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Ovarian Cysts

By Apollo 24|7, Published on- 22 November 2022 & Updated on -

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  • Symptoms: pelvic pain in waves of varying intensity, sharp pain below the belly button (usually towards one side), constant feeling of fullness in the belly, bloating, irregular periods, pain during sex, sudden weight loss, lower chances of getting pregnant, increase in urgency to urinate, increase in urination frequency, painful bowel movements
  • Causes: Hormonal problems, endometriosis, a severe pelvic infection, pregnancy
  • Risk Factors: Genetic conditions, structural issues within the female reproductive system, a previous cyst
  • Severity: Mild to moderate (depends on the type and size of ovarian cyst)
  • Which doctor to consult: OB-Gynaecologist

Overview

Ovarian cysts refer to fluid-filled sacs that can grow inside or on the surface of the ovaries. Every female has two ovaries present each on both sides of the uterus. These ovaries are quite small in size and resemble the shape of an almond. These ovaries then accommodate the growth of eggs, which later develop, mature, and exit the body through monthly menstrual cycles.

These cysts are common in women who haven't undergone menopause or are pregnant. Ovarian cysts can be further segmented into various types, most of which are harmless and painless. With that being said, ovarian cysts are generally harmless. There is a chance that one can get one cyst every month, and it is just painlessly ejected from the body during the menstrual cycle. Often a woman can't even feel the presence of the cyst, other than a feeling of fullness and bloating around the pelvis.

However, the real problem occurs when the cyst isn't eliminated during the menstrual cycle or grows in size. The process will get quite painful then. Additionally, a large ovarian cyst might also serve as a stepping stone for cancer.

A woman is more at risk of contracting ovarian cancer from a cyst as she grows older.

For instance, if the cyst grows larger than 2.5 cm, a woman will experience symptoms such as irregular periods, sudden weight loss, pain during sex, vomiting, nausea and bowel movement pain. Now that the cyst is huge in size, one might not be able to pass it. This might take surgery to get rid of.

Also, if the cyst isn't treated on time, it might even impact ovulation, paving the way for PCOD (ovaries have minute cysts on the surface). This will make conceiving difficult. Furthermore, some other risks associated with ovarian cysts are ovarian rupture and ovarian torsions.

When to Consult a Doctor?

Here are some of the top signs that suggest a ovarian cyst is growing out of proportion and can cause irreparable damage

  • Inability to get pregnant

If a woman has been trying to conceive a child for more than a year without any luck, there is a chance that she might have an ovarian cyst or PCOD. The presence of these cysts impact ovulation, making it difficult, or in some cases, impossible to conceive a child. So, if a woman is facing this issue, she should visit a gynaecologist as soon as possible. This is because reproduction and pregnancy are matters that no woman can think beyond a certain age. Not taking timely precautions can lead to permanently compromised fertility.

  • Regular pelvic examinations

As a general thumb rule, every woman who has approached puberty must visit a gynaecologist for regular body checkups at least once a year. As a result, she will be able to catch any looming gynaecological emergency in its early stages, paving the way for a swift prognosis and treatment.

As mentioned earlier, most of these cysts are asymptomatic, making them very difficult to detect. Hence, regular pelvic exams are necessary to ensure that the ovarian cyst doesn't grow or show signs of growing out of control.
An early diagnosis will help a woman to catch these ovarian issues on time, avoiding the need for risky complications down the line.

  • Visible symptoms

If a woman is experiencing the symptoms of ovarian cysts, she must get it checked by a doctor as soon as possible. To give a better idea, here are a few symptoms of ovarian cysts one must look out for.

  1. Nausea
  2. Fever 
  3. Vomiting
  4. Swelling around ovaries
  5. Pelvic pain in waves of varying intensity
  6. Sharp pain below the belly button (usually towards one side)
  7. Constant feeling of fullness in the belly, bloating
  8. Irregular periods, pain during sex
  9. Sudden weight loss
  10. Not getting pregnant
  11. Increase in urgency to urinate, 
  12. Increase in urination frequency
  13. Painful bowel movements

Diagnosis:

To diagnose the presence of ovarian cysts, one needs to visit a licensed gynaecologist. The doctor will look for symptoms and perform a comprehensive physical examination to check for swelling in the area around the ovaries. The doctor will also perform routine pelvic exams.

Upon grasping a basic understanding of the condition, the doctor will prescribe a set of imaging and lab tests to confirm the cyst’s exact size, location, composition, and nature. Once both the physical examination and testing are done, the doctor will pool the results and choose the appropriate treatment method for cyst removal.

To give a better detail about the various tests that entail ovarian cyst detection, here are some diagnostic tests that are used:

Diagnostic tests:

  • Lab Tests

One of the primary ways to check for the presence of ovarian cancer is via a blood sample. The protein known as cancer antigen is found in excess when the person suffers from ovarian cancer. If a woman has a cyst that has already solidified, she is exposed to a considerable risk of ovarian cancer.

The doctor might then order a cancer antigen 125 test (CA 125 Test) and other important blood tests. But remember that the CA 125 levels will also be elevated for certain non-cancerous conditions such as pelvic inflammatory disease, endometriosis, etc.

  • Imaging Tests

Imaging tests are a compulsion during the diagnosis of an ovarian cyst. Firstly, the doctor will ask the patient to get a pelvic ultrasound done. This test leverages sound waves to create images of the internal organs. It will confirm the presence or absence of an ovarian cyst.

Next up, the doctor will ask the patient to get a couple of other imaging tests, including an MRI, CT scan, or sonography. In essence, an MRI is a machine that employs magnetic fields to come up with in-depth images of the internal organs.

On the other hand, a CT scan creates a cross-sectional image of the internal organs. All these imaging tests will help the doctor understand the exact nature of the cyst, i.e., whether it is solid or filled with fluid.

  • Advanced Tests

Laparoscopy falls under this category of the most advanced pelvic tests to detect the presence of ovarian cysts. Essentially, the test uses a specialised medical instrument known as the laparoscope, which is inserted into the abdomen through a minute incision. This instrument will allow the doctor to view the ovaries very clearly, and hence they can check for the growth of cysts in or on the ovary surface.

All this is possible because the laparoscope has a small camera attached at the insertion end, allowing the doctors to see inside the body through the incision. By doing so, the doctor can gauge the accurate location and size of the cyst, leading to a much more precise diagnosis.

Treatment

The treatment method one adopts for dealing with ovarian cysts will vary based on age, underlying symptoms, and other factors. Here are some of the top treatment options one can take to get rid of ovarian cysts:

  • Home Care

There is a chance that a ovarian cyst might go away without treatment. In case the cyst is functional, the doctor might just ask the patient to adopt a wait-and-see approach. In the meanwhile, one can relieve pain using a warm compress, painkillers, and  home remedies. However, remember that sharp pain will suggest an ovarian rupture, and one should consult a doctor immediately.

  • Medication

Once ovarian cysts grow beyond a certain point, all medicines can do is act as painkillers. The only way one can deal with enlarged cysts is via surgical intervention. However, it is possible to control cyst formation by consuming hormonal medications like birth control.

  • Surgical Treatment

In case the cyst is too large to be passed, doctors will suggest surgical treatment. Certain cysts can be removed without having to remove the ovary (cystectomy). On the other hand, certain surgical operations can help get rid of the ovary as well (oophorectomy).

Risks & Complications if Left Untreated

Here are certain complications of leaving a severe ovarian cyst untreated:

  • Ovarian torsion

This is when the cyst becomes so large that it might cause the ovary to move. As a result, the ovary might undergo painful twisting, resulting in nausea, vomiting, and severe pelvic pain. This condition might also restrict blood flow to the ovaries.

  • Cyst rupture

This is when the said ovarian cyst bursts open, resulting in bleeding inside the pelvis and intense pain. As the size of the cyst increases, the chances of it rupturing will also increase. Furthermore, activities that lay too much pressure on the pelvis (e.g., vaginal sex) can also lead to the rupture of this cyst.

  • Rapid growth of cyst

If an ovarian cyst is left untreated, it will keep growing in size. If not treated on time, this cyst can grow as much as 40-42 cm. This will lead to abnormal ovary functioning, sharp pain, compromised fertility, and abnormal functioning of the reproductive organs.
 

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Frequently Asked Questions

If a woman takes medications containing hormones that stop ovulation, there is a chance she might prevent the occurrence of cyst growth. In general, these cysts are quite harmless and don't need prevention as such. Instead, one should pay attention to any symptom that suggests the presence of an ovarian cyst and inform a doctor about it immediately. She should visit a gynaecologist for pelvic exams often so that the doctor can diagnose, detect, and get rid of any cyst that might pose a threat to the patient’s well-being.

The main risk of contracting an ovarian cyst is hormonal issues. A massive hormone imbalance is caused when a woman takes fertility drugs that bring about ovulation. For instance, if a woman consumes letrozole or clomiphene for pregnancy, there might be a significant hormonal imbalance.

Here are certain things one can do to make sure that the ovarian cysts don’t come back: Making healthy lifestyle changes can help dodge the possibility of ovarian cysts from returning  Taking birth control pills  Visiting a gynaecologist  Maintaining a healthy weight  Keeping away from smoking and chewing tobacco