Ovarian Cysts are a common condition, they are often no cause for concern and many women don’t know they have them. They can appear and then disappear without causing any symptoms. However, for around 1 in 10 women symptoms can mean treatment is required at some stage in their life.
What are Ovarian Cysts
An ovarian cyst is a large fluid filled sack (more than 3cm in diameter), which develops on or in an ovary. The size of a cyst can vary. It can often be a few centimetres in size and up to the size of a large melon.
Ovarian cysts may only contain fluid and be thin walled, this is also known as a simple cyst. There are more complex cysts which contain thicker fluids, blood or solid areas.
Types of ovarian cyst
There are many different types of ovarian cysts which can occur before menopause, some of the more common examples are;
- A simple cyst– This is typically a large follicle that has continued to grow after egg release. Simple cysts are the most common cysts to occur before menopause and most of them disappear within a few months
- An endometrioma- Endometriosis can cause ovarian cysts, also known as endometriomas. Learn more about endometriosis
- A dermoid cyst– This is a type of cyst which develops from the cells that make eggs in the ovary. This type of cyst often contains substances like hair and fat.
Are cysts cancerous
This is always one of the first questions patients ask and whilst it’s not possible to assess without testing almost all ovarian cysts which occur before the menopause are benign.
Symptoms
Often the diagnosis of a cyst happens by chance, at a routine examination or during an ultrasound scan for another reason. It is quite possible you may have no symptoms at all. However, women may experience some of the following;
- Lower abdominal pain or pelvic pain
- Painful periods, or a change in the pattern of your period
- Pain during sex
- Pain related to your bowels
- A feeling that you want to pass urine urgently and more frequently
- A change in appetite or feeling full quickly
- A swollen abdomen
- Difficulty in becoming pregnant- this may have links with endometriosis.
Diagnosis
To discover if you have an ovarian cyst and further diagnose the type and size first we carry out a pelvic examination and generally an ultrasound, depending on what we discover further tests might be needed.
- Pelvic ultrasound. A wand like device scanned over the area with a cold gel sends and receives ultrasound waves to create an image of your uterus and ovaries on a video screen. We analyse the image to confirm the presence of a cyst, this will help to identify the location and determine whether it’s solid, filled with fluid or mixed.
- A small, camera is inserted into your abdomen through a small incision —we can then see your ovaries and remove the ovarian cyst. This is a surgical procedure that requires anaesthesia.
- CA 125 blood test. Blood levels of a protein called cancer antigen 125 (CA 125) often are elevated in women with ovarian cancer. If your cyst is partially solid and you’re at high risk of ovarian cancer, your doctor might order this test.
However elevated CA 125 levels can also occur in noncancerous conditions, such as endometriosis, uterine fibroids and pelvic inflammatory disease.
- Pregnancy test. A positive test might suggest that you have a specific type of cyst called a corpus luteum cyst.
Treatments
Very often the first treatment option offered for ovarian cysts is ‘watching and waiting’ to decide if an operation to remove the cyst is needed. If it increases in size or is complex, then an operation is required.
Your choice on whether to have surgery depends of your symptoms, the appearance and the size of the cyst and the results of any blood tests. Treatments for ovarian cysts are up to you and what you would want to do after we have outlined all the options and the positives and negative associated with them. We will help you take into account all the aspects looking at your own circumstances.
Treatments for simple cysts;
These are cysts that measure less than 5cm in diameter- generally for these, treatment isn’t necessary. They usually disappear on their own after a few months, it is unlikely that you will need a follow up appointment.
Cysts measuring 5-7cm in diameter- You will have a follow-up appointment to assess the symptoms as well as a follow up ultrasound scan a year later.
Cysts measuring more than 7cm in diameter – For these types of cysts we may recommend further tests, such as MRI scan or surgery before assessing the treatment options with you.
Surgery for cysts is generally keyhole (laparoscopic) surgery. This type of surgery is less invasive and less painful afterwards than if you were to have open surgery (laparotomy) It also means you are able to leave hospital earlier and have a quicker recovery and with fewer risks of infection.