What are ovaries?

• The ovaries are a pair of organs in the female reproductive system. They are located in the pelvis, one on each side of the uterus.
• Each ovary is about the size and shape of an almond.
• The ovaries produce eggs and female hormones.
• Every month during the menstrual cycle an egg is released from one ovary in a process called ovulation.
• The ovaries are also the main source of the female hormones estrogen and progesterone. These hormones influence the development of a woman's breasts, body shape, and body hair. They also regulate the menstrual cycle and pregnancy.

What are ovarian cysts?

• A cyst is a fluid-filled sac. Cysts can occur anywhere in the body, but many different types of cysts can form on the ovaries.
• Functional Ovarian Cyst:
• This is the most common type of ovarian cyst. Functional cysts often form during the normal menstrual cycle.
• Each month, a woman's ovaries grow tiny cysts that hold the eggs.
• When an egg is mature, the sac breaks open to release the egg for fertilization and then the sac dissolves.
• Follicular Ovarian Cyst:
• This is a type of functional cyst, however the sac doesn't break open and release an egg.
• Follicular cysts may continue to grow.
• This type of cyst usually disappears on its own in one to three months.
• Corpus Luteum Ovarian Cyst:
• This is another functional cyst that can occur if the egg is released and the sac seals off again. Fluid may continue to build inside this sac.
• Corpus luteum cysts usually go away on their own after a few weeks.
• Sometimes, these cysts can continue to grow. They may bleed, twist, or cause pain.
• Endometriomas:
• These cysts develop in women who have endometriosis. Endometriosis occurs when tissue from the lining of the uterus grows outside the uterus. This tissue may attach to the ovary and form a growth.
• These cysts can be painful during sexual intercourse and during menstruation (your period).
• Cystadenomas:
• These cysts develop from cells on the outer surface of the ovary.
• They are often filled with a watery fluid or a thick, sticky gel.
• They can become large and cause pain.
• Dermoid Cysts:
• The cells in the ovaries are able to make hair, teeth, and other growing tissues. Sometimes these cells can become part of a forming ovarian cyst.
• These cysts can become large and cause pain.
• Polycystic Ovaries:
• A woman with polycystic ovaries can have multiple small cysts present.
• The eggs mature within the follicles (or sacs) but the sac doesn't break open to release the egg. The cycle repeats, follicles continue to grow inside the ovary, and cysts form.

What are the symptoms of ovarian cysts?

• Many women have ovarian cysts without having any symptoms.
• Sometimes a cyst can cause the following problems:
• Pressure, fullness, or pain in the abdomen
• Dull ache in the lower back and thighs
• Problems passing urine completely
• Pain during sexual intercourse
• Weight gain
• Painful periods and abnormal bleeding
• Nausea or vomiting
• Breast tenderness
• If you have any of these symptoms, contact your doctor right away or consider going to the emergency room:
• Pain with fever and vomiting
• Sudden, severe abdominal pain
• Fainting, dizziness, or weakness
• Rapid breathing or shortness of breath

How are ovarian cysts found?

• Since ovarian cysts may not cause symptoms, they are usually found during a routine pelvic exam. Your healthcare provider may be able to feel the swelling of the cyst on your ovary.
• Once a cyst is found, an ultrasound may be done in order to see how the cyst is shaped, how big it is, where it is located, and whether it is fluid filled, solid, or mixed.

How are ovarian cysts treated?

• Watchful waiting:
• The patient waits and gets re-examined in one to three months to see if the cyst has changed in size or gone away.
• This is a common treatment for women who are in their childbearing years, have no symptoms, and have a fluid-filled cyst.
• This may also be an option for postmenopausal women with ovarian cysts.
• Birth control pills:
• If you frequently develop ovarian cysts your doctor may prescribe birth control pills to prevent you from ovulating.
• If you do not ovulate it lowers your chances of forming new cysts.
• Surgery:
• If the cyst does not go away after several menstrual periods, has gotten larger, looks unusual on the ultrasound, causes pain, or if you are postmenopausal your provider may want to remove the cyst.
• There are two main surgical procedures:
• Laparoscopy:  If the cyst is small and looks benign (not cancerous or suspicious for cancer) your doctor may perform laparoscopy. This procedure is done under general anesthesia. A very small incision is made near the navel (your belly button) and a small instrument is inserted. This instrument acts like a telescope and allows your doctor to see inside your abdomen. If the cyst is small and looks benign, it can be removed.
• Laparotomy:  If the cyst is large and looks suspicious the doctor may perform a procedure called laparotomy. This procedure involves making a bigger incision to remove the cyst. While you are under general anesthesia the doctor is able to have the cyst tested to find out if the tissue is abnormal or cancerous. If it is cancerous the doctor may need to remove the ovary and other tissues that may be affected, like the uterus or lymph nodes.

Can ovarian cysts be prevented?

• No, ovarian cysts cannot always be prevented.
• Sometimes we can decrease the formation of ovarian cysts with the use of birth control pills.
• Fortunately, the vast majority of ovarian cysts do not cause any symptoms, are not related to cancer, and go away on their own.