What is Ovarian Cyst?

Almost all women have had an ovarian cyst. It is very common. For most, they don’t even feel it. 

In this article, we will discuss ovarian cysts. We will explain why it happens, signs and symptoms, different types and most important, treatment. Let us first start by understanding the significance of the ovary. 

Ovary – Meaning

The ovary is a part of the female reproductive system. There are two ovaries. The ovaries are on either side of the uterus. It has two main functions. One, it produces eggs for fertilization. Two, it produces the reproductive hormones; estrogen and progesterone. 

Proper functioning of the ovary is crucial for a woman’s fertility. Any issue with the ovary may cause fertility issues. One of the problems is an ovarian cyst. Let us learn more about it in the next section.

Ovarian Cyst Meaning

A cyst is an abnormal sac in the body made of a thin membrane. In it either fluid or semisolid material is present. An ovarian cyst is an abnormal cyst that is formed in the uterus. 

The severity of the problem depends on the size, substance and cause. In rearrest of the rare case, it can be cancerous. 

Types of Ovarian Cyst

The type of ovarian cyst depends on the substance inside it. Also, it is based on the degree of concern. The two types are: –

Functional ovarian cysts

They occur in the follicle which forms and releases the egg. The cyst is formed when the follicle grows but do not rupture to release the egg. If the fluid is left behind in the tissue after it is ruptured then also it can form a cyst.

It is also called a simple cyst. They are more common. Filled with water. It happens due to minor problems during the menstrual cycle. It may come and go and the woman will not feel any symptoms. They are not usually a concern. It heals on its own within two or three menstrual cycles. 

The functional ovarian cyst is of two types: –

• The follicular cyst- Follicle is the place where the egg is formed. The follicle does not shed fluid and shrink after releasing the egg or does not release an egg. In these cases, it swells and becomes a cyst. 
• Luteal Ovarian cyst- The tissue left behind after the egg is released is known as corpus luteum. It becomes a cyst when the tissue fills with blood. 

Pathological Ovarian Cysts

They are less common. The cyst is filled with either blood or a hard substance. They are not related to the menstrual cycle. They are caused due to abnormal cell growth. They are also called complex cysts.

The complex ovarian cyst has further three types: –

• Endometriomas- The inner lining of the uterus that flows out during menstruation, grows outside. These tissues form a cyst in or outside the uterus. 
• Dermoid ovarian cyst- The cyst in this type is made out of cells of skin, hair, fat, or teeth.
• Cystadenomas- Ovarian tissue makes these cysts. 

The types vary and can even overlap. So, what are the signs you should be looking for in your body? When to go to the doctor?

Ovarian Cyst Symptoms

Simple ovarian cysts do not cause any symptoms. However, the complex once can create a problem. Some of the evident symptoms could be: –

• Severe or dull abdominal or pelvic pain
• Fullness or heaviness in your abdomen
• Bloating
• Heavy, irregular and painful menstruation
• Unusual bleeding
• Painful sex
• Frequent and urgent need to urinate
• Inability to empty the bladder completely
• Hormonal abnormalities 
• Dizziness, weakness or feeling faint
• Feeling very full after only eating a little.
• Fertility issues

Go for a medical checkup immediately if any of these are bothering you. Also, some past or present factor increases your chances of having an ovarian cyst. What are those? Let us find out together. 

Ovarian Cyst – Risk Factors

Some of the factors that can increase your chances of having an ovarian cyst are: – 

• Infertility
• Hormonal imbalance can be even caused by medicines
• Pregnancy, as during this the cyst forms as the eggs stays in the ovary
• Severe pelvic infection that spreads to the ovary
• Endometriosis
• History of previous ovarian cyst
• Irregular menstrual cycle
• PCOS (polycystic ovarian syndrome)
• Obesity
• Early menstruation
• Hyperthyroidism

These all could be risk factors. The reason behind the growth of an ovarian cyst is given in the next section. 

Ovarian Cyst Causes

The five common causes of ovarian cysts are: –

1. Endometriosis- In endometriosis, the tissues that form the inner lining of the uterus and flow out during periods flows back and forms a cyst. This can be painful and even lead to infertility.
2. PCOS- Hormonal imbalance can cause a problem with ovulation. This problem can lead to the formation of a cyst. Irregular periods, reduced fertility, obesity and hair growth are some of the problems related to PCOS. 
3. Pregnancy- During pregnancy as there is hormonal imbalance, it is common for a cyst to form during ovulation. If the size of the cyst is small, then there is nothing to concern about. 
4. Previous ovarian cyst- If you had any cyst earlier, there can be a chance of reoccurrence. 
5. Pelvic Infections- If there is an infection in the pelvic region, there is the possibility of spreading it to the ovaries. The infection can then cause cyst formation. 

We now know the possible causes. So, if you ever had or have the above mentioned, keep an eye for the symptoms. Not to scare you but some can cause problems in the future. 

Ovarian Cyst Complication

Most of the cysts are not at all harmful. Even many you cannot feel. In the case of a functional ovarian cyst, there is no complication. But sometimes it can create complications. Some of the problems could be: –

1. Ovarian Torsion- When the cyst grows on the stalk of the ovary it can twist it. The twisting will stop the blood supply to the cyst causing severe pain. 
2. Ovarian cancer- Some cysts can have the possibility of becoming cancerous. 
3. Ruptured ovarian cyst- Some cysts can bleed into themselves or burst. The removal of the cyst, in this case, has to be immediately done. 
4. Infertility- In some cases for treatment, the ovary has to be removed. This will cause infertility. 
5. Damage to surrounding organs- If the cyst grows large it puts pressure on the bladder or the rectum. It can cause damage to these organs. 

Oh! Even this simple thing can create so many complications. It needs to be treated. The next section will talk about the diagnosis. Also, you will know next when to go for medical help. 

Ovarian Cyst Diagnosis

Go to the doctor immediately if you feel the following: –

• Severe and sudden abdominal pain
• Weakness
• Fainting
• Dizziness
• Abdominal pain with fever and vomiting

To confirm the suspicion of ovarian cyst the either of the following tests is done: – 

1. Ultrasound- Pelvic ultrasound will help to determine whether the cyst has fluid, and/or solid tissue. Transvaginal ultrasound gives more detail about the cyst.
2. Laparoscopy- Surgery is done in the abdomen through which a laparoscope is passed. It will help to identify the cyst and remove it.
3. Serum CA-125 Assay- The cancer-agent 125 blood test will help to identify whether the cyst is cancerous or not. 
4. Hormone Levels- The hormone level test is done to see whether the cyst is caused by PCOS.
5. Culdocentesis- It is done by taking a fluid sample from the pelvic region. It helps to rule out the possibility of bleeding into the abdominal cavity. 

After the diagnosis, comes the treatment. How is it done? Does in all cases removal of the cyst is needed? Let us find out. 

Ovarian Cyst Treatment

They are generally harmless but the large ones need to be removed. The treatment of the cyst largely depends on the age, menopause, size and substance of the cyst and symptoms. If the cyst is not large and does not need immediate action the first step is watchful observation.

• Watchful observation- As we have discussed above some cysts disappear on their own. In those cases, only observation is required. If the cyst grows or creates complications then only further steps should be taken. 
• Birth Control Pills- They help in balancing the hormone. This will lead to slowing down the growth of the cyst. It will also reduce the risk of developing ovarian cancer. 
• Surgery- There are further four more types under surgery. The choice will be based on the location and size of the cyst. The four types of surgery are: –

1. Laparoscopy- This procedure is used both for diagnosis and treatment. Recommended for removing one or multiple small cysts. 
2. Ovarian cystectomy- If you want to preserve your fertility this is a good option. In this cyst is removed without removing the ovary.
3. Oophorectomy- Affected cyst is only removed.
4. Total hysterectomy- In this uterus, ovaries and fallopian tube is removed. This procedure is recommended where the cyst has become cancerous. 

Ruptured Ovarian Cyst Treatment

The cyst may sometimes break open or rupture. A ruptured cyst can cause mild symptoms. The main symptom is a sharp pain in the lower abdomen. The majority of the time it can be treated with pain medicines. Sometimes surgery is done to stop the bleeding and to remove the blood clot. 

Blood loosed due to rupture of the cyst can flow to the organs. It can be life-threatening as well. In severe cases, surgery is needed. 

We now know the treatment for ovarian cyst as well as what to do in case it ruptures. But wait, what about your fertility? Will you be able to get pregnant with an ovarian cyst? Can the treatment make you infertile? We will answer all your queries. 

Ovarian Cyst and Infertility

An ovarian cyst can cause difficulty in conceiving. It can be difficult to detect the reason when there is no symptom. Some symptoms which could indicate infertility due to ovarian cyst are: 

• Irregular, short or long periods
• Tenderness in your breast
• Sharp pain in the pelvic region.

Ovarian cyst due to PCOS or endometriosis can result in infertility. On the other hand, functional cysts, cystadenomas and dermoid cysts will not cause any issue. Sometimes the size of the cyst can be the cause of complications in pregnancy. 

Fertility does not get affected directly because of the cyst. The reason behind the cyst can affect fertility. For instance, endometriosis or PCOS. Also, surgery to remove the cyst can make you infertile. 

Thus, if you wish to get pregnant keep all the above factors in mind. Nevertheless, there are other options available for you. Let us look into some. 

Ovarian Cyst and Pregnancy

After the treatment, you may face difficulty in conceiving. Ovarian cyst generally does not cause difficulty in pregnancy. When it is severe, it may require surgery and removal of ovaries. Thus, leading to infertility. 

Do not worry, you can still fulfil your dream of becoming a parent through Assisted Reproductive Techniques (ART). Some of the ART methods are: –

1. In-vitro fertilization (IVF) – In this, the eggs are collected on the 2nd day of periods. After that semen sample from the father is taken. The egg and sperm are fertilized in a petri dish in which an embryo is formed. The embryo is then transferred to the uterus of the mother. 
2. Intrauterine insemination (IUI) – Sperm is taken from the father and is directly placed in the uterus at the time the ovary releases eggs. In there the fertilization takes place. 
3. Intra cytoplasm sperm injection (ICSI) – This method is used when the egg has a very hard shell. The hard shell does not allow the sperm to get in for fertilization. In ICSI, the woman is given medication to produce mature eggs. The mature eggs are then taken through the vagina. The sperm sample is prepared by centrifuging. Then the single live sperm cell is injected directly into the egg. 
4. Cryopreservation – Sometimes for the treatment of ovarian cyst your ovaries had to be removed. Eggs can be taken out before the removal of the ovary. The eggs can be stored at low temperatures and can be used in future for the above processes. 
5. Surrogacy – Another woman bears the child of the couple. It is done in the same process as IVF. The only difference is that in place of the mother’s womb, the embryo is placed in the uterus of another woman. 

So, you can see that we are here to fulfil your dream of getting a baby. All the methods mentioned here are available at Fertility Zilla. 

Conclusion

To sum it all up, a cyst is an abnormal growth in the body. The ovarian cyst is common and for many, it appears and goes away with menstruation. The main reason behind it is endometriosis, PCOS and pregnancy. If you have the symptoms like sharp pain in the pelvic region, have fever and vomiting and nausea immediately go for medical help. In most cases, it heals itself without any treatment. Wherever it is required the process is very simple. Talking about fertility issues with an ovarian cyst, there is no concern. However, its treatment can sometimes cause infertility. In those cases, you always have the road of ART. 

Suggestion

To prevent ovarian cyst, a good diet, regular exercise, and stress management is suggested. Go for regular overall health checkups with your gynaecologist. Never ignore the signs. Sometimes the treatment can cause infertility. In that case, you can go for assisted reproductive techniques. Fertility Zilla provides the best IVF service in India. If you have any queries related to it feel free to contact us at contact@fertilityzilla.com or +91 8969340069. 

FAQs

What causes a cyst on the ovaries?

The leading cause of ovarian cyst is endometriosis and PCOS. Other reasons can be pregnancy, history of ovarian cyst and pelvic infection. Obesity, early menstruation and hypothyroidism can be some aggravating factors.

Are there any symptoms of an ovarian cyst?

If you have a simple ovarian cyst, you may not see any symptoms. There can be some symptoms like pain in the pelvic region, irregular periods, painful sex, bloating, etc. 

Can a simple ovary cyst be a complex cyst?

Yes, a simple ovarian cyst can become complex. If the size increases or becomes cancerous it can cause problems. To rule out the possibility examinations must be done especially the CA 125 blood test.

How big is a normal follicular cyst in the ovary?

The normal size of the ovary is around 2*3 cm. When a cyst is formed, the size of the cyst can increase up to 10 cm.

How long does it take for an ovarian cyst to go away?

The cyst which shows no symptoms, mainly the simple cysts go away on their own. It goes away within weeks. However, those which are complex need treatment be it either medicine or surgery. 

References

1. https://www.medicinenet.com/ovarian_cysts_pictures_slideshow/article.htm.
2. https://www.medicalnewstoday.com/articles
3. https://karenthrelkelnd.com/blog
4. https://www.mayoclinic.org/diseases-conditions/ovarian-cysts/expert-answers/ovarian-cysts-and-infertility/faq-20057806. 
5. https://www.infertilityscience.com/female-infertility
6. https://www.nhs.uk/conditions/