Obstetrics and Gynecology

Ovarian Cysts

An ovarian cyst is a sac or pouch filled with fluid or other tissue that forms on or inside a woman's ovary. Ovaries are the small reproductive glands located on each side of your uterus that make hormones and store and release eggs.

Ovarian cysts are common and in most cases benign (not cancerous).

There are many types of ovarian cysts. The most common is the functional cyst, which forms as a result of ovulation (when the ovary releases an egg). Functional cysts typically do not cause symptoms and go away on their own without treatment.

Other types of ovarian cysts may cause symptoms and require treatment.

What causes ovarian cysts?

The exact cause of ovarian cysts is unknown, however they tend to form when the ovaries produce too much of the hormone estrogen.

What are the symptoms of ovarian cysts?

Smaller cysts typically cause few if any symptoms. If the cyst is larger, it may cause:

  • Abnormal menstrual bleeding
  • Pelvic pain or a dull backache
  • Bloated feeling in your abdomen
  • Pain during intercourse
  • Painful periods
  • Pain during bowel movements or pressure on your bowels
  • Pressure on your rectum or bladder - difficulty emptying your bladder completely

Cysts that rupture may cause severe pain and swelling in the abdomen.

How are ovarian cysts diagnosed?

An ovarian cyst may be found during a routine pelvic exam or a physical exam as the doctor feels the reproductive organs for any lumps or changes.

Additional tests that may be ordered to gain more information include:

  • Blood tests
  • Ultrasound. Uses sound waves to create images of the uterus and ovaries on a video screen, showing cysts and their shape, size, location and composition (fluid filled, solid or a mix).
  • Laparoscopy. Uses a thin tube with a camera on the end (laparoscope) inserted through a small incision in the abdomen to view the ovaries. Laparoscopy also can be used to treat cysts or remove tissue samples for testing.

How are ovarian cysts treated?

Treatment depends on your age, the type and size of cyst, and symptoms. Treatment options include:

Watchful waiting. A common approach if you have a small, fluid-filled cyst and no symptoms. The doctor will monitor the cyst through periodic follow-ups.

Birth control pills. To prevent you from ovulating, reducing the likelihood of new cysts developing.

Surgery. The cyst may need to be removed if it is large, growing, not a functional cyst, or causing pain or other symptoms. The cyst can be removed through laparoscopy, a minimally invasive approach in which a tiny tube with a camera on the end (laparoscope) is inserted into the abdomen through a small incision, allowing the surgeon to view and remove the cyst. Or it can be removed through laparotomy (open abdominal surgery). If cancerous, the doctor may remove one or both ovaries and the uterus (hysterectomy).