Although they’re quite common—especially during the childbearing years—ovarian cysts are rarely a reason to panic. Still, it’s important to detect and evaluate these growths as early as possible for a couple of reasons. First, there’s a slim chance that ovarian cysts may be cancerous, and second, treatment—if necessary—is easier and less invasive at an early stage. Most cysts are detected during a routine pelvic exam, so it’s important not to skip your regular gynecological checkup.
Functional cysts, the most common type, are essentially a byproduct of ovulation. There are two types of functional cysts—a follicular cyst and a corpus luteum cyst. Small and painless, follicular cysts are usually harmless and disappear within two to three menstrual cycles. Corpus luteum cysts, on the other hand, can grow more than four inches in diameter, sometimes twisting the ovary and causing pelvic pain. They can also trigger late periods or irregular vaginal bleeding. Like functional cysts, they tend to go away on their own.
Polycystic ovarian syndrome (PCO) is marked by the growth of tiny, benign cysts on both ovaries. Unrelated to ovulation, PCO is usually the result of a hormonal imbalance. Since women with polycystic ovaries rarely or never ovulate, their periods are irregular or absent. Women with PCO may also suffer from infertility, excess body hair and obesity.
Dermoid cysts, benign growths that contain skin, hair, teeth or bone, usually affect women ages 20 to 40. Although these cysts develop from cells that normally produce an egg, they are not pregnancy related. Because dermoid cysts may bleed, rupture or twist the ovary, they are usually removed.
Endometrial cysts, also known as chocolate cysts because they’re filled with reddish-brown blood, grow as a result of endometriosis—a disease in which patches of tissue from the uterine lining grow outside the uterus. An endometrial cyst can grow to the size of a grapefruit, preventing ovulation and causing fertility problems. Some women with endometrial cysts suffer severe menstrual cramps, painful intercourse or discomfort during bowel movements.
Cystadenomas, which develop from ovarian tissue, may be serous or mucinous. Usually symptomless, serous cystadenomas are filled with thin watery fluid and usually affect women in their 30s and 40s. Mucinous cystadenomas often develop in women ages 30 to 50. Filled with a gelatinous material, these cysts can swell to 12 inches in diameter
If a cyst is discovered during a routine pelvic exam, an ultrasound exam is usually the next step. The painless test is used to rule out ectopic pregnancy and confirm not only the presence of cysts, but their number and size as well as whether they’re filled with solid or liquid material. (Solid growths are more likely to be cancerous.)
Laparoscopy—a procedure in which surgical instruments and a narrow viewing scope are inserted through a small incision near the navel—is often recommended for cysts larger than four inches. Laparoscopy allows the surgeon to inspect the cyst, test it for infection, perform a biopsy, drain it or possibly even remove it.
The type of cyst, its size and location, the symptoms it produces and a woman’s age and childbearing plans are some of the factors that help determine how a cyst will be treated. A wait-and-see approach is often best for functional cysts since they tend to go away on their own. Alternatively, birth control pills may help “shrink” the cysts. But if neither approach works or if a cyst is very large or painful, surgery may be necessary.
When an ovarian cyst is found in a postmenopausal woman, however, the approach is generally more aggressive. That’s because the cyst is more likely to become cancerous.
Fortunately, cysts can usually be removed without disturbing the ovary (keep in mind that pregnancy is possible even if just a small portion of an ovary remains). Sometimes, however, one or both ovaries must also be removed. And in severe cases, it may be necessary to remove the fallopian tubes and possibly the uterus.
Because your outlook is best when an ovarian cyst is discovered early, make sure you visit your doctor for your annual checkup. Don’t wait for symptoms to strike.