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ovarian cysts

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Ovarian cysts

Ovarian cysts are fluid-filled sacs or growths that form on the ovaries. The ovaries are small organs on either side of a woman's uterus that produce an egg each month, as well as the hormones oestrogen and progesterone.

What is going on in the body?
Each month, when an ovary produces an egg, a small, cyst-like structure called a follicle grows inside the ovary. When mature, the follicle breaks and the egg is released. If pregnancy does not occur, the empty follicle dissolves.

A cyst is a fluid-filled sac. It is like a large blister. Some ovarian cysts are formed as a result of ovulation, or release of the egg. Ovarian cysts are quite common. There are two types: functional and abnormal.

Functional cysts develop as a part of the normal function of the ovary, or ovulation. Functional cysts are usually smaller than abnormal cysts and go away without treatment. Some cysts may require surgical or medical treatment.

Abnormal cysts often occur as result of an imbalance in the hormone levels of oestrogen and progesterone, either as a result of medical conditions or from treatment used to cause ovulation.

What are the signs and symptoms of the condition?
Ovarian cysts are often found during a pelvic examination. Most ovarian cysts do not cause symptoms. If symptoms do occur, the symptoms may include:
  • delayed, irregular or unusually painful periods.
  • dull ache or sense of pressure or fullness in the abdomen.
  • pain during intercourse.
  • pain during exercise.
  • irregular bowel or bladder function.

If the cyst is twisted or has ruptured, symptoms may include:
  • severe abdominal pain.
  • nausea and vomiting.
  • signs of shock from internal haemorrhaging, or bleeding.

What are the causes and risks of the condition?
Most cysts are not cancerous. The cysts usually occur in women during reproductive years. If a cyst is discovered before puberty or after menopause, it may be cancerous and it should be surgically removed as soon as possible to see if it is cancerous. Other more common types of cysts occur throughout life and include:
  • dermoid cysts, a tumour of "eggs" in the ovary, filled with various types of tissue, such as hair, mucous and skin tissue.
  • cystadenoma cysts, which develop from cells on the outer surface of the ovary.
endometriomal cysts, which are formed when tissue similar to the lining of the uterus, called endometrial tissue, develops on the ovaries. Polycystic ovarian disease is a build-up of follicle cysts that causes the ovaries to become enlarged and form a thick outer covering, preventing ovulation.

A few cysts may turn out to be cancerous. For this reason, all cysts must be evaluated carefully. The risk of ovarian cancer is very small. It can be treated more successfully if it is found early in the course of the disease. Ovarian cancer is not common in women before the menopause. Women who have an ovarian cyst between the ages of 50 to 70 are at a higher risk of having ovarian cancer.

What can be done to prevent the condition?
Because the causes of ovarian cysts are unknown, the best prevention is to have regular pelvic examinations. Sometimes oral contraceptives will prevent the more common functional cysts of ovulation from forming. Oral contraceptives are also used in women with known polycystic ovary syndrome to prevent the formation of more follicle cysts.

How is the condition diagnosed?
Ovarian cysts are first found during a pelvic examination. Confirming this finding is usually accomplished by the following tests:
  • pelvic ultrasound
  • abdominal CT scan
  • MRI
  • x-ray of the urinary system
  • diagnostic laparoscopy, or use of a scope with a small camera that is inserted into the abdominal cavity to view the pelvic organs
What are the long-term effects of the condition?
Functional cysts resolve without treatment. Endometriomas in association with endometriosis may cause infertility, chronic menstrual problems and chronic pelvic pain. If cysts become large, they may become twisted, which can cut off their blood supply. This is considered an abdominal emergency and surgery may be necessary to prevent gangrene of that ovary.

What are the treatments for the condition?
Treatment depends on the type, size and age of the of cyst and the age of the woman. Cysts 5 centimetres (about 2 inches) or larger that do not go away usually need surgery to be removed. Treatments include:
  • birth control pills.
  • laparoscopy, a procedure that uses a small camera and instruments to see the cysts, drain fluid or remove the cyst.
  • laparotomy, an incision is made in the abdomen to remove the cyst.
What are the side effects of the treatments?
Side effects of oral contraceptives include nausea, abdominal bloating and headaches. Surgery may require recuperation for a few days or weeks, depending on the type of surgery performed.

What happens after treatment for the condition?
More frequent pelvic examinations may be suggested by a doctor for the first year after surgery. Certain cysts have a chance of returning.

How is the condition monitored?
Follow-up ultrasounds may be performed if certain cysts are discovered during surgery that are known to recur or come back.

Author: Eva Martin, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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