Ovarian Cysts 101

Ovarian cysts: they’re not something anyone really chooses to think about if they don't have to. Nonetheless, at least 10% of women experience ovarian cysts.

Simply put, ovarian cysts are fluid-filled pouches that develop within or on the surface of your ovaries. Many people with ovaries don't even realize they're there because benign cysts can be asymptomatic and a lot of the time they resolve on their own without treatment in the course of a few menstrual cycles. Other times, they can cause a bit of discomfort but will still go away on their own. Sometimes, though, they can grow too large and/or rupture and/or cause severe pain. In very rare cases, they could become cancerous.

While ovarian cysts are pretty common and typically not dangerous, without proper knowledge, they can at times lead to fertility issues, hormonal imbalances, and even medical emergencies. Recognizing and understanding the symptoms of cysts can go a long way toward heading off problems before they get serious—and maybe even preventing them from occurring in the first place.

Symptoms of ovarian cysts

Although most ovarian cysts are benign and asymptomatic, if you happen to have a larger one, you might experience one or more of the following symptoms:

- On-and-off pelvic pain

- Painful sex, sometimes just with deeper penetration, or just on one side

- A dull ache or sharp pain in the area below your navel toward one side

- Fullness, pressure or heaviness in your abdomen

- Bloating

- Cramping

If any of these symptoms are sudden or severe, or you experience fever or vomiting as well, seeking the immediate advice of a doctor is 100% the way to go.

Types of ovarian cysts

Not all ovarian cysts are created equal. There are several types, and they include the following:

Functional cysts

By far the most common type of ovarian cyst, functional cysts are most often harmless, and they form in the course of a regular menstrual cycle. They are typically benign and often resolve on their own. The two subtypes of functional cysts are follicular cysts and corpus luteum cysts.

- Follicular cysts occur when a follicle (a fluid-filled sac containing an immature egg) fails to release an egg during ovulation. Instead of rupturing to release the egg, the follicle keeps growing, forming a cyst.

- Corpus luteum cysts develop after the release of an egg during ovulation. The empty follicle, known as the corpus luteum normally shrinks. If, however, it fills with fluid and doesn't break down, it can become a cyst.

Dermoid cysts

Usually benign, dermoid cysts, AKA mature cystic teratomas can contain a range of tissues including hair, skin, and teeth and even parts of other organs like eyes or thyroid tissue—strange but true. Dermoid cysts develop from germ cells, which are present at your time of birth, believe it or not. In some cases, these germ cells become trapped and, over time, develop into cysts.

Endometriomas

AKA chocolate cysts, endometriomas form when endometrial tissue grows on the ovaries in a condition known as endometriosis. They contain old blood, giving them their “chocolate” hue. Whether or not they require treatment depends on various factors, including the size of the cysts, whether they cause pain or not, and your fertility goals.

Cystadenomas

Cystadenomas tend to develop on the surface of the ovaries. They are characterized by the presence of a cystic sac filled with fluid or mucus-like material. Most cystadenomas are benign, although they can sometimes grow large enough that they cause discomfort, pain, or other complications.

Polycystic ovary syndrome (PCOS)

PCOS is a common hormonal imbalance which affects an estimated 8–13% of reproductive-aged women. The condition causes multiple small cysts to form on the ovaries, which, in turn, can lead to irregular menstrual cycles, excess androgens (male hormones), and a higher risk of diabetes, among other health and fertility concerns. Believed to be caused by a combination of genetic and environmental factors, PCOS is the most common cause of anovulation and a leading cause of infertility. Treatment can include lifestyle changes, hormone therapy, and medication.

Possible complications

While they don't happen very often, complications can occur, even with benign ovarian cysts.

These include:

Ovarian torsion

A cyst that gets too large can cause your ovary to move, increasing the chances of it twisting painfully—a phenomenon known as torsion. If this happens, you may experience sudden, severe pelvic pain, nausea, and vomiting. Ovarian torsion can also reduce or stop blood flow to the ovary. Torsion is considered a medical emergency.

Cyst rupture

A cyst that bursts or ruptures can cause severe pain and bleeding inside the pelvis. There is a greater risk of this happening with larger cysts. Vigorous activity that affects the pelvis, like vaginal sex, can also increase the chances of rupture. But whether rupture is considered an emergency or not depends on your symptoms. For instance, if you experience severe, sudden abdominal or pelvic pain, heavy vaginal bleeding, dizziness, or fainting, seek immediate medical attention. On the other hand, if you experience sudden pain that subsides quickly with little or no bleeding, you may be okay to monitor the situation closely at home.

Treatment of ovarian cysts

Many doctors adopt the wait-and-see approach, particularly with functional cysts. You may be told to wait a few weeks (or until after your period) and come back for an ultrasound to see if the cyst has gone away by itself. It can take anywhere from 4 weeks to 3 months for a cyst to disappear, but you should feel relief from any symptoms you have as it heals.

If you have been through menopause, your doctor may recommend an ultrasound and blood tests just to rule out anything malignant, as post-menopausal women have a higher risk of ovarian cancer.

If you have a persistent or recurring ovarian cyst, one that is large, or you’re experiencing severe symptoms, surgical removal may be the way to go. However, surgery for ovarian cysts is treated as a last resort and is usually only recommended if tests show a risk of cancer.

Ovarian cyst prevention

According to doctors, there’s no way to prevent most ovarian cysts. But, regular pelvic exams can certainly help ensure that any changes in your ovaries are checked out as early as possible.

Keeping track of changes in your menstrual cycle can also be a help. Make a note of any unusual symptoms, especially ones that go on for more than a few cycles.

If you’re looking for a way to treat the root causes of a hormonal imbalance and are not finding the help you need within the healthcare system, there is growing evidence to show that a range of different natural health practitioners—from acupuncturists, to osteopaths, and naturopaths—may be of help managing the symptoms of ovarian cysts, or even eliminating their occurrence altogether. Plus, as a baseline, a hormone-happy diet and a stable sleep schedule can also go a long way toward helping you reach peak hormonal health.

You got this. <3