Ovarian cysts are fluid-filled sacs commonly seen in women during their reproductive years. Most types of ovarian cysts are harmless and can go away without any treatment. The normal function of the ovaries is to produce an egg each month. During the process of ovulation, a cyst-like structure called a follicle is formed inside the ovary. The mature follicle ruptures when an egg is released during ovulation. A corpus luteum forms from the empty follicle, and if pregnancy does not occur, the corpus luteum dissolves. Sometimes, however, this process does not conclude appropriately, causing the most common type of ovarian cyst, the functional ovarian cysts. Abnormal ovarian cysts may result from an imbalance of female hormones (oestrogen and progesterone).
Ovarian cysts often cause no symptoms; however, when symptoms are present, ovarian cysts may cause a dull ache or a sense of fullness or pressure in the abdomen. Pain during intercourse and at other times can also indicate the presence of ovarian cysts. Pain or pressure is caused by a number of factors, such as size, bleeding or bursting of a cyst. Pain can also be caused when a cyst is twisted (ovarian torsion), which can block the blood flow to the ovary. Other possible symptoms of ovarian cysts include delayed, irregular, or unusually painful periods.
Diagnosis may require a gynaecology scan, blood tests, tumour markers (CA125) and other special imaging tools (CT, MRI).
Treatment of ovarian cysts depends on several factors, including:
- The size and type of cyst
- Age and general health
- Future pregnancy plans
- Current symptoms
Generally, the earlier ovarian cysts are found, the less invasive the treatment.
Expectant management with a repeat ultrasound scan in 2-3 months to see whether the cyst disappears on its own.
Medical treatment may include pain killers and hormonal drugs (contraceptive pill) to try and shrink the cyst. A repeat scan will help identify the success of such method.
Surgical treatment includes removal of the cyst (cystectomy) usually via minimally invasive technique (laparoscopy). Occasionally removal of the ovary may be required.
In the presence of any suspicious findings during diagnosis suggesting malignancy (cancer), additional special tests will be required (blood tests, serum tumour markers, MRI, etc) and expert oncology opinion should be sought.