Ovarian Cysts

Having an ovarian cyst does not mean you have ovarian cancer. Ovarian cysts can be fairly common, while ovarian tumors are quite rare; ovarian cysts are fluid-filled while ovarian tumors are solid masses. Most ovarian cysts are not harmful, don’t cause symptoms, and are not indicative of risk for future ovarian cancer, though some complex ovarian cysts may raise the risk. Ovarian cysts are common in women with regular menstrual cycles, and less common in post-menopausal women. Approximately 8% of pre-menopausal women develop large ovarian cysts that require treatment.

Symptoms

Ovarian cyst symptoms are uncommon unless they twist or rupture, or become large enough that a woman can feel the cyst. The most common symptoms of ovarian cysts are abdominal bloating, pressure, pain, or swelling, particularly on the side of the abdomen with the ovarian cyst. Other symptoms can include:

• Painful bowel movements
• Pelvic pain before or during the menstrual cycle
• Painful intercourse
• Pain in the lower back or thighs
• Urinary frequency
• Breast tenderness
• Nausea and vomiting

Causes

• Hormonal problems: Functional cysts usually go away on their own and may be caused by hormonal problems or drugs that promote ovulation.
• Endometriosis: A condition where the lining of the uterus grows outside the uterus, forming cysts.
• Severe pelvic infections: Infections can spread to the fFallopian tubes and the ovaries, causing cysts.
• Pregnancy: An ovarian cyst normally develops only until the placenta forms to support the pregnancy.
• Polycystic ovary syndrome (PCOS): Women with PCOS often have many small cysts on their ovaries.

Diagnosis

• Pelvic exams: Initial identification of ovarian cysts.
• Tests: Pregnancy test, transvaginal ultrasound, laparoscopy surgery, CA-125 blood test.

Treatment

• Observation: Many ovarian cysts go away on their own.
• Medications: Pain relief and hormonal birth control to prevent future cysts.
• Follow-up: Regular pelvic ultrasounds to monitor cysts.

Surgery

• Laparoscopy: For smaller ovarian cysts that look benign.
• Laparotomy: For larger cysts or those that may be cancerous.

Recovery

• Laparoscopy: Resume normal activities within a day, avoid strenuous activity for about a week.
• Laparotomy: Hospital stay of 2 to 4 days, return to usual activities in 4 to 6 weeks.

Questions to Ask Your Doctor

• What did you see on the ultrasound results to refer me to a gynecologic oncologist?
• What factors were present? For example, was the mass solid and not fluid-filled? Was it more complex than cysts usually are? Does there appear to be a blood supply flowing to it?
• Which type of surgery will you do initially?