Ovarian cyst
Encyclopedia
An ovarian cyst is any collection of fluid, surrounded by a very thin wall, within an ovary
. Any ovarian follicle
that is larger than about two centimeters is termed an ovarian cyst. An ovarian cyst can be as small as a pea
, or larger than an orange.
Most ovarian cysts are functional in nature and harmless (benign
). In the US, ovarian cysts are found in nearly all premenopausal women, and in up to 14.8% of postmenopausal women.
Ovarian cysts affect women of all ages. They occur most often, however, during a woman's childbearing years.
Some ovarian cysts cause problems, such as bleeding and pain. Surgery may be required to remove cysts larger than 5 centimeters in diameter.
that are described as types of cyst
s, but are not usually grouped with the functional cysts. (Some of these are more commonly or more properly known by other names.) These include:
may be present, though it is possible not to experience any symptoms:
or CT scan.
, meaning they are not cancerous.
Treatment for cysts depends on the size of the cyst and symptoms.
Pain caused by ovarian cysts may be treated with:
Also, limiting strenuous activity may reduce the risk of cyst rupture or torsion.
Cysts that persist beyond two or three menstrual cycle
s, or occur in post-menopausal women, may indicate more serious disease and should be investigated through ultrasonography and laparoscopy
, especially in cases where family members have had ovarian cancer
. Such cysts may require surgical biopsy
. Additionally, a blood test
may be taken before surgery to check for elevated CA-125
, a tumor marker
, which is often found in increased levels in ovarian cancer, although it can also be elevated by other conditions resulting in a large number of false positives.
For more serious cases where cysts are large and persisting, doctors may suggest surgery. Some surgeries can be performed to successfully remove the cyst(s) without hurting the ovaries, while others may require removal of one or both ovaries.
Ovary
The ovary is an ovum-producing reproductive organ, often found in pairs as part of the vertebrate female reproductive system. Ovaries in anatomically female individuals are analogous to testes in anatomically male individuals, in that they are both gonads and endocrine glands.-Human anatomy:Ovaries...
. Any ovarian follicle
Ovarian follicle
Ovarian follicles are the basic units of female reproductive biology, each of which is composed of roughly spherical aggregations of cells found in the ovary. They contain a single oocyte . These structures are periodically initiated to grow and develop, culminating in ovulation of usually a single...
that is larger than about two centimeters is termed an ovarian cyst. An ovarian cyst can be as small as a pea
Pea
A pea is most commonly the small spherical seed or the seed-pod of the pod fruit Pisum sativum. Each pod contains several peas. Peapods are botanically a fruit, since they contain seeds developed from the ovary of a flower. However, peas are considered to be a vegetable in cooking...
, or larger than an orange.
Most ovarian cysts are functional in nature and harmless (benign
Benign
A benign tumor is a tumor that lacks the ability to metastasize. Common examples of benign tumors include moles and uterine fibroids.The term "benign" implies a mild and nonprogressive disease. Indeed, many kinds of benign tumors are harmless to human health...
). In the US, ovarian cysts are found in nearly all premenopausal women, and in up to 14.8% of postmenopausal women.
Ovarian cysts affect women of all ages. They occur most often, however, during a woman's childbearing years.
Some ovarian cysts cause problems, such as bleeding and pain. Surgery may be required to remove cysts larger than 5 centimeters in diameter.
Non-functional cysts
There are several other conditions affecting the ovaryOvary
The ovary is an ovum-producing reproductive organ, often found in pairs as part of the vertebrate female reproductive system. Ovaries in anatomically female individuals are analogous to testes in anatomically male individuals, in that they are both gonads and endocrine glands.-Human anatomy:Ovaries...
that are described as types of cyst
Cyst
A cyst is a closed sac, having a distinct membrane and division on the nearby tissue. It may contain air, fluids, or semi-solid material. A collection of pus is called an abscess, not a cyst. Once formed, a cyst could go away on its own or may have to be removed through surgery.- Locations :* Acne...
s, but are not usually grouped with the functional cysts. (Some of these are more commonly or more properly known by other names.) These include:
- Dermoid cystDermoid cystA dermoid cyst is a cystic teratoma that contains developmentally mature skin complete with hair follicles and sweat glands, sometimes clumps of long hair, and often pockets of sebum, blood, fat, bone, nails, teeth, eyes, cartilage, and thyroid tissue. Because it contains mature tissue, a dermoid...
- Chocolate cyst of ovaryChocolate cyst of ovaryAn endometrioma, endometrioid cyst, endometrial cyst, or chocolate cyst of ovary is a condition related to endometriosis.-Pathophysiology:...
: An endometrioma, endometrioid cyst, endometrial cyst, or chocolate cyst is caused by endometriosisEndometriosisEndometriosis is a gynecological medical condition in which cells from the lining of the uterus appear and flourish outside the uterine cavity, most commonly on the ovaries. The uterine cavity is lined by endometrial cells, which are under the influence of female hormones...
, and formed when a tiny patch of endometrial tissue (the mucous membraneMucous membraneThe mucous membranes are linings of mostly endodermal origin, covered in epithelium, which are involved in absorption and secretion. They line cavities that are exposed to the external environment and internal organs...
that makes up the inner layer of the uterine wall) bleeds, sloughs off, becomes transplanted, and grows and enlarges inside the ovaries.
- A polycystic-appearing ovary is diagnosed based on its enlarged size — usually twice normal —with small cysts present around the outside of the ovary. It can be found in "normal" women, and in women with endocrine disorders. An ultrasoundUltrasoundUltrasound is cyclic sound pressure with a frequency greater than the upper limit of human hearing. Ultrasound is thus not separated from "normal" sound based on differences in physical properties, only the fact that humans cannot hear it. Although this limit varies from person to person, it is...
is used to view the ovary in diagnosing the condition. Polycystic-appearing ovaryOvaryThe ovary is an ovum-producing reproductive organ, often found in pairs as part of the vertebrate female reproductive system. Ovaries in anatomically female individuals are analogous to testes in anatomically male individuals, in that they are both gonads and endocrine glands.-Human anatomy:Ovaries...
is different from the polycystic ovarian syndrome, which includes other symptoms in addition to the presence of ovarian cysts. - Ovarian serous cystadenomaOvarian serous cystadenomaOvarian serous cystadenoma, also known as serous cystadenoma, is a very common benign ovarian tumour.It has a very superficial resemblance to the most common type of ovarian cancer under the microscope; however, it is virtually impossible to mix-up with its malignant counterpart , and does not...
- Ovarian mucinous cystadenomaMucinous cystadenomaMucinous cystadenoma is a type of tumor in the cystadenoma grouping.There are four major categories of ovarian tumors:1. Epithelial tumors - serous or mucinous cystadenoma/carcinoma, clear cell carcinoma, Brenner tumor...
Signs and symptoms
Some or all of the following symptomsmay be present, though it is possible not to experience any symptoms:
- Dull aching, or severe, sudden, and sharp pain or discomfort in the lower abdomenAbdomenIn vertebrates such as mammals the abdomen constitutes the part of the body between the thorax and pelvis. The region enclosed by the abdomen is termed the abdominal cavity...
(one or both sides), pelvisPelvisIn human anatomy, the pelvis is the lower part of the trunk, between the abdomen and the lower limbs .The pelvis includes several structures:...
, vaginaVaginaThe vagina is a fibromuscular tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. Female insects and other invertebrates also have a vagina, which is the terminal part of the...
, lower back, or thighs; pain may be constant or intermittent—this is the most common symptom - Fullness, heaviness, pressure, swelling, or bloatingBloatingBloating is any abnormal general swelling, or increase in diameter of the abdominal area. As a symptom, the patient feels a full and tight abdomen, which may cause abdominal pain sometimes accompanied by increased borborygmus or more seriously the total lack of borborygmus.-Symptoms:The most common...
in the abdomen - Breast tenderness
- Pain during or shortly after beginning or end of menstrual period.
- Irregular periods, or abnormal uterine bleeding or spotting
- Change in frequency or ease of urinationUrinationUrination, also known as micturition, voiding, peeing, weeing, pissing, and more rarely, emiction, is the ejection of urine from the urinary bladder through the urethra to the outside of the body. In healthy humans the process of urination is under voluntary control...
(such as inability to fully empty the bladderUrinary bladderThe urinary bladder is the organ that collects urine excreted by the kidneys before disposal by urination. A hollow muscular, and distensible organ, the bladder sits on the pelvic floor...
), or difficulty with bowel movements due to pressure on adjacent pelvic anatomy - Weight gain
- Nausea or vomiting
- FatigueFatigue (physical)Fatigue is a state of awareness describing a range of afflictions, usually associated with physical and/or mental weakness, though varying from a general state of lethargy to a specific work-induced burning sensation within one's muscles...
- InfertilityInfertilityInfertility primarily refers to the biological inability of a person to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term...
- Increased level of hair growth
- Increased facial hairFacial hairFacial hair is a secondary sex characteristic of human males. Men often start developing facial hair in the later years of puberty or adolescence, approximately between 17–20 years of age, and most do not finish developing a fully adult beard until their early 20s or even later...
or body hair - Headaches
- Strange pains in ribs, which feel muscular
- Bloating
- Strange nodules that feel like bruises under the layer of skin
Diagnosis
Ovarian cysts are usually diagnosed by either ultrasoundUltrasound
Ultrasound is cyclic sound pressure with a frequency greater than the upper limit of human hearing. Ultrasound is thus not separated from "normal" sound based on differences in physical properties, only the fact that humans cannot hear it. Although this limit varies from person to person, it is...
or CT scan.
Treatment
About 95% of ovarian cysts are benignBenign
A benign tumor is a tumor that lacks the ability to metastasize. Common examples of benign tumors include moles and uterine fibroids.The term "benign" implies a mild and nonprogressive disease. Indeed, many kinds of benign tumors are harmless to human health...
, meaning they are not cancerous.
Treatment for cysts depends on the size of the cyst and symptoms.
Pain caused by ovarian cysts may be treated with:
- pain relievers, including acetaminophen/paracetamol (TylenolTylenolTylenol is a North American brand of drugs advertised for reducing pain, reducing fever, and relieving the symptoms of allergies, cold, cough, and flu. The active ingredient of its original, flagship product, paracetamol , is marketed as an analgesic and antipyretic...
), nonsteroidal anti-inflammatory drugs such as ibuprofenIbuprofenIbuprofen is a nonsteroidal anti-inflammatory drug used for relief of symptoms of arthritis, fever, as an analgesic , especially where there is an inflammatory component, and dysmenorrhea....
(Motrin, AdvilAdvilAdvil is a brand of ibuprofen, a nonsteroidal anti-inflammatory drug . Advil is manufactured by Pfizer and has been on the market since 1984.-History:...
), or narcoticNarcoticThe term narcotic originally referred medically to any psychoactive compound with any sleep-inducing properties. In the United States of America it has since become associated with opioids, commonly morphine and heroin and their derivatives, such as hydrocodone. The term is, today, imprecisely...
pain medicine (by prescription) may help reduce pelvic pain. NSAIDs usually work best when taken at the first signs of the pain.
- a warm bath, or heating padHeating padA heating pad is a pad used for warming of parts of the body in order to manage pain. Localized application of heat causes the blood vessels in that area to dilate, enhancing perfusion to the targeted tissue...
, or hot water bottleHot water bottleA hot water bottle is a container filled with hot water and sealed with a stopper, used to provide warmth, typically whilst in bed, but also for the application of heat to a specific part of the body....
applied to the lower abdomen near the ovaries can relax tense muscles and relieve cramping, lessen discomfort, and stimulate circulation and healing in the ovaries. Bags of ice covered with towels can be used alternately as cold treatments to increase local circulation.
- combined methods of hormonal contraceptionHormonal contraceptionHormonal contraception refers to birth control methods that act on the endocrine system. Almost all methods are composed of steroid hormones, although in India one selective estrogen receptor modulator is marketed as a contraceptive. The original hormonal method—the combined oral contraceptive...
such as the combined oral contraceptive pill – the hormones in the pills may regulate the menstrual cycle, prevent the formation of follicles that can turn into cysts, and possibly shrink an existing cyst. (American College of Obstetricians and Gynecologists, 1999c; Mayo Clinic, 2002e)
Also, limiting strenuous activity may reduce the risk of cyst rupture or torsion.
Cysts that persist beyond two or three menstrual cycle
Menstrual cycle
The menstrual cycle is the scientific term for the physiological changes that can occur in fertile women for the purpose of sexual reproduction. This article focuses on the human menstrual cycle....
s, or occur in post-menopausal women, may indicate more serious disease and should be investigated through ultrasonography and laparoscopy
Laparoscopy
Laparoscopy is an operation performed in the abdomen or pelvis through small incisions with the aid of a camera...
, especially in cases where family members have had ovarian cancer
Ovarian cancer
Ovarian cancer is a cancerous growth arising from the ovary. Symptoms are frequently very subtle early on and may include: bloating, pelvic pain, difficulty eating and frequent urination, and are easily confused with other illnesses....
. Such cysts may require surgical biopsy
Biopsy
A biopsy is a medical test involving sampling of cells or tissues for examination. It is the medical removal of tissue from a living subject to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically...
. Additionally, a blood test
Blood test
A blood test is a laboratory analysis performed on a blood sample that is usually extracted from a vein in the arm using a needle, or via fingerprick....
may be taken before surgery to check for elevated CA-125
CA-125
CA-125 also known as mucin 16 or MUC16 is a protein that in humans is encoded by the MUC16 gene. MUC16 is a member of the mucin family glycoproteins...
, a tumor marker
Tumor marker
A tumor marker is a substance found in the blood, urine, or body tissues that can be elevated in cancer, among other tissue types. There are many different tumor markers, each indicative of a particular disease process, and they are used in oncology to help detect the presence of cancer...
, which is often found in increased levels in ovarian cancer, although it can also be elevated by other conditions resulting in a large number of false positives.
For more serious cases where cysts are large and persisting, doctors may suggest surgery. Some surgeries can be performed to successfully remove the cyst(s) without hurting the ovaries, while others may require removal of one or both ovaries.