Any woman in her reproductive years, i.e. after puberty and before menopause, could have ovarian cysts. Ovarian cysts come in a variety of sizes, shapes, and appearances. The term ‘ovarian cyst’ brings confusion and distress to female patients, but in reality, most of the cysts that occur are functional, involved and necessary in the ovulation process.
What are ovarian cysts?
What do ovarian cysts mean? The ovaries are part of the female reproductive system. They are located in the lower abdomen on either side of the uterus. Women have two ovaries that produce the egg needed for fertilization, as well as the hormones oestrogen and progesterone.
Sometimes a sac-like formation filled with fluid called a cyst will develop on one or both ovaries. Many women will develop at least one cyst in their lifetime. In most cases, cysts are painless and cause no symptoms.
Types of ovarian cysts
There are different types of ovarian cysts, such as dermoid cysts and endometrioma cysts. However, functional cysts (those that occur normally) are the most common type. The two types of functional cysts include follicular and corpus luteum cysts.
Follicle cysts: During a woman’s menstrual cycle, an oocyte (the early phase of the egg) grows in a sac called a follicle, located inside the ovary. In most cases, this follicle or sac opens and releases an egg, a process called ovulation. But if the follicle doesn’t open, the fluid inside the follicle can form a cyst on the ovary.
Yellow body cysts: After the egg is released, the follicle turns into a yellow body, which continues the release of hormones. But if the follicle doesn’t turn, extra fluid can develop inside the follicle, and this build-up of fluid causes a yellow body cyst.
Other types of ovarian cysts include:
- Dermoid cysts: sac-like growths on the ovaries that may contain hair, fat and other tissue.
- Cystadenoma: non-cancerous growths that may develop on the outer surface of the ovaries.
- Endometriomas: tissues that normally grow inside the uterus may develop outside the uterus and attach to the ovaries, resulting in a cyst.
How do we know we have ovarian cysts?
Most often, the presence of ovarian cysts is not accompanied by any symptoms, and they can only be discovered during a gynecological consultation. That is why an annual check-up after sexual debut is recommended to prevent any problems. There are also cases in which, with the growth of the cyst, various symptoms appear, such as:
- Pelvic or abdominal pain.
- Abnormal pain before and during the menstrual cycle.
- Painful sexual intercourse.
- Breast tenderness.
- Nausea and vomiting.
There are a number of severe symptoms caused by ovarian cysts that require immediate medical attention. These include:
- Severe or throbbing pelvic pain.
- Fainting or dizziness.
- Hyperventilation (rapid breathing).
These aggravated symptoms may suggest a rupture of the cyst or torsion of the ovary, which blocks blood flow to that area and can lead to complications with serious consequences if overlooked.
Ovarian cysts treatment
Depending on the size of the ovarian cysts, the treatment chosen may vary. Your doctor may initially recommend treatment to try to shrink the cyst, and if it grows or doesn’t go away, you may have surgery to remove it.
The first type of treatment commonly used to treat cysts is the contraceptive pill. If there is a recurrence of cysts, oral contraceptives may be prescribed to stop ovulation and prevent new cysts developing. Oral contraceptives also have other advantages, including lowering the risk of ovarian cancer.
Laparoscopy or laparotomy – When oral contraceptives have proved ineffective, surgery may be an option. When the ovarian cyst is small and the possibility of malignancy (cancer) is ruled out, the doctor will perform a procedure called laparoscopy. This consists of a small incision near the navel and the insertion of an instrument into the abdomen to remove the cyst. If the size of the cyst is large and cannot be addressed by laparoscopy, a laparotomy is used. A large incision is made in the abdomen and an immediate biopsy is taken to determine if it is cancerous. If this is the case, a hysterectomy will be performed to remove the ovary and uterus.
Early intervention is preferred for cysts in order to identify them at a smaller size because laparoscopy, being a less invasive procedure, is preferred over laparotomy. Laparoscopy has a number of advantages, including:
- reduced risk of infection and thrombus (blood clots).
- reduced post-operative complications.
- short recovery time (you can go home the next day after the operation).
- less post-operative pain.
- damage to neighboring organs is much less common than with more invasive operations.
Ovarian cysts and polycystic ovary syndrome
A common health problem involving ovarian cysts is Polycystic Ovarian Syndrome (PCOS). Polycystic means more than one cyst compared to one. If you have PCOS, you develop many small benign cysts in your ovaries. The cysts develop because of a problem with ovulation, caused by a hormonal imbalance arising from various causes in the body. PCOS is associated with menstrual problems, reduced fertility, hair growth, obesity, and acne. Currently, it is estimated that over 50% of women experience this condition and require consultation with a gynecologist to prevent complications. If left untreated, polycystic ovaries can cause infertility.
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