Ovarian Cyst
Ovarian Cyst
An ovarian cyst is any collection of fluid, surrounded by a very thin wall, within an ovary. Any
ovarian follicle that is larger than about two centimeters is termed an ovarian cyst. An ovarian
cyst can be as small as a pea, or larger than an orange.
Most ovarian cysts are functional in nature, and harmless (benign). In the US, ovarian cysts are
found in nearly all premenopausal women, and in up to 14.8% of postmenopausal women.
Ovarian cysts affect women of all ages. They occur most often, however, during a woman's
childbearing years.
Some ovarian cysts cause problems, such as bleeding and pain. Surgery may be required to
remove cysts larger than 5 centimeters in diameter.
The following are possible risk factors for developing ovarian cysts:
Oral contraceptive/birth control pill use decreases the risk of developing ovarian cysts because
they prevent the ovaries from producing eggs during ovulation.
Usually ovarian cysts do not produce symptoms and are found during a routine physical exam or
are seen by chance on an ultrasound performed for other reasons. However, the following
symptoms may be present:
Lower abdominal or pelvic pain, which may start and stop and may be severe, sudden, and
sharp
Irregular menstrual periods
Feeling of lower abdominal or pelvic pressure or fullness
Long-term pelvic pain during menstrual period that may also be felt in the lower back
Pelvic pain after strenuous exercise or sexual intercourse
Pain or pressure with urination or bowel movements
Nausea and vomiting
Vaginal pain or spotty bleeding from the vagina
Infertility
Ovarian Cysts Diagnosis
A health care practitioner may perform the following tests to determine if a woman has an
ovarian cyst or to help characterize the type of cyst that is present:
Endovaginal ultrasound: This type of imaging test is a special form of ultrasound developed to
examine the pelvic organs and is the best test for diagnosing an ovarian cyst. A cyst can be
diagnosed based on its appearance on the ultrasound.
Other imaging: CT scanning aids in assessing the extent of the condition. MRI scanning may also
be used to clarify results of an ultrasound.
Laparoscopic surgery: In this procedure the surgeon makes small incisions through which a thin
scope (laparoscope) can pass into the abdomen. The surgeon identifies the cyst through the
scope and may remove the cyst or take a biopsy from it.
Serum CA-125 assay: This blood test checks for a substance called CA-125, which is associated
with ovarian cancer (the CA stands for cancer antigen). This test is used in the assessment of
epithelial ovarian cancer and may help determine if an ovarian mass is harmless or cancerous.
However, sometimes benign conditions such as endometriosis or uterine fibroids may result in
the elevated levels of CA-125 in the blood, so the test does not positively establish the diagnosis
of ovarian cancer.
Hormone levels: A blood test to check LH, FSH, estradiol, and testosterone levels may indicate
potential problems concerning these hormone levels.
Pregnancy testing: The treatment of ovarian cysts is different for a pregnant woman than it is
for a nonpregnant woman. An ectopic pregnancy (pregnancy outside the uterus) must be ruled
out because some of the symptoms of ectopic pregnancy may be similar to those of ovarian
cysts.
Culdocentesis: This test involves taking a fluid sample from the pelvis with a needle inserted
through the vaginal wall behind the uterine cervix.
Oral contraceptives: Birth control pills may be helpful to regulate the menstrual cycle, prevent
the formation of follicles that can turn into cysts, and possibly reduce the size of an existing cyst.
Pain relievers: Anti-inflammatory medication such as ibuprofen (for example, Advil) may help
reduce pelvic pain. Narcotic pain medications by prescription may relieve severe pain caused by
ovarian cysts.
Laparoscopic surgery: The surgeon makes small incisions through which a thin scope
(laparoscope) can pass into the abdomen. The surgeon identifies the cyst through the scope and
may remove the cyst or take a sample from it.
Laparotomy: This is a more invasive surgery in which an incision is made through the abdominal
wall in order to remove a cyst.
Surgery for ovarian torsion: An ovarian cyst may twist and cause severe abdominal pain as well
as nausea and vomiting. This is an emergency, surgery is necessary to correct it.