What Are Ovarian Cysts, and Do I Need to Get Them Treated?

These are so common, and with a little proactive care they don't have to be a big deal.
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These are so common, and with a little proactive care they don't have to be a big deal.
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Art Credit: Jay Gorman

Ovarian health isn't something to start worrying about only when you're thinking about having babies. Our ovaries play a primary role in fertilization. They produce eggs and hormones that regulate our menstrual cycle. But they can also be sources of pain—and even death—if they aren't functioning properly. As young women, it's important to inform ourselves to keep these almond-sized glands healthy. A great place to start is by learning about ovarian cysts.

Chances are you’ve heard of ovarian cysts before but might be fuzzy on what they actually are. You aren’t alone. A few of us at Verily have experienced ovarian cysts ourselves, and we were completely clueless when first diagnosed.

Ovarian cysts are quite common, so equip yourself to recognize the signs—some of which are harmless and others require medical attention. We talked to Amie E. Holmes, MD, OBGYN, a fellow at PPVI Institute for the Study of Human Reproduction at Creighton University Medical School, to get the scoop on what you need to know about ovarian cysts.

WHAT ARE OVARIAN CYSTS?

An ovarian cyst is a sac that forms in the ovary and is typically filled with fluid or tissue, says The American College of Obstetricians and Gynecologists.

 They are more common than you might think. “Women who are cycling normally form an ovarian cyst every cycle prior to ovulation as the follicle [the structure where eggs mature] develops,” says Dr. Holmes. This type of cyst typically ruptures, forms a temporary structure called the corpus luteum that supplies progesterone hormones to the body and generally does not cause any harm or pain.

Functional Ovarian Cysts

Experts at The Mayo Clinic say the most commonly occurring cyst is called a functioning cyst. These form when a follicle in your ovary grows for longer than normal during your menstrual cycle. Delayed or abnormal ovulation can result in this type of cyst. Some functioning cysts disappear on their own. For the ones that don't, “these cysts tend to resolve with progesterone administration,” says Dr. Holmes. Your gynecologist can recommend the best treatment.

Other Ovarian Growths

There are other types of ovarian cysts caused by other conditions. Some can be noncancerous (benign) growths while others can be related to cancer. A neoplastic cyst contains cells that are deemed abnormal. Endometrioma is an ovarian cyst that can develop if tissue inside your uterus begins to grow outside it. Neoplastic cysts and endometriomas can be harmful and require some type of treatment, such as minimally invasive surgery (more on this below).  

WHEN SHOULD I BE CONCERNED?

Most functioning cysts are small and considered harmless. In fact, experts at Johns Hopkins University say that these types of benign cysts typically disappear on their own after a few months. If a cyst is dysfunctional, however, common symptoms include: abdominal pressure (feeling full quickly) or ache, irregular menstrual cycles, unusual hair growth on the face or body, and sharp pelvic pain accompanied by nausea (if the cyst twists or ruptures). If you experience any of these symptoms, set an appointment with your gynecologist to discuss your concerns. These symptoms may be related to other reproductive-related issues such as a hormone imbalance or PMS so be sure to go through all your symptoms with your doctor.

HOW WILL MY DOCTOR DIAGNOSE A POSSIBLE CYST?

A doctor may use one of several common methods of diagnosis, depending on the symptoms you report. These include a pelvic exam, pelvic ultrasound, or laparoscopy [inserting a fiber-optic instrument into the abdomen to view the organs inside]. “Your gynecologist may also order blood tests, such as a CA-125, if the exam or ultrasound results show a cyst that looks abnormal,” says Dr. Holmes. These tests will give your gynecologist a better idea of what type of cyst you have so that he or she can recommend the best type of treatment.

HOW WILL MY DOCTOR TREAT MY CYST?

It all depends on the type and severity of your cyst. For benign cysts, hormonal treatment, such as progesterone administration, is the treatment of choice, says Dr. Holmes. If the cyst does not resolve itself within three months, then your gynecologist will typically recommend minimally invasive surgery to remove the cyst.

If your gynecologist determines that you have a neoplastic cyst or endometrioma, she will likely recommend surgery to remove the cyst, says Dr. Holmes. Some gynecologists may offer to drain the endometrioma instead of removing it, but she warns that there is a high recurrence rate with this treatment method. If your gynecologist recommends surgery, be sure to discuss what type of surgery is needed and any concerns you have about potentially preserving fertility, she advises.

WHAT ABOUT OVARIAN CANCER?

According to Dr. Holmes, “Ovarian cancer occurs more frequently in older women and those who have a family history of breast cancer or ovarian cancer. Symptoms of ovarian cancer, such as bloating, feeling full quickly, and fatigue, are vague and are generally associated with a late-stage of the disease.” Ovarian tumors and ovarian cysts share many of the same symptoms. So if you experience any of these symptoms or have a family history of ovarian or breast cancer, Dr. Holmes recommends sharing your concerns with your gynecologist who can recommend the best next steps.

Paying attention to your body and making note of any changes, particularly keeping track of your cycle, is a great way to take charge of your reproductive health. Keep an eye out for symptoms and take the time to find out about your family history regarding ovarian cysts, ovarian cancer, and breast cancer. By being proactive, you’ll be better able to prevent future problems and make sure you get the best possible care.