Ovarian Cysts

Women's Health and Childbirth

An ovarian cyst occurs when fluid collects in a sac or pocket in or on the surface of an ovary. The ovaries are the reproductive organs found on both sides of the uterus that produce eggs and the hormones estrogen and progesterone. Ovarian cysts are common and most women will have ovarian cysts at least once during their lives. These cysts are typically painless and symptomless. However, in rare cases, a cyst will burst and cause sudden and severe abdominal pain requiring medical intervention. Some ovarian cysts may be cancerous. If you are concerned you have an ovarian cyst and it is causing you discomfort, make an appointment with your primary care provider to help treat your symptoms.

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Symptoms

If you have an ovarian cyst, you may not feel any symptoms. However, large cysts may cause signs and symptoms. These include:

  • Bloating
  • Pelvic pain
  • Feeling the urge to have a bowel movement
  • Heaviness in the abdomen
  • Abdominal pain (may radiate to the low back)
  • Pain during sexual intercourse
  • Nausea and vomiting

Types

Functional cysts. The most common type of ovarian cyst. These develop from changes in tissue during ovulation. There are two types of functional cysts, follicle and corpus luteum. Both typically do not produce symptoms and go away within a few weeks or months.

Dermoid cysts. These are made up of different tissues, such as skin, hair, teeth, fat, or nails. They can be found in both ovaries and usually are small. If they grow large, they can cause symptoms.

Cystadenomas. These cysts will grow on the outer surface of the ovaries. Usually benign, cystadenomas can be quite large and can cause pain.

Endometriomas. Linked with endometriosis. These are formed from endometrial tissue that grows in the ovaries responding to hormonal fluctuations that occur monthly. These types of cysts are filled with dark, reddish-brown blood.

Risk Factors

  • Infertility treatment
  • Pregnancy
  • Hypothyroidism
  • Smoking tobacco
  • Tubal ligation
  • Tamoxifen (breast cancer treatment medication)
  • Postmenopausal women at higher risk for malignancy-related cyst

Diagnosis

Ovarian cysts are often found during a routine pelvic exam. During this exam, your doctor will ask about any symptoms you are having, take a thorough medical history, and give you a pelvic exam.  Some cysts are found during the pelvic exam when the doctor feels a lump or lumps when palpating your reproductive organs.  If your doctor is concerned you have a cyst, you may be asked to get the following tests:

Blood tests. These tests measure levels of hormones. The tests also can measure CA 125, a protein biomarker produced by certain types of ovarian cancer.

Pregnancy test. Rules out pregnancy. Ectopic pregnancy can produce the same symptoms as ovarian cysts. This is a medical emergency in which a fertilized egg implants in the fallopian tube and may burst.

Imaging tests. These tests are used to determine the shape, location, composition (fluid or solid filled), and size of the cyst or cysts. Different imaging tools used to diagnose ovarian cysts include:

  • Ultrasound
  • Computerized tomography (CT)
  • Magnetic resonance imaging (MRI)

Treatments

Cysts that do not produce symptoms are usually monitored without any treatment or intervention. Many cysts will go away on their own within a few weeks or months. If the cysts are causing you discomfort, your doctor may recommend non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen.  Your doctor will ask you to get another ultrasound after several weeks to see if the cyst has disappeared. If there are no changes, your doctor may order tests to rule out other conditions. If your doctor is concerned that the cyst is cancerous, you may be asked to get a biopsy. Recurrent ovarian cysts respond to oral contraceptives by preventing ovulation and the development of new cysts. In other cases, you may need to have the cyst removed. The following procedures may be ordered:

Laparoscopy. In this procedure, a small incision is made near your navel where the surgeon uses a small instrument in your abdomen to remove the cyst.

Laparotomy. This surgery is performed if the cyst is large. The surgeon makes a large incision in the abdomen to remove the cyst. During this surgery, the cyst is immediately biopsied to determine if it is cancerous. If it is cancerous, the surgeon may perform a hysterectomy to remove the ovaries and uterus.

Alternative Treatments and Home Remedies

Many people will choose to use an alternative treatment, such as anherbal remedy or a nutritional supplement to help them with symptoms.If you are interested in taking an alternative treatment be sure to tell your doctor to make sure it does not interact with any medications. Alternative treatments for ovarian cysts include:

Acupuncture. Studies have shown that acupuncture can help women with cysts associated with endometriosis by helping to shrink the endometrioma and improve fertility.

Epsom salt bath. Hot baths can help you relax and ease the pain. Epsom salts added to the bath are an added form of relief due to their effect of helping with aches and pains.

Heat therapy. Placing a heating pad or hot water bottle over your lower abdomen can help relieve the pain related to a cyst and menstrual cramping.

Magnesium. Supplementing with magnesium can help with chronic pain. Magnesium is found in high concentrations in almonds, spinach, seeds, and whole grains.

Herbal teas. Non-caffeinated herbal teas can help relax tension and relieve uncomfortable symptoms related to the cysts. Chamomile tea has anti-inflammatory properties that can help reduce anxiety. Other herbal teas that may help are those that contain ginger, maca root, red clover, and dandelion.

Massage. The surrounding muscles around the cyst can become very sore or tense, especially during your period. Massaging your lower back, stomach, thighs, and buttocks can release tension and alleviate pain.

Lifestyle Changes

  • Keep a healthy weight (lowers risk for polycystic ovarian syndrome)
  • Do not smoke
  • Schedule regular visits with your gynecologist
  • Begin a regular exercise routine and incorporate stretching
  • Reduce sugar and unhealthy fat intake

References

Higuera, V. (2015, June 15). Ovarian cysts. Retrieved from Healthline: https://www.healthline.com/health/ovarian-cysts

Iglesia, C. B. (2019, April 01). Ovarian cysts. Retrieved from Office on Women’s Health: https://www.womenshealth.gov/a-z-topics/ovarian-cysts

Marcin, A. (2019, March 07). 11 home treatments for ovarian cyst symptoms. Retrieved from Healthline: https://www.healthline.com/health/womens-health/ovarian-cyst-treatment-at-home

Mayo Clinic Staff. (2020, August 26). Ovarian cysts. Retrieved Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/ovarian-cysts/symptoms-causes/syc-20353405

Mobeen S., & Apostol R. (2020, July 08). Ovarian Cysts. StatPearls. Retreated from National Institutes of Health: https://www.ncbi.nlm.nih.gov/books/NBK560541/#_NBK560541_pubdet_

Stöppler, M. C. (2019, September 11). Ovarian cysts: Symptoms, causes, types, and treatment. Retrieved from MedicineNet:https://www.medicinenet.com/ovarian_cysts/article.htm

Zhu, J. (2018, March 15). Acupuncture treatment of subfertility and ovarian endometrioma. Open Access Macedonian Journal of Medical Sciences, 6(3), 519-522. Retrieved from National Institutes of Health: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874376/

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