About Ovarian Cysts

An ovarian cyst is a small fluid-filled sac in the ovary. About 95 percent of ovarian cysts are non-cancerous, though cancer and other serious medical problems can be indicated by the presence of certain cysts. While some benign cysts may be due to endocrine disorders or other conditions, any ovarian follicle over 2 centimeters can also be termed an ovarian cyst.

Types

• Most ovarian cysts are "functional cysts". Functional ovarian cysts occur as part of the development of ovarian follicle, or folliculogenesis. Once she begins to menstruate, a woman has ovarian follicles at all stages of development in her ovaries.
  Follicular Cyst: This is a mature follicle that is either not released during ovulation, or collapses in on itself prior to ovulation. While these cysts can grow to over 2 inches in diameter, they are normally harmless. However, they can cause pain if they rupture. Follicular cysts usually do not require medical intervention, and will disappear after a few months.
  Corpus Luteum Cyst: When a woman ovulates, the ovarian follicle releases the mature egg. The follicle itself is then known as the corpus luteum, and it is subsequently broken down by the body and reabsorbed. If the corpus luteum instead fills with blood or fluid and stays in the ovary, it becomes a cyst. These cysts are often asymptomatic.
  Hemorrhagic Cyst: This is the most potentially serious of the functional cysts. If during folliculogenesis a blood vessel in the ovarian follicle bursts, blood can leak into the follicle. If the bleeding does not cease on its own, blood can leak into the ovary, forcing it to enlarge. This can cause intense pain, and should the cyst rupture, blood can leak into the abdominal cavity. Hemorrhagic cysts infrequently require surgery.
  Another type of benign cyst is a dermoid cyst. Also referred to as teratomas, these cysts can form not only in the ovary, but in other areas of the body. They consist largely of fat, but may also produce cartilage, bone and other types of tissue. Surgery is required to remove them.
  Cystandenomas are benign cysts formed from ovarian tissue and filled with a fluid similar to mucous. They are usually removed with surgery.

Identification

• Cysts are usually found during a gynecological exam or via ultrasound, laparoscopy, or CT scans. The best way to diagnose different typs of ovarian cysts is through endovaginal ultrasound. A thin wand is inserted into the vagina, and positioned next to the ovary. The image is detailed enough to determine whether cysts solid, fluid-filled, or contain a mixture of fluid and solid material. An MRI may be performed to further assess the contents of the cyst.

Size

• A follicular cyst can measure up to 2.5 inches in diameter. A corpus luteum can be up to 4 inches. Endometrial can be up to 8 inches. Cystandemona cysts can be up to 12 inches. Non-cancerous cysts that are less than 4 inches in diameter usually do not require surgery in pre-menopausal women.

Effects

• Most ovarian cysts are asymptomatic, but symptoms can include abdominal/pelvic pain and pressure, irregular periods, nausea or vomiting, vaginal pain or bleeding/spotting, pelvic pain after exercise, intercourse or with urination and bowel movements.

Warning

• Ovarian cysts can be indicative of serious medical problems.
  Endometriosis is a condition in which uterine tissue grows outside the uterus. Severe abdominal and/or pelvic pain is the main symptom of endmetriosis. If uterine tissue grows inside the ovary, an endometrial cyst develops. The rupturing of this type of cyst, which may grow for up to 10 years, can lead to infertility. Only women who have endometriosis are at risk.
  Polycystic ovarian syndrome (PCOS) is an endocrine disorder in which follicle growth arrests prior to maturity, leading to the presence of many immature follicles within the ovary. An ovary is called polycystic if 12 or more of these follicles are found during an ultrasound. An ovary can appear to be polycystic even if the patient does not have endocrine abnormalities, and therefore does not have PCOS.
  Ovarian cancer usually manifests in solid or solid and fluid -filled tumors. Cancer may arise from the outer layer of tissue surrounding the ovary (epithelial tumors), connective tissue cells inside the ovary (stromal tumors), or from the cells that produce the ovum (germ cell tumors).