bleeding than normal.

There are two main types of cysts:

• functional ovarian cysts: follicular cyst, corpus luteum cyst;
• non-functional ovarian cysts: endometriotic cyst, dermoid cyst, cysts associated with polycystic ovary syndrome (PCOS).

The formation of functional cysts is associated with the course of the menstrual cycle, during which the Graff follicle forms. Most often these cysts are benign in nature and do not require treatment. The situation is different for non-functional cysts.

Follicular cysts

During a normal menstrual cycle, the egg cell matures to form a Graaf follicle. After its rupture, the cell escapes freely into the fallopian tube. However, sometimes, in the case of hormonal disturbances, the signal that initiates the rupture of the follicle will not occur. Such a follicle fills with fluid over time and grows to form a follicular cyst.

Corpus luteum cysts

A ruptured Graaf's follicle physiologically develops into a corpus luteum, which disappears if pregnancy does not occur. However, it can happen that the corpus luteum does not disappear and a corpus luteum cyst forms inside it.

Endometrial cysts

Endometriotic cysts, otherwise known as chocolate cysts, are cysts that form in the course of endometriosis. Endometriosis refers to the finding of tissue which is very similar to the tissue that lines the womb (the endometrium) in other places, most commonly in the pelvis. When endometriosis is found on the ovary it typically forms cysts called endometriomas. Each cycle the endometriomas bleed into themselves so they become enlarged and filled with old blood which is dark in colour. This type of cyst is often removed surgically, especially if they are large, as they can pose a risk to the patient's health. If such a cyst ruptures, blood can spill into the abdominal cavity and cause peritonitis.

Dermoid cysts

These types of cysts are also known as dermoid cysts. Dermoid cysts contain embryological cells that can form a number of different tissues so that the cyst may contain hair, skin, sebaceous fluid, nails or even teeth. They are the most common form of mature cystadenoma, which is a benign tumour of the ovary. Due to the frequency of complications, they are removed surgically unless they are very small.

Polycystic ovary syndrome (PCOS)

PCOS is when there are multiple small follicular cysts in the ovary and disordered hormone production that causes symptoms and prevents ovulation.

When women with PCOS menstruate, they may experience heavy bleeding, too. They even experience higher testosterone levels, which can cause extra hair to grow on their face and chest. Your doctor will probably find this kind of condition during a general check-up. Also, dietary change/weight change can be very important for PCOS.

Signs and symptoms of an ovarian cyst

The process of cyst formation on the ovary is slow and usually does not produce any symptoms or they do not appear until later. In many cases, we find out about the cyst in the gynaecologist's office after a routine ultrasound examination.

Cysts at an advanced stage can already cause many unpleasant symptoms. Depending on their size and location, they can give the following ovarian cyst symptoms:

• a feeling of pressure on the bladder,
• pain in the lower abdomen,
• noticeable pain in the ovary where the cyst is located,
• persistent bloating
• change in bowel function eg constipation
• increased abdominal size (despite no weight gain),
• cycle disorders,
• bleeding between periods,
• low back pain
• weight gain,
• early postprandial satiety,
• discomfort during intercourse,
• painful and/or heavy menstrual bleeding,
• changes in body hair,
• breast tenderness,

If you notice these types of symptoms in yourself signs of ovarian cyst, it is best to make an appointment with a specialist as soon as possible.

Also find out what brown vaginal discharge means.

What causes an ovarian cysts?

Ovarian cysts causes can arise spontaneously and can also disappear on their own. There are also cysts that are caused by hormonal disturbances or diseases in the body. For example, cysts can cause:

• endocrine disorders - caused by a malfunctioning endocrine system that lowers sex hormone levels; in the case of polycystic ovaries, it is excess androgens that contribute to the formation of numerous cysts;
• endometriosis - this condition involves the presence of the endometrium, or mucous membrane lining the uterus, outside the uterine cavity; the endometrium can then invade the ovaries leading to the formation of cysts.

What causes ovarian cyst in addition? The reasons for the formation of cysts include also:

• genetic factors,
• inflammation of the genital tract,
• neoplastic lesions.

Diagnosing an ovarian cyst

Transvaginal ultrasound is used in the diagnosis of cysts. On the basis of this, the gynaecologist is able to determine the size of the cyst, its shape, the thickness of the walls, as well as the type of fluid inside I character of the lesion. In addition, depending on the type of cyst patients may be advised to carry out:

• measurement of the levels of sex hormones (progesterone and oestrogen);
• a measurement of the levels of pituitary hormones (luteinising hormone LH, folliculotropic hormone FSH);
• in addition, an androgen test may be ordered if polycystic ovaries are suspected.

Sometimes a biopsy of the cyst is also necessary.

If cancerous lesions are suspected, the ovarian cancer marker CA 125 is also tested, but it is important to remember that the result of this test is not the basis for diagnosis, as CA 125 levels can rise in the course of many other conditions.

How treat ovarian cysts?

Any cyst should be checked by a doctor. Even though most ovarian cysts aren't usually cancerous, you shouldn't take the chance. Pelvic exams help doctors to see if you have cysts at all. If, after an exam, your doctor suspects cysts, they may recommend other tests such as:

• Ultrasound — where sound waves are used to obtain a picture of your reproductive organs and the cysts can be identified and measured.
• Laparoscopy — It is an operation where a telescope is placed through the belly button under general anaesthetic to make a diagnosis or provide treatment.
• Blood test.

They will enable further ovarian cyst treatment

There are several ways to treat ovarian cysts:

• Birth control pills can only shrink functional cysts or hinder their development.
• Hormone therapy can help in the treatment of PCOS or endometriotic cysts
• Surgery may be required for large cysts or cysts that are not functional. The type of operation depends on where the cyst is found, its size and type and the woman's age. Indications for surgery may include significant pressure on organs or tissues next to the cyst and the risk of endometriosis or ovarian cancer.
• Oral contraceptives can prevent the more common functional cysts of ovulation from forming.

The treatment of cysts varies, depending on the type of cyst and also on the age of the patient. In patients of reproductive age, simple small cysts are left for observation. Those larger than about 5-7 cm, endometriotic cysts and those that cause symptoms are often indications for surgery. In postmenopausal patients, the choice of treatment depends on the risk of cyst malignancy.

Ovarian cyst prevention

Like we said, most cysts are a normal, everyday occurrence. By listening to your body and keeping up with your gynaecological exams, you’ll be a strong, healthy girl! How to prevent ovarian cyst?

Once your ovarian cyst treatment is complete, be sure to have regular check-ups scheduled by your gynaecologist. In addition, it is a good idea to introduce some healthy rules into your daily life:

• Healthy diet - a diet rich in fibre and water helps to reduce tension in the abdominal area;
• Warm compresses - help reduce swelling and relieve ovarian cyst pain by allowing the muscles to relax;
• Regular exercise - great for the menstrual cycle.

Have you ever known someone with an ovarian cyst?