Ovarian Cysts

Types of Ovarian Cysts ~ Symptoms ~ Diagnosis ~ Treatment ~ Treatment Options ~ Prevention

Ovarian cysts are fluid filled sacs (similar to blisters) that form on the ovaries. The ovaries are two small organs (one on each side of your womb) that produce hormones and an egg each month. Ovarian cysts are very common in women during their reproductive years. When an ovarian cyst is found, the first important decision to be made is whether this cyst will go away without treatment. Spontaneous resolution is expected and normal for the functional cysts related to ovulation. Women with healthy ovaries normally release an egg from a small ovarian cyst each month. The small cyst becomes a corpus lutem cyst and then lasts for two to three weeks waiting to support a new pregnancy. If pregnancy does not occur, the woman will experience a menstrual period as part of the process of the disappearing corpus lutem cyst. These normal cysts, also called functional cysts, are usually only two to three centimeters in size buy may reach six to eight centimeters if filled with blood or extraordinary amounts of fluid.

Functional cysts uniformly resolve in the span of one to two menstrual cycles and so can be identified by their disappearing behavior. Their presence explains why reproductive age (not yet menopausal) women have small cysts in the ovary all the time. What is not as common are functional cysts that grow so fast as to cause pain, or so large as to be easily felt on exam.


Types of Ovarian Cysts
Most ovarian cysts are noncancerous (benign). Although ovarian cysts may cause symptoms that require treatment, they usually don't spread to other parts of the body.

Functional/Normal Cyst
A functional cyst is the most common type. During each cycle your ovary creates a cyst-like structure called a follicle, which contains an egg. The follicle breaks open and your egg is released from the ovary; the follicle then dissolves. If the follicle does not dissolve, as it should, a functional cyst may form. Functional cysts usually do not cause symptoms and disappear on their own within 1-3 menstrual cycles.

A dermoid is a cyst filled with various types of tissue, such as hair and skin.

A cystadenoma is a cyst that develops from cells on the outer surface of your ovary.

Endometrial/Chocolate Cyst
Sometimes patches of cells (endometrial cells), which should only be found in the lining of your uterus (womb), appear outside of your uterus. This condition is called endometriosis. When endometrial cells are found on your ovary, they may cause an endometrial cyst to grow. This cyst is sometimes called a chocolate cyst because of the dark, red-brown blood inside of it.

Polycystic Ovarian Disease
Polycystic ovarian disease occurs if functional/normal cysts do not dissolve. Instead, these cysts build up, creating a thick outer cover over the ovary, which may prevent ovulation (the release of an egg) and cause irregular bleeding and/or infertility.


Ovarian cysts do not usually cause any symptoms. However, when symptoms do occur, they may include:

Symptoms are caused by: 

Pelvic Exam

Ovarian cysts are often felt by your health care provider during a pelvic exam. If your provider detects what she/he thinks may be a an abnormal ovarian growth, other tests may be performed to confirm its presence -- even if you have no symptoms.

Ultrasound is a test in which sound waves are used to create pictures of the organs found inside of your body. An electronic device is moved over the abdomen; images are viewed on a TV-like screen.

Laparoscopy is a surgical procedure that allows a doctor to look inside of your abdominal cavity, where your pelvic organs (uterus, ovaries, fallopian tubes) are located. A slender instrument with a light and a telescope-like lens (laparoscope) is passed through a small incision made below your belly button.
During this procedure, your doctor may: 


Treatment for ovarian cysts depends upon:

* If you are over the age of 40 (premenopause), your risk of ovarian cancer increases, therefore treatment may be more aggressive. 
* Functional cysts, which usually go away on their own, are not usually found in women who have begun menopause. 

Treatment Options

  1. Cyst doesn't go away after a few menstrual periods
  2. Cyst does not go away after treatment with hormones
  3. Cyst is very large
  4. Symptoms (pain, bleeding) are severe
  5. Cyst becomes twisted, which blocks blood flow to the ovary and causes severe pain 

Although there's no definite way to prevent the growth of ovarian cysts, regular pelvic examinations can help ensure that changes in your ovaries are diagnosed as early as possible. In addition, be alert to changes in your monthly cycle, including symptoms that may accompany menstruation that aren't typical for you or that persist over more than a few cycles. Talk with your doctor about any concerns relating to menstruation.


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