Ovaries, your primary reproductive organs, are located in the lower abdomen on both sides of your uterus (also known as the womb, is the secondary female reproductive organ). You have two ovaries and they are responsible for producing eggs and female sex- hormones, estrogen, and progesterone. A fluid-filled sac(s) can develop inside your ovaries, called ovarian cysts, which can lead to complications if infected. 

Ovarian cysts, a common gynaecological problem, affects most women at some point in their life. Ovarian cysts are the tiny fluid-filled sacs, present within the surface of your ovary surrounded by cells. Many cysts go away on their own. However, if the cyst leaks and causes symptoms like abdominal pain, breast tenderness, nausea, vomiting, and bloating, then it is advisable to consult your gynaecologist immediately. 

There are many types of ovarian cysts that can form due to various reasons.

1. Functional or Physiological Cysts. These are the most common types of cysts found in your ovaries. These are usually clear, simple cysts or sometimes hemorrhagic (pertaining to bleeding or the abnormal flow of blood) cysts. If you develop functional or physiological cysts, then you will usually have no symptoms like pain, nausea, etc. These are usually accidentally detected in an ultrasound (a medical test that uses high-frequency sound waves to capture live images from the inside of your body). 

Most of them disappear on their own within a few months and in most cases, no medical treatment is needed. Your gynaecologist might prescribe oral hormonal pills for about 2 to 3 months to treat functional ovarian cysts.

There are two types of functional cysts and they are:

  • Follicular cyst: During your menstrual cycle or periods (monthly shedding of your uterine wall in the form of blood), an egg grows in a sac (follicle), located inside your ovaries. In most cases, this follicle or sac breaks open and releases an egg. If the follicle does not break open, then the fluid inside the follicle can form a cyst on your ovary.

  • Corpus luteum cyst: Once the egg is released, the empty follicle shrinks and starts to get ready for the next egg. This follicle is now called the corpus luteum. It becomes a cyst when fluid collects inside.

2. Chocolate Cysts. Also known as endometrioma, these red or brown colored filled cysts are caused as a result of endometriosis. Endometriosis is a painful condition in which the tissues that normally line the inside of your uterus, start to grow outside of the uterus. When endometriosis involves the ovaries, the tissues might grow outside and start to form blood-filled cysts over a period of time.  

Chocolate cysts usually produce symptoms such as pain in your abdomen, pain during your menstrual cycle or periods, pain during sexual intercourse, etc. These gradually increase in size and may cause difficulty in your pregnancy. A number of treatment options are available varying from medications to surgery to treat chocolate cysts. 

If your cyst(s) is/are larger than 4cm, then your doctor might recommend going for laparoscopic surgery to remove the painful cysts. A laparoscopic procedure uses small incisions and specialized tools to examine the organs inside your abdomen.

However, remember that the appropriate treatment option depends upon your age, symptoms, size of the cyst, wish of childbearing in the near future, etc.

3. Dermoid Cysts. Dermoids are cysts that form from cells present in your ovary from birth. These cysts are saclike growths that are present at birth. They are commonly filled with hair, fluid, teeth, or skin glands that can be found on or in your skin. Dermoid cysts grow slowly and can pose a serious issue only when they are ruptured (break or burst suddenly). Besides the ovaries, dermoid cysts can also occur on your face, inside the skull, or on your lower back.

If your dermoid cyst ruptures, becomes inflamed (swelled), or causes pain or fever, you should seek immediate medical advice. Depending on the severity of your symptoms, your doctor might advise laparoscopic surgery. 

4. Benign Tumours. There are many ovarian cysts that are benign (noncancerous) in nature. Benign tumours are mainly functional cysts and do not cause any symptoms. It rarely causes pain or a feeling of heaviness in your pelvis (the lower part of the trunk of the human body between your abdomen and thighs). These might be detected during a regular pelvic examination and are most likely to occur in women after 40 years of age.

If a cyst persists for more than 2 to 3 months, then certain blood tests, known as tumour markers are done. Tumour markers are tests conducted to identify proteins that are produced by your body in response to cancer cells. If the test results are negative, it means your cyst is noncancerous. 

5. Cancerous Ovarian Cysts. These are the least common among all types of ovarian cysts. When cancer cells start to grow in your ovarian cysts, they are known as cancerous ovarian cysts. These are mostly seen in postmenopausal women. Menopause is the natural stopping or cessation of your monthly periods, which happens between 45 and 55 years of age.

These are usually diagnosed as complex cysts (cysts that contain blood, or solid substances). Blood tests for tumour markers are done to confirm the nature of your cyst. The only treatment option is open surgery. Laparoscopic surgeries are usually not recommended for such cysts.

Open surgery is the cutting of your skin and tissues so that your doctor/surgeon can have a full view of the structures or organs involved. A large incision has to be made so your doctor can see the cysts and the surrounding tissues. 

Many times, paraovarian cysts (cyst that forms near your ovary or fallopian tube, and does not adhere to any internal organ) or pelvic collections due to infections are falsely documented as ovarian cysts. Laparoscopic surgery is not needed in such cases and these resolve with medications. 

To summarize, there is no way to prevent ovarian cysts. Early diagnosis of ovarian cysts is possible during regular check-ups and pelvic examinations. Watch for any unusual changes in your monthly cycle, symptoms which persist longer than usual. Consult your gynaecologist immediately if the changes are persistent. 

Disclaimer: This article is written by the Practitioner for informational and educational purposes only. The content presented on this page should not be considered as a substitute for medical expertise. Please "DO NOT SELF-MEDICATE" and seek professional help regarding any health conditions or concerns. Practo will not be responsible for any act or omission arising from the interpretation of the content present on this page.