Doctor's Notes on Ovarian Cysts
An ovarian cyst is an enclosed sac-like structure filled with fluid or semi-solid material located in the ovary. Ovarian cysts are very common and can arise due to a number of causes. Causes of ovarian cysts include hormonal changes during the menstrual cycle (follicular cysts), endometriosis, benign tumors, and cysts due to polycystic ovary syndrome (PCOS). Most ovarian cysts are benign (not cancerous), but in some cases, ovarian cancers may be associated with cysts.
Ovarian cysts do not always cause signs or symptoms. Signs and symptoms are more common with larger cysts. Symptoms of an ovarian cyst can include pain in the abdomen, pelvis, or low back, bloating, or increased abdominal girth. Associated symptoms with larger cysts can include pain during sexual intercourse difficulty with bowel movements, having painful bowel movements, or nausea and vomiting.
Ovarian Cysts Symptoms
Usually ovarian cysts do not produce symptoms, and are found during a routine physical exam. They also may be seen as an incidental finding on an ultrasound performed for other reasons. However, symptoms can be present, especially with large cysts or ruptured cysts. These are variable and may include:
- Pain with sexual intercourse, especially with deep penetration
- Lower abdominal or pelvic pain. This may be intermittent, or can be severe, sudden, and sharp
- Irregular menstrual periods
- A feeling of lower abdominal or pelvic pressure or fullness
- Chronic pelvic pain or low back pain throughout the menstrual cycle
- Pelvic pain following exercise or vigorous activity
- Pain or pressure with urination or bowel movement
- Nausea and vomiting
- Vaginal pain or spotty bleeding from the vagina
- Problems having bowel movements
- Feeling pressure to have a bowel movement
- Abdominal tenderness
- Abdominal distension
- Feeling of abdominal fullness
- Feeling full early when eating
- Problems with the control of urination
A ruptured ovarian cyst typically causes severe pain that comes on suddenly. This most commonly occurs in the mid-menstrual cycle and often happens following sexual intercourse or exercise.
Ovarian Cysts Causes
The following are risk factors for developing ovarian cysts:
- History of previous ovarian cysts
- Irregular menstrual cycles
- Early menstruation (11 years or younger)
- Infertility treatment with gonadotropin medications
- Tamoxifen (Soltamox) therapy for breast cancer
Oral contraceptive/birth control pill usage decreases the risk of developing ovarian cysts, because they prevent ovulation.
Ovarian cysts are fluid-filled sacs that grow inside or on top of one (or both) ovaries. A cyst is a general term used to describe a fluid-filled structure. Ovarian cysts are usually asymptomatic, but pain in the abdomen or pelvis is common.
What Are the Ovaries? What Do the Ovaries Do?
The ovaries are reproductive organs in women that are located in the pelvis. One ovary is on each side of the uterus, and each is about the side of a walnut. The ovaries produce eggs and the female hormones, estrogen and progesterone. The ovaries are the main source of female hormones that control sexual development including breasts, body shape, and body hair. The ovaries also regulate the menstrual cycle and pregnancy.
What Is Ovulation?
Ovulation is controlled by a series of hormone chain reactions originating from the brain’s hypothalamus. Every month, as part of a woman’s menstrual cycle, follicles rupture, releasing an egg from the ovary. A follicle is a small fluid sac that contains the female gametes (eggs) inside the ovary. This process of releasing and egg from the ovary an into the Fallopian tube is known as ‘ovulation’.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.