Pelvic pain, heavy menstrual bleeding or pain during sex can all be signs of an ovarian cyst. An ovarian cyst forms when fluid accumulates in a membrane of an ovary. They often occur during reproductive years. While some women may have visible symptoms, some don’t have any. Though they are mostly harmless, it is best to get treatment sooner rather than later.

Dr Suhasini Inamdar, Consultant Obstetrician & Gynaecologist at Motherhood Hospitals in Bangalore explains the types of ovarian cysts, it’s effects on the body, recommended treatments and all you need to know about surgery.

1. What are ovarian cysts?

Female reproductive system has two ovaries located in the pelvis on both sides of the uterus. The ovaries produce eggs as well as the hormones Estrogen and Progesterone. Sometimes fluid-filled sacs or pockets called cysts develop inside one of the ovaries or on its surface. Many women have ovarian cysts sometime in their lifetime.

2. What are the types of ovarian cysts?

There are various types of ovarian cysts. The most common type of cysts are functional cysts of which are of two types: Follicle and Corpus luteum cysts. The others are Dermoid, Endometriotic, Serous Adenomas.

  • Follicle Cyst: An egg grows in a sac called a follicle during the menstrual cycle in the ovaries. Normally, this sac breaks open and releases an egg at the time of ovulation but if the follicle doesn’t break open then the follicle can form a follicular cyst on the ovary.
  • Corpus Luteum Cyst: Follicle after releasing an egg seals itself and produces essential hormones for the development of embryos. This is called corpus luteum cyst.
  • Dermoid Cyst: Cysts in the ovaries in the form of the sac that contains hair, fat, and other tissue.
  • Endometriomas Cyst: Cysts having endometrium, which normally is the inner lining of the uterus, grows and bleeds inside, resulting in a cyst.

3. What are some common signs and symptoms of ovarian cysts?

Most of the time, ovarian cysts do not cause any symptoms. However, as the cyst grows symptoms can appear. Symptoms may include:

  • Abdominal bloating or swelling
  • Nausea and vomiting
  • Painful bowel movements
  • Pelvic pain before or during the menstrual cycle
  • Painful intercourse
  • Pain in the lower back or thighs

4. Are ovarian cysts dangerous? What health complications can arise due to it?

Most of the ovarian cysts are harmless and the majority of them disappear without treatment within a few months. But those ovarian cysts that have ruptured, got infected, twisted can cause serious symptoms.

Ovarian cysts that develop after menopause might be cancerous. Cysts, when they grow bigger in size, can cause the ovary to move, increasing the chance of painful twisting of your ovary. This complication is called ovarian torsion and can also decrease or stop blood flow to the ovaries.

Larger the cysts greater is the chance of rupturing. Once ruptured can cause severe pain and internal bleeding.

5. What is the procedure to diagnose ovarian cysts?

To diagnose ovarian cysts there should be a routine pelvic examination by the doctor. If there is a cyst they might notice a swelling on your ovaries and will order for an ultrasound test to confirm the presence of a cyst. Ultrasound CT scan MRI produces an image of the internal organs which can be used to determine the size, location, shape, and composition (solid or fluid-filled) of a cyst. If the cyst size increases or there is no change in size, doctors will recommend additional tests to determine other causes of symptoms such as pregnancy test, hormone level test, a CA-125 blood test to screen for ovarian cancer.

6. What treatments are recommended for ovarian cysts?

The treatment for ovarian cyst depends on age, type, size of your cyst, and your symptoms. 

Suggestions made by doctors are:

  • Watchful Waiting: Mostly, a cyst disappears if you don’t have any serious symptoms. In this case, doctors recommend follow-up pelvic ultrasounds at intervals to see if your cyst changes in size.
  • Medication: Oral contraceptives pills, hormonal injections to create temporary reversible menopause, progestins in oral, intrauterine or injectable form.
  • Surgery: Surgery is recommended by a doctor when the cyst is large in size and is not a functional cyst. Other indications would be: when it continues growing through two or three menstrual cycles, causes infertility or causes pain. In most cases, a cyst can be removed without removing the ovary and in some affected ovary needs be removed. If the cystic mass is cancerous, then the uterus, ovaries and fallopian tubes are removed (pan hysterectomy) and possibly chemotherapy or radiation is provided. Surgery is also recommended when an ovarian cyst develops after menopause.

7. What does an ovarian cyst removal surgery entail?  

The surgery named laparoscopy is used with small cuts or buttonholes and specialized tools are used to remove the cyst. This surgery offers faster recovery times compared to open surgery, which uses a larger abdominal incision.

8. How long does it take to recover from ovarian cyst surgery?

After laparoscopic surgery, you may stay at the hospital for 1-2 days and return to your usual activities in 4 to 6 weeks. No bed rest as such is required. It takes time for your body to heal and come back to normal, however, some tips that can help you recover faster are:

  • Establish a daily routine just like you had in your normal days this will help you feel positive about yourself
  • Eat a healthy and balanced diet, make sure your body gets all the nutrients in a balanced form
  • Your attitude towards your body is an important factor while recovering. So make sure you have a positive outlook and take this time to analyze and change habits that are harmful to your body and adapt positive things like daily exercise

9. What are some long-term effects of ovarian cysts?

Most ovarian cysts resolve on their own and don’t have any long term effects. Cancerous, Endometriotic, rapidly increasing cysts can have a long term effect otherwise the vast majority of ovarian cysts do not have any long term effects.

10. When should one visit the doctor for this problem?

If you experience any of the symptoms of ovarian cyst like sharp abdominal pain, fever, constipation, bloating or vomiting you should immediately consult a doctor.