Ovarian cysts are fluid-filled sacs that develop on or inside one or both ovaries. They are very common, affecting over half of all women at some point in their lives. Most ovarian cysts are small and harmless, and go away on their own without treatment. However, some cysts can grow large and cause pain, or they can be a sign of a more serious medical condition which may be more concerning, especially if they continue to enlarge over a short period.
Age and Menstrual Status: Postmenopausal women have a higher risk of ovarian cancer, and the size of cysts in this group may be more concerning. Cysts in premenopausal women can often be managed more conservatively.
Family History: A family history of ovarian cancer can increase the concern about cysts.
Types of ovarian cysts
The size of an ovarian cyst alone is not the only factor that determines its level of danger. Ovarian cysts can vary in size, and their potential risk depends on various factors. The type of cyst is important. Functional cysts, which are the most common, usually resolve on their own and are often not dangerous regardless of their size. However, complex cysts or cysts with solid components might be of more concern. There are many different types of ovarian cysts, but the most common include:-
Functional cysts: These cysts are the most common type of ovarian cyst. They form during the normal menstrual cycle and usually go away on their own within a few months.
Endometriomas: These cysts form when endometrial tissue, the tissue that lines the uterus, grows outside of the uterus. Endometriomas can be painful and can sometimes make it difficult to get pregnant.
Dermoid cysts: These cysts are rare and can contain hair, teeth, or other types of tissue. They usually need to be removed surgically.
Cystadenomas: These cysts can grow very large and can sometimes be cancerous. They usually need to be removed surgically.
Symptoms of ovarian cysts
Most ovarian cysts do not cause any symptoms. The presence of symptoms can indicate a more significant issue. Large cysts, even if benign, can cause symptoms. Cysts that rupture or twist can lead to severe pain and complications. However, the ovarian cyst can cause the following symptoms:-
- Pelvic pain
- Bloating
- Fullness in the abdomen
- Painful intercourse
- Abnormal menstrual bleeding
- Painful bowel movements or urination
Investigations and Diagnosis of Ovarian Cysts
If you have any symptoms of an ovarian cyst, your doctor will perform a physical exam and ask you questions about your medical history and menstrual cycle. They may also order some of the following tests to help diagnose the cyst and determine its type:-Pelvic ultrasound: This is the most common test used to diagnose ovarian cysts. It uses sound waves to create images of your reproductive organs.
Transvaginal ultrasound: This type of ultrasound is similar to a pelvic ultrasound, but the probe is inserted into the vagina to get a closer look at the uterus and ovaries.
Blood tests: Blood tests may be ordered to check for pregnancy hormones, cancer markers, or other signs of infection or inflammation.
CA-125 test: This is a blood test that can be used to detect a protein called CA-125. CA-125 levels can be elevated in women with ovarian cancer, but they can also be elevated in women with other conditions, such as endometriosis or fibroids.
hCG levels: can be measured in the blood to help diagnose Gestational Trophoblastic Disease (GTD) and dysgerminoma. In addition, hCG levels can be measured in the fluid of an ovarian cyst to help determine the type of cyst. For example, if the hCG levels in the cyst fluid are high, this suggests that the cyst may be a GTD or dysgerminoma. However, it is important to note that hCG levels can also be elevated in other conditions, such as pregnancy, miscarriage, and ectopic pregnancy. Therefore, a high hCG level alone does not necessarily mean that a woman has an ovarian cyst or GTD.
MRI or CT scan: These imaging tests may be ordered if the ultrasound is not able to provide a clear picture of the cyst or if the doctor suspects that the cyst may be cancerous.
Important: If the results of these tests suggest that you may have an ovarian cyst, your doctor may recommend watchful waiting. This means that they will monitor the cyst over time with ultrasound exams to see if it goes away on its own. If the cyst is large, causing symptoms, or does not go away on its own, your doctor may recommend surgery to remove it.
Management and Treatment: Generally, most small ovarian cysts (under 5 cm or about 2 inches) are not considered dangerous and may resolve on their own. However, larger cysts or those with concerning features should be evaluated by a healthcare provider. Ovarian cysts are typically monitored through follow-up exams and imaging, and treatment decisions are made based on a combination of factors, including the cyst's size, type, and the patient's overall health.
It's essential to consult with a healthcare professional for a proper evaluation and guidance if you have concerns about ovarian cysts.
Treatment of ovarian cysts
The treatment for ovarian cysts depends on the type of cyst, its size, and whether or not it is causing any symptoms. Most functional cysts do not require treatment and will go away on their own within a few months. However, if a functional cyst is large or causing symptoms, your doctor may recommend conservative treatment to prevent new cysts from forming.
Conservative treatment of ovarian cysts: This is the approach of treating cysts without surgery. This is the preferred approach for most ovarian cysts, in young and women of child bearing age, as It allows the patient to keep her ovaries, which is important for fertility and hormone production. Conservative treatment options for ovarian cysts include:-
Watchful waiting: This involves monitoring the cyst over time with ultrasound exams to see if it goes away on its own. Watchful waiting is often recommended for small cysts that are not causing any symptoms.
Hormonal therapy: This can be used to suppress ovulation and prevent new cysts from forming. Hormonal therapy options include birth control pills, progestin-only pills, and gonadotropin-releasing hormone (GnRH) agonists.
Pain management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can be used to relieve pain caused by ovarian cysts. In some cases, prescription pain medication may be needed.
Conservative treatment is usually successful in resolving ovarian cysts. However, if a cyst is large, causing symptoms, or does not go away on its own, surgery may be necessary.
Surgery for ovarian cysts
Endometriomas and dermoid cysts: They usually need to be removed surgically. This can be done laparoscopically, which is a minimally invasive procedure. In some cases, the cyst may be removed along with the ovary (oophorectomy).
Cystadenomas: They also usually need to be removed surgically. If the cyst is cancerous, your doctor may also further recommend chemotherapy or radiation therapy.
There are two main types of surgery for ovarian cysts:-
Laparoscopic surgery: This is a minimally invasive procedure that is performed through small incisions in the abdomen. A laparoscope, which is a thin tube with a camera on the end, is inserted through one of the incisions to allow the surgeon to see inside the abdomen. The cyst can then be removed through another incision.
Laparotomy: This is a more invasive procedure that is performed through a larger incision in the abdomen. Laparotomy is usually only recommended for large cysts or cysts that are suspected to be cancerous.
After surgery, you will be monitored in the hospital for a period of time to ensure that there are no complications. You will also need to rest at home and avoid strenuous activity for a few weeks.
Complications of ovarian cysts: These are rare, but can occur. The most common complications are:-
Ovarian torsion: This occurs when the ovary twists on its pedicle, or blood supply. This can cause severe pain, nausea, and vomiting. If not treated promptly, ovarian torsion can lead to ovarian necrosis, or death of the ovary.
Ovarian cyst rupture: This occurs when an ovarian cyst bursts open. This can cause sudden and severe pain, bleeding, and nausea. In some cases, a ruptured ovarian cyst can lead to sepsis, a life-threatening condition caused by a widespread infection.
Endometriosis: This is a condition in which endometrial tissue, the type of tissue that lines the uterus, grows outside of the uterus. Endometriosis can cause pain, heavy menstrual bleeding, and infertility. In some cases, endometriosis can develop in ovarian cysts.
Ovarian cancer: Ovarian cancer is a rare, but serious complication of ovarian cysts. Ovarian cancer is more likely to develop in women with certain types of ovarian cysts, such as cystadenomas and dermoid cysts.
Red Alerts
If you have any of the following symptoms, you should seek medical attention immediately:-
- Severe pelvic pain
- Sudden and severe abdominal pain
- Nausea and vomiting
- Fever
- Heavy vaginal bleeding
- Lightheadedness or dizziness
These symptoms could be a sign of a serious complication of an ovarian cyst.
Prevention of ovarian cysts
There is no way to completely prevent ovarian cysts. Here are some tips to help reduce your risk of developing ovarian cysts:-
- Maintain a healthy weight.
- Exercise regularly.
- Take birth control pills if prescribed by your doctor.
- Avoid smoking.
Conclusion
Ovarian cysts are very common and most are harmless. However, it is important to see a doctor if you have any symptoms of an ovarian cyst, so that they can diagnose the cyst and recommend the best course of treatment.
If you have any questions or concerns about ovarian cysts, please comment or e-mail me. i'll love to respond to you.
.jpeg)
Comments
Post a Comment
If you have any query, doubt or seek any advice or help, I am always available.