Women’s health is complicated. As women, we all know that, but if you haven’t had any experience with ovarian cysts – or perhaps even if you have – they can seem like a particularly complex issue.
For CMB contributor Kristin, her experience with ovarian cysts started at a very young age, “I was 17 when I found out I had ovarian cysts. I was sitting in class during a test and had to sneeze. I held it in because I didn’t want to disturb anyone and by doing that, one burst. The pain was excruciating, and I hobbled down to the nurse’s office. That afternoon at the doctor’s appointment they told me it was a ruptured ovarian cyst.”
Poor Kristin! As if being a 17-year-old girl isn’t hard enough, to add a mysterious – and sometimes painful – women’s health issue on top of it all? On behalf of womenkind, Kristin, we apologize.
In all seriousness, though, and because we know Kristin isn’t alone in suffering from ovarian cysts and the issues that surround them, we turned to our friends at The Christ Hospital Health Network for answers to the basic – and not so basic – questions about ovarian cysts.
What is an ovarian cyst?
Yes, it’s a pretty basic question, but knowledge is power. The good news is ovarian cysts are usually harmless and benign (non-cancerous). They are fluid-filled sacs that form on the ovary – also known as follicular cysts – during ovulation each month. Typically, these cysts don’t cause any symptoms and go away all by themselves, leaving you blessedly unaware that they even existed. Only about 8 percent of pre-menopausal women who develop cysts need treatment.
According to Laura T. Broxterman, MD, physician with The Christ Hospital Medical Center, “An ovarian cyst can be either functional or pathologic. Every month when a woman ovulates, the site of egg rupture leaves behind a ‘cyst’ in its place. This ‘cyst’ is called a corpus luteum and produces progesterone to support an early pregnancy. If the woman conceives that month, it persists until the placenta takes over the progesterone production. If the woman does not conceive, the cyst resolves.”
Cancerous ovarian cysts are rare and there is no reliable routine screening test. If you have a family history of the disease or other risk factors, be sure to get checked by your doctor, especially after menopause.
Other, less common types of cysts are:
- Cystadenomas—filled with a watery fluid. These can grow to a large size.
- Dermoids—come from cells present at birth.
- Endometriomas—are caused by endometriosis.
- Polycystic ovary syndrome (PCOS)—occurs when the ovaries produce many small cysts. These can make getting pregnant difficult.
What causes ovarian cysts?
Ovarian cysts can – and do – occur in women and girls of all ages. As we learned above, most cysts are a normal part of ovulation and menstruation, but some conditions that cause ovarian cysts can lead to other issues.
The most common causes are:
- Endometriosis— This condition causes tissue to attach to the ovary and form a growth.
- Pregnancy — The many changes that occur in a woman’s body during pregnancy can cause the development of cysts early in pregnancy.
- Severe pelvic infections — If the infection spreads to the ovaries and fallopian tubes, it can cause cysts to form.
How do I know I have an ovarian cyst? What are the symptoms?
While the majority of ovarian cysts will resolve themselves without you even knowing they were there, in certain cases, you might need to see your doctor.
Dr. Broxterman says, “Many cysts are asymptomatic and do not cause any symptoms at all. If cysts become large or don’t resolve on their own such as dermoids or endometriomas, they may require surgical excision. This can often be accomplished laparoscopically but sometimes requires a bigger incision. Most cysts resolve with time.”
You could experience abdominal pressure, bloating and swelling or abnormal vaginal bleeding or spotting. If you have a change in your menstrual periods, pelvic pain (sharp or dull) or pain with sex, urination or bowel movements, you should make an appointment with your OB/GYN to get everything checked out.
A cyst on the verge of bursting can sometimes cause nausea and vomiting, but in Kristin’s case, she didn’t have any warning.
“The second time I had a cyst burst was November 2017. I wasn’t sure what caused it that time, but the pain came out of nowhere and was awful again. The only relief was lying in the fetal position, and after 10 minutes the pain subsided. My OB did an ultrasound to see if there were any more and there weren’t. We both made the decision to remove my Mirena and have me go back to oral birth control.”
How are ovarian cysts treated?
As Kristin mentioned, she and her physician made the decision to treat her cysts using oral birth control. Dr. Broxterman concurs, “Birth control pills can often be used to suppress corpus luteal and hemorrhagic cyst formation.” Because this type of birth control prevents ovulation, it helps keep the cysts from returning by eliminating the circumstances in which they most commonly form.
Sometimes, if the cysts are asymptomatic except for the pain they cause, the best course of treatment might be as simple as pain medication, whether over-the-counter or prescription.
There are cases in which surgery is the best option. At The Christ Hospital Health Network, their expert physicians will review your options and choose the best one for your health. In fact, they specialize in a minimally-invasive procedure that is done through small incisions, resulting in less pain and scarring and a shorter recovery. Benign cysts can usually be removed while preserving the ovary. However, complete removal of the ovary may be necessary, if the cyst is large or potentially cancerous. The National Institutes of Health (NIH) estimates that out of the 5 to 10 percent of women who have surgery to remove an ovarian cyst–only 13 to 21 percent of these cysts are cancerous.
For Kristin, trial and error helped her find what worked best for her. She said,
“My personal course of treatment was hormonal birth control. I had the patch at first, then went to the pill. I was worried about the negative side effects of cysts as well as long-term birth control use such as infertility. Fortunately, I was able to get pregnant without any complications.”
This brings us to the next major concern when it comes to ovarian cysts.
Do ovarian cysts cause problems with becoming pregnant?
Thankfully, they usually do not. The most common types of cysts that were discussed above usually don’t cause issues with fertility. Some less common causes can present fertility problems (PCOS, for example), and those could require more intervention from your OB/GYN.
According to Dr. Broxterman, “Occasionally a large cyst can affect the ability to get pregnant if it is interfering with ovulation, but usually they do not cause problems. They do not impact the ability to stay pregnant.”
Overall, while the common kinds of ovarian cysts can sometimes be a nuisance, they usually aren’t a major issue. Keep in mind, however, that everyone’s body is different and different conditions can cause widely-varied symptoms. Be sure to visit your doctor immediately if you have any of the following symptoms.
- Severe vaginal bleeding
- Sudden dizziness with abdominal discomfort that persists for two hours or more
- Sudden, severe pelvic pain with vomiting or nausea
At The Christ Hospital Health Network, their Women’s Health team treats thousands of women each year. Each one gets individualized care, no matter how common or how rare the condition.