What are ovarian cysts? – Types, symptoms and treatment

By BSc, MSc (embryologist), MD (gynecologist), BSc, MSc (embryologist) and BSc, MSc (psychologist).
Last Update: 11/09/2021

Ovarian cysts are fluid-filled sacs that can form on the ovaries, either on the surface or inside one or both ovaries. Many women have a cyst of this type during their lifetime.

Most ovarian cysts form during ovulation and the woman has no symptoms or only mild discomfort. In these cases, ovarian cysts usually disappear on their own within a few months, without the need for treatment.

However, at other times, ovarian cysts can cause symptoms and even severe pain. In this situation, surgical intervention may be necessary to solve it. It´s important to know the symptoms and to make an early diagnosis to avoid confusion with ovarian cancer or other pathologies

Why do ovarian cysts appear?

Normally, cysts occur during normal ovarian functioning, either because the follicle does not rupture to release the egg (follicular cysts) or because, upon release, fluid accumulates in the remaining structure of the follicle (corpus luteum cysts). These two types of cysts that occur normally in the menstrual cycle are called functional cysts.

Follicular cysts can be more than 2.5 cm in diameter, are usually painless, and disappear spontaneously in two or three menstrual cycles.

However, corpus luteum cysts can measure up to 3 cm and usually disappear on their own within a few weeks.

Types of ovarian cysts

In addition to the aforementioned functional cysts, there are also other less common types of cysts. These are non-functional ovarian cysts that do not occur with the menstrual cycle but can have various origins. These ovarian cysts include the following:

  • Serous cystadenoma: cyst of clear content and smooth surface. It can be of large size.
  • Mucinous cystadenoma: ovarian tumor that can reach large size. They are round or ovoid masses, with a smooth, bluish-gray surface.
  • Endometrioma: cyst produced by endometriosis, containing a thick chocolate-colored liquid.
  • Dermoid cyst or mature teratoma: germ cell tumor that is usually benign.

In order to detect ovarian cysts that do not produce symptoms, it is very important to attend gynecological check-ups.

Symptoms

Generally, the appearance of ovarian cysts does not cause symptoms. Despite this, some women may notice:

  • Constant abdominal or pelvic pain, which may radiate to the legs or back.
  • Pelvic pain before and throughout menstruation.
  • Irregular menstruation.
  • Dyspaneuria, i.e., pain during intercourse.
  • Nausea, vomiting or increased breast tenderness.
  • Feeling of weight or abdominal distention.
  • Pressure in the rectum or bladder, with a sensation of difficulty in emptying the bladder completely.

However, in case of acute abdominal or pelvic pain that appears suddenly, or if it occurs together with vomiting and fever, it is very important to go immediately to the emergency room. This pain may be caused by a complication such as a cyst rupture or ovarian torsion. This torsion means that the ovary rotates its position causing severe pain and can also make it difficult for blood to reach the ovary.

Nonetheless, it should be noted that if the ovarian cysts are of the endometrioma type, they can cause fertility problems in women.

Assisted procreation, as any other medical treatment, requires that you rely on the professionalism of the doctors and staff of the clinic you choose. Obviously, each clinic is different. Get now your Fertility Report, which will select several clinics for you out of the pool of clinics that meet our strict quality criteria. Moreover, it will offer you a comparison between the fees and conditions each clinic offers in order for you to make a well informed choice.

Diagnosis

Some ovarian cysts can be detected by gynecological examination by palpating the ovaries. Secondly, a transvaginal pelvic ultrasound may be performed to view the ovaries and facilitate identification of the cysts and their contents.

It will also be necessary to rule out pregnancy by doing a determination of beta hCG in the blood. If the result is positive, it may be a corpus luteum cyst, as this type of cyst is quite common during pregnancy.

Other complementary tests are a blood test for a protein called CA-125 and magnetic resonance imaging, which can be done in case of diagnostic doubt or if it is suspected that the cyst may be malignant.

Treatment

Treatment will depend on the type of cyst, its size, the symptoms it causes, and the age of the patient. After menopause, it is advisable to follow up any type of cyst because of its increased risk of malignancy.

In this way, the specialist may opt to simply wait and check after a few weeks that the cyst has disappeared. However, you may also consider resorting to surgical treatment to remove, above all, cysts that may be cancerous and all those that cause pain or other symptoms.

In women of reproductive age, an attempt will be made to remove as little ovarian tissue as possible, but in some cases, surgery may require removal of the ovary or even both ovaries. Finally, the anatomical pathology service will be the one to give the definitive diagnosis after analyzing the lesion.

FAQs from users

What problems can be caused by the presence of ovarian cysts?

By Sergio Rogel Cayetano MD (gynecologist).

Cysts are cavities in the organism that contains liquid inside and have a capsule around them. There are functional cysts, non-functional cysts, and malignant tumors. Depending on the type of cyst a woman has in her ovaries, the problems it will cause will be different.

For this reason, it is essential to have gynecological check-ups to detect any alteration and to be able to request complimentary tests to make a safe diagnosis. In this way, the most appropriate treatment can be established to avoid major problems.
Read more

Do ovarian cysts require surgical removal?

By Silvia Azaña Gutiérrez BSc, MSc (embryologist).

No, not all ovarian cysts require surgery. There are ovarian cysts that will disappear by themselves in a few months, without the need for any treatment.

However, the specialist may opt for surgical intervention depending on the type and size of the ovarian cyst, the symptomatology it is producing, and the woman's age.

Throughout the article, we have discussed the menstrual cycle. If you want to learn more, you can visit the following link: The Different Phases of the Menstrual Cycle.

However, if you are interested in knowing more about endometriosis, we recommend you to read this article: What is endometriosis - Symptoms, diagnosis, and treatment?

Our editors have made great efforts to create this content for you. By sharing this post, you are helping us to keep ourselves motivated to work even harder.

References

Asfour V, Varma R, Menon P. Clinical risk factors for ovarian torsion. J Obstet Gynaecol. 2015;35(7):721-5.

Bottomley C, Bourne T. Diagnosis and management of ovarian cyst accidents. Best Pract Res Clin Obstet Gynaecol. 2009 Oct;23(5):711-24.

Farghaly SA. Current diagnosis and management of ovarian cysts. Clin Exp Obstet Gynecol. 2014;41(6):609-12.

Legendre G, Catala L, Morinière C, Lacoeuille C, Boussion F, Sentilhes L, Descamps P. Relationship between ovarian cysts and infertility: what surgery and when? Fertil Steril. 2014 Mar;101(3):608-14.

Mobeen S, Apostol R. Ovarian Cyst. 2020 Jul 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–.

Nowak-Psiorz I, Ciećwież SM, Brodowska A, Starczewski A. Treatment of ovarian endometrial cysts in the context of recurrence and fertility. Adv Clin Exp Med. 2019 Mar;28(3):407-413.

FAQs from users: 'What problems can be caused by the presence of ovarian cysts?' and 'Do ovarian cysts require surgical removal?'.

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Authors and contributors

 Sara Salgado
Sara Salgado
BSc, MSc
Embryologist
Degree in Biochemistry and Molecular Biology from the University of the Basque Country (UPV/EHU). Master's Degree in Human Assisted Reproduction from the Complutense University of Madrid (UCM). Certificate of University Expert in Genetic Diagnosis Techniques from the University of Valencia (UV). More information about Sara Salgado
 Sergio Rogel Cayetano
Sergio Rogel Cayetano
MD
Gynecologist
Bachelor's Degree in Medicine from the Miguel Hernández University of Elche. Specialist in Obstetrics & Gynecology via M. I. R. at Hospital General de Alicante. He become an expert in Reproductive Medicine by working at different clinics of Alicante and Murcia, in Spain, until he joined the medical team of IVF Spain back in 2011. More information about Sergio Rogel Cayetano
License: 03-0309100
 Silvia Azaña Gutiérrez
Silvia Azaña Gutiérrez
BSc, MSc
Embryologist
Graduate in Health Biology from the University of Alcalá and specialized in Clinical Genetics from the same university. Master in Assisted Reproduction by the University of Valencia in collaboration with IVI clinics. More information about Silvia Azaña Gutiérrez
License: 3435-CV
Adapted into english by:
 Cristina  Algarra Goosman
Cristina Algarra Goosman
BSc, MSc
Psychologist
Graduated in Psychology by the University of Valencia (UV) and specialized in Clinical Psychology by the European University Center and specific training in Infertility: Legal, Medical and Psychosocial Aspects by University of Valencia (UV) and ADEIT.
More information about Cristina Algarra Goosman
Member number: CV16874

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