Ovarian Cysts

ABOUT THIS CONDITION

Ovarian cysts are little sacs filled with fluid that are in the ovary or on the surface of it. Ovarian cysts are quite common in young women. Cysts usually don’t have any symptoms and are typically harmless.

Symptoms of Ovarian Cysts

Ovarian cysts are so common that many women have them at some point in their lifetime. Most cysts are painless and harmless and disappear within a few months without treatment. Large cysts can cause symptoms:

  • Bloating
  • Frequent urination
  • Pelvic pain, pressure or fullness
  • Unusual vaginal bleeding

If you have these symptoms you should see your gynaecologist. They will perform a pelvic exam to determine possible causes for your symptoms.

Ruptured cysts cause severe pain and internal bleeding. Larger cysts are more likely to rupture. You should seek immediate medical attention if you have:

  • Sudden and severe abdominal or pelvic pain
  • Fever or vomiting
  • Signs of shock (cold, clammy skin; rapid breathing; lightheadedness or weakness)

Cysts can become very large and move the ovary out of position. This can cause painful torsion (twisting) of the ovary. This can result in decreased or blocked blood flow to the ovary.

Your risk of ovarian cancer increases as you age. Post-menopausal women are at a greater risk.

Cysts during pregnancy should be monitored in case they twist, rupture or cause problems during childbirth. Most ovarian cysts do not impact your chances of getting pregnant. Although, if there is an underlying condition that is causing your cysts these may impact fertility such as endometriosis.

Ovarian Cyst Tests

If you think you have an ovarian cyst your gynaecologist will do a pelvic exam. Your doctor may watch and wait or order tests to determine treatment (especially if you have pain). Testing includes:

  • An ultrasound to see the shape, size, location and make up of the cysts (fluid or solid)
  • A hormone level test to check for hormone-related problems
  • Blood tests if you are postmenopausal to measure cancer-antigen 125 (CA-125) in your blood. This is associated with ovarian cancer
  • Pregnancy tests to rule out pregnancy

Treatment

Depending on how much discomfort the cyst is causing you, your gynaecologist may recommend treatment. They may prescribe pain medication (over the counter or stronger medications) or hormonal birth control if you have cysts often. Hormonal birth control can lower the chance of you developing more cysts.

Your cyst may require surgery. This is necessary in 10% of women. A removed cyst will be sent for testing. Surgery is recommended if:

  • You are post-menopausal
  • The cyst has not gone away after several menstrual cycles
  • The cyst gets larger
  • The cysts cause pain
  • The cyst looks unusual on the ultrasound


Your gynaecogist may remove the cyst or may need to remove your entire ovary. Surgery can be performed via:

  • Laparoscopy – A tiny cut is made in or near your belly button to enter your body, and look around your pelvic area with a camera and remove the cyst via keyhole surgery
  • Laparotomy – A larger cut in the belly is used to remove the cyst. If your cyst is large or looks suspicious this method will likely be used. If there is a suspicion that the cyst is cancerous then a Gynaecological Oncologist may need to perform the surgery and remove the ovary and other tissues, like the uterus, omentum, peritoneum and lymph glands.