Ovarian Cysts: Causes, Symptoms and Treatment

Women of all ages are affected by fluid-filled sacs called ovarian cysts, which form on the ovaries. While a lot of cysts are safe and go away on their own, some can hurt and lead to problems. It is essential to understand the causes, symptoms, & potential therapies of ovarian cysts to manage them well and avoid consequences.

Ovarian Cysts Causes

Numerous reasons, from simple physiological processes to more complex pathological situations, can result in ovarian cysts. Understanding the diverse causes helps in identifying risk factors and tailoring appropriate treatments. There are many types like functional cysts, Pathological cysts and pregnancy related cysts.  

Functional Cysts

• Follicular Cysts: Occur when a mature follicle fails to release an egg during the menstrual cycle. This leads to the follicle accumulating fluid, forming a cyst.
• Corpus Luteum Cysts: Develop when the ruptured follicle reseals and fills with fluid. Although these cysts normally go away on their own, occasionally they might hurt and cause issues.

Pathological Cysts

• Endometriomas: Result from endometriosis, a condition where the tissue lining the uterus grows outside it. Old blood can accumulate in cysts formed by this tissue adhering to the ovaries.
• Dermoid Cysts: These cysts contain tissues like hair, skin, and even teeth. They develop from embryonic cells and can be present at birth but often become noticeable during reproductive years.
• PCOS: PCOS is a common hormonal condition that involves an excess of androgens produced by the ovaries, which causes many tiny cysts to grow. Fertility problems and unpredictable menstrual periods may be increased by these cysts.
• Cystadenomas: These cysts originate from the ovarian tissue and can become quite large. Cystadenomas are usually benign but may cause discomfort and complications due to their size.
• Torsion: Torsion occurs when an ovarian cyst causes the ovary to twist, disrupting its blood supply. This can result in more pain & requires immediate medical attention.

Pregnancy-related Cysts

Corpus Luteum Cysts in Pregnancy: In some cases, the corpus luteum may persist during early pregnancy, leading to the formation of cysts. While these often resolve without intervention, they can occasionally cause pain or complications.

Symptoms of Ovarian Cysts

• Pelvic Pain: One of the most prevalent symptoms is pelvic pain, which can range from a dull, intermittent ache to sharp and severe discomfort. The pain may be concentrated on one side of the pelvis and can be exacerbated during activities like intercourse or menstruation.
• Menstrual Irregularities: Ovarian cysts can influence the menstrual cycle, leading to irregular periods. Women may experience changes in the length, flow, or frequency of their menstrual cycles.
• Bloating and Abdominal Swelling: Large ovarian cysts can cause the abdomen to feel bloated or swollen. This occurs when the cyst expands, putting pressure on surrounding organs & tissues.
• Frequent Urination: Ovarian cysts, particularly when they grow large, can exert pressure on the bladder, causing a frequent need to urinate. This symptom is more common when the cyst is located near the bladder.
• Digestive Issues: Cysts may press on the intestines, leading to digestive problems such as indigestion, a feeling of fullness even after consuming small amounts of food, or changes in bowel habits.
• Pelvic Pain during Intercourse: Some women with ovarian cysts may experience pain or discomfort during sexual intercourse. This can be attributed to the pressure the cyst exerts on pelvic structures during sexual activity.
• Breast Tenderness: Hormonal changes associated with ovarian cysts may lead to breast tenderness or swelling. Certain cyst types—like those linked with the menstrual cycle—are more likely to present with this symptom.
• Pelvic Pressure: The presence of a cyst can cause a feeling of heaviness or pressure in the pelvic region, particularly if the cyst grows to a significant size.
• Lower Back Pain: Some women may experience lower back pain due to the pressure exerted by a cyst on the pelvic nerves or spine.
• Painful Bowel Movements: In cases where a cyst is located near the rectum, it can lead to discomfort or pain during bowel movements.

Diagnosis and Evaluation

• Pelvic Examination: A thorough pelvic examination is often the first step. The healthcare provider assesses the size, shape, & tenderness of the ovaries, detecting any abnormalities or signs of cysts.
• Transvaginal Ultrasound: This imaging technique utilizes high-frequency sound waves to create detailed images of the ovaries. It helps in visualizing the size, location, & characteristics of the cysts, aiding in diagnosis. 
• MRI or CT Scans: In certain cases, especially when further clarification is needed, magnetic resonance imaging (MRI) or computed tomography (CT) scans may be recommended. These methods of imaging can assist in identifying the type and size of the cyst and give a more thorough image of the pelvic organs.
• CA-125 Blood Test: The presence of a tumour marker linked to ovarian cancer is measured by the CA-125 blood test. While elevated CA-125 levels can indicate the presence of ovarian cysts, it is not a definitive diagnostic tool and is often used in conjunction with imaging studies.
• Pregnancy Test: In cases where a woman of childbearing age presents with symptoms, a pregnancy test may be performed to rule out the possibility of a corpus luteum cyst, which can occur during early pregnancy.

Clinical History and Symptom Assessment

Monitoring and Follow-up: For small, asymptomatic cysts, a watchful waiting approach may be adopted, involving regular monitoring through imaging studies to track any changes in size or characteristics.

To choose the best method of action, an accurate and precise diagnosis is required. By combining pelvic tests, ultrasounds, and blood tests, medical professionals may distinguish between different types of ovarian cysts, assess the likelihood of complications, and choose the best course of action for each patient. To improve the prognosis for reproductive health, ovarian cysts must be identified and evaluated at an early stage by routine gynaecological checkups.

Treatment Options 

• Watchful Waiting: Small, asymptomatic cysts may require no immediate intervention. Alternatively, medical professionals may decide to take a "cautious waiting" position, periodically conducting imaging tests to track the cyst's features and growth.
• Pain Management: Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can be recommended to alleviate mild to moderate pain associated with ovarian cysts.
• Hormonal Birth Control: Oral contraceptives containing hormones like estrogen and progestin can regulate the menstrual cycle and prevent the formation of new cysts. They work very well at controlling functional cysts and easing related symptoms. Surgical Intervention - Cystectomy: For larger or persistent cysts, surgical removal (cystectomy) may be necessary. Laparoscopic surgery and other minimally invasive methods are frequently used to perform cystectomies.
• Oophorectomy: In cases where cysts are recurrent, large, or suspected to be cancerous, the surgical removal of one or both ovaries (oophorectomy) may be recommended. This is a more extensive procedure and is typically considered when preserving ovarian function is not a priority.
• Laparoscopic Surgery: Minimally invasive laparoscopic surgery is a common approach for cyst removal. It involves making small incisions through which a thin, flexible tube with a camera (laparoscope) is inserted. The surgeon can visualize and remove the cyst with specialized instruments.
• Ovarian Cystectomy during Pregnancy: If an ovarian cyst poses a threat during pregnancy, surgical intervention may be considered. The timing and approach depend on factors such as the trimester, the size of the cyst, and the potential risks to both the mother and the baby.
• Management of Complications: Cases of complications like torsion or rupture of an ovarian cyst may call for emergency medical care. Surgical intervention is frequently required to treat these issues and stop more harm.

Preventive Measures 

• Regular Gynecological Check-ups: Routine examinations allow for early detection and monitoring of ovarian cysts.
• Hormonal Balance: Managing hormonal imbalances through lifestyle changes or medical guidance can contribute to cyst prevention.
• Healthy Lifestyle: Maintaining a balanced diet, regular exercise, and weight management support overall reproductive health and may reduce the risk of certain types of ovarian cysts.

Conclusion

When women are aware of ovarian cyst causes, symptoms, and potential treatments, they can make educated decisions about their reproductive health. Preventing problems and maintaining general well-being are largely dependent on early detection and adequate management. A healthy lifestyle, timely medical intervention, and routine gynaecological exams all support efficient cyst management, which enhances women's reproductive health and quality of life.

Frequently Asked Questions(FAQs)

What is the main cause of ovarian cyst treatment?

The risk of having an ovarian cyst is higher with Hormonal problems. These include taking a fertility drug that causes you to ovulate, for example, clomiphene or letrozole (Femara). ​

What are the symptoms of ovarian cyst?

Pelvic pain can range from a dull, heavy sensation to a sudden, severe and sharp pain, pain during sex, difficulty emptying your bowels, a frequent need to urinate.