Cyst on ovary – Ovarian cyst definition

Ovarian cysts are biological formations that resemble a sack or a pocket filled with fluid that develop in or on the ovaries. This is a quite common condition, most women having ovarian cysts especially before menopause without even knowing it. These cysts are usually harmless, but they can also be pathological (malignant).

The subject of reproductive health is a very important one and for better understanding what ovarian cysts are, where they come from, who gets them and when, we’ll first attempt to understand what are the ovaries and how they work.

Overview

The ovaries represent a very important part of the reproductive system of a woman. They are the female gonads (male gonads are the testicles or testes), acting as glands responsible for secreting and releasing hormones while also harboring the eggs and releasing them for the purpose of fertilization.

A female normally has two ovaries that they are born with. At birth, these organs or glands are not fully developed, the maturation process starting just as the female enters puberty. The ovaries have an ovoid shape, they weigh approximately 6-8 g and have a diameter of 3-5 cm. This pair of organs are situated in the pelvic region, on each side of the uterus being held in place by some ligaments that connect them to the uterus.

As far as to what they do, the ovaries have a mixt function: exocrine – they produce the ovules (ova) and endocrine – they are responsible for the secretion of estrogen and progesterone, the two female reproductive hormones. Therefore, the ovaries are the primary female reproductive organs and also endocrine glands responsible for the reproductive health of the female.

• Ovaries – hormone production

The two main hormones produced and released by the ovaries are estrogen and progesterone and they have significant roles during puberty, as well as after. During puberty, they are the main promotors of the development of sex characteristics in females. Estradiol (which together with estriol and estrone are the three hormones that make up the estrogen cluster of hormones) is especially known for its role in fat distribution in the body (mainly in the breasts, hips, legs) and in the development of the female reproductive organs.

One more hormone released by the ovaries is relaxin. This hormone is somewhat understated because it is useful primarily during labor and birth when its role is to relax the pelvic ligaments, making it easier for them to stretch. Another hormone is inhibin which through a system of negative feedback between the ovaries and the pituitary gland inhibits the secretion of the follicle-stimulating hormone as well as the secretion of the luteinizing hormone from the hypothalamus.     

•  The menstrual cycle

The menstrual cycle and its characteristics are the ones that can give a lot of information about the reproductive health of a woman. It consists of a set of changes that the body goes through every month to prepare for an eventual pregnancy. In short, since puberty until menopause, every month, the ovaries release an egg (they take turns, one month is the left ovary, the next month is the right one) in a process called ovulation. All this is very much dependent on hormone levels and changes that not only stimulate the release of the egg in order for it to (potentially) get fertilized, but they also help prepare the uterus for sustaining a potential pregnancy. If the egg is not fertilized, the inner wall of the uterus that had become thicker in order to receive the egg will shed through the vagina, causing menstrual bleeding or period.

A complete menstrual cycle usually takes between 21 to 35 days, with the bleeding lasting from 2 to 7 days. It’s quite normal for the cycle to have some irregularities and not have the same length every month, but assessing what’s “normal” regarding the menstrual cycle is very risky since it depends on so many characteristics that vary from one person to another. This is why it’s important to track your menstrual cycle and the symptoms you have every month and consult with a healthcare professional in case you have any questions or doubts regarding whether or not what you experience is normal or could be a sign of a disease. Some of the medical conditions that could interfere with your menstrual cycle and make it irregular can be eating disorders, polycystic ovary syndrome (PCOS – which will be the focus of this article later on), pelvic inflammatory disease (PID) or uterine fibroids.

• Ovulation

Ovulation is the process in which one of the two ovaries releases an egg each month with the intention of getting the egg fertilized. This seemingly easy process is very complex and it’s regulated by the hormonal activity of the ovaries, hypothalamus and pituitary gland. In short, the hypothalamus sends a signal alerting the pituitary gland to begin the secretion and release the follicle stimulating hormone and the luteinizing hormone.

In each of the two ovaries there is a significant number of follicles that each nest a dormant egg. When the pituitary gland is stimulated and starts the release of follicle stimulating hormone and luteinizing hormone, one of these eggs inside a follicle starts maturing while the follicle migrates to the wall of the gland. This is when the ovulation begins.

When the follicle and the egg are mature enough, the follicle ruptures, letting the egg travel to the nearest fallopian tube (two tubes that connect the ovaries to the uterus) and eventually to the uterus. This is also the time in which the old spot in the ovary where the egg was (called corpus luteum) starts the secretion of progesterone, preparing the inner walls of the uterus to receive the egg. While the egg travels and arrives in the uterus, if there are no spermatozoids to fertilize it, the secretion of progesterone starts to drop and the egg will eventually be eliminated during menstruation. However, if the egg is fertilized, the secretion of progesterone continues, making sure the uterus is prepared to “host” the embryo while also preventing the ovaries from producing more eggs.

Is it possible to have a menstrual cycle without ovulation? The short answer is yes. Different environmental or individual factors can prevent ovulation from happening at certain times and, for this case, professionals use the term “anovulatory” cycle.

• Ovaries medical examination

There are a few medical methods to assess one’s gynecological health or to diagnose a medical condition. Doctors refer to a pelvic exam as a combination of these methods meant to check the vulva, vagina, cervix, fallopian tubes, ovaries, uterus, bladder and rectum. A pelvic exam can include:

1. Visual exam – which can be external or internal; the external visual exam is designed to check for any abnormalities, including inflammation or sores, in the vulva area; the internal visual exam is performed with a plastic or metal instrument called speculum that is used to open the vaginal walls; this way, the doctor can see the vagina and cervix;
2. Pap test/Pap smear – collection of cervical cells with a small wand that is later analyzed in a lab setting;
3. Physical exam – this is the part of the examination where the doctor can exam the ovaries and uterus by palpating the abdomen and pelvis; the doctor usually checks for the size and shape of these organs and can feel if there are any abnormalities present.

• Pathology of the ovaries – diseases and disorders

Most of the problems regarding the ovaries are caused by cysts. Therefore, the most common conditions related to the ovaries are cysts and polycystic ovary syndrome (PCOS). We will discuss in detail about these later in this article so if they are of interest for you, keep on reading. However, there are also other medical conditions associated with the ovaries, such as ovarian cancer, primary ovarian insufficiency (POI) and ovarian torsion.

Ovarian cancer. Even though it’s a very rare form of cancer, ovarian cancer is the leading cause of death among other types of reproductive cancers. This is partly due to the fact that ovarian cancer is usually very hard to detect and is diagnosed when it’s in its later stages. Some of the symptoms can be pain in the lower abdomen region, heavy feeling in the pelvis, bleeding, weight changes, irregular menstruation, back pain, nausea. The tests used to diagnose it include a physical and pelvic exam, ultrasound, lab tests and biopsy. While it’s difficult to treat once it gets advanced, surgery and chemotherapy can offer some hope.

Primary ovarian insufficiency (POI). It’s also called premature ovarian failure. These terms are used to describe the condition when a female’s ovaries stop working properly before the age of 40. This means that for these women the symptoms of menopause start way early, the most significant ones being irregular menstruation and reduced fertility. However, POI is not to be confused with premature menopause because these women can still have periods from time to time and even get pregnant. Some of the symptoms of primary ovarian insufficiency, besides irregular periods, are hot flashes, irritability, low sex drive and vaginal dryness. This medical condition can be diagnosed doing a physical exam, blood tests or a pelvic ultrasound. While there is no specific treatment yet that can help restore ovarian function, there are some things that can help with the symptoms. Also, in case a woman with POI wants to get pregnant, IVF or in vitro fertilization can be used. For preventing osteoporosis and heart diseases, hormone replacement therapy, calcium and vitamin D supplements and regular physical activity are advised.

Ovarian torsion. Ovarian torsion refers to when an ovary twists around the ligaments that maintain its position in the pelvic area. This is a serious medical condition because it causes low blood supply in the ovary which in time can lead to the death of the tissues. Some of the symptoms associated with ovarian torsion are nausea and vomiting, severe pain in the pelvic area, fever or bleeding. Seeing as how these symptoms are quite similar to those experienced when someone has appendicitis, gastroenteritis or kidney stones, it’s pretty difficult to diagnose ovarian torsion. However, some of the tests that can be used in order for a diagnosis to be made can be transvaginal or abdominal ultrasounds, CT scans or blood tests. Unfortunately, the only treatment option is surgery, medication being useful in alleviating some of the symptoms.

Further, we will address the topic of ovarian cysts in detail, from symptoms, causes and types to diagnosis and treatment options. Plus, the differences between ovarian cysts and polycystic ovary syndrome (PCOS) will be discussed.

Ovarian Cysts

A cyst on your ovary or even multiple ones sounds like something bad, but, in reality, it’s more common and harmless than you might think. “Cyst” is a term used to describe a sack structure filled with fluid that can sometimes be a tumor (benign or malignant) or a neoplasm. Usually, ovarian cysts don’t cause any discomfort which is why women don’t even know they have them. It’s very common for women that are at a reproductive age to have ovarian cysts, especially when pregnant (cyst on ovary while pregnant). These cysts typically don’t require any medical attention, going away on their own. However, if a cyst doesn’t go away or starts to grow, it can become painful and cause some other symptoms.

Symptoms and signs of ovarian cysts

Most ovarian cysts resolve themselves without the person even noticing there is something there. However, in some cases, the most common sign of an ovarian cyst is abdominal or pelvic pain that can have different potential causes, such as rupture of the cyst, growth of the cyst, bleeding or torsion of the cyst around its blood source.

When a cyst grows and reaches a larger size, it can cause other symptoms beside abdominal or pelvic pain, such as:

• bloating and a feeling of abdominal expansion;
• back pain, especially in the lower region (cyst on ovary back pain);
• indigestion;
• urinary deficiency – either a feeling of urgency to go or difficulty emptying the bladder;
• bowel movements changes.

If you experience any sudden and severe pain in the abdominal or pelvic region, nausea and vomiting (cyst on ovary nausea), a feeling of fainting and hyperventilation, it’s recommended that you seek medical assistance immediately because there is a high chance of the cysts causing ovarian torsion.

Is discharge normal if you have ovarian cysts (cyst on ovary discharge)? In short, yes. The cysts can cause some uterine bleeding which mixed with the other natural secretions of the body can be eliminated as a brown-colored discharge.

Can ovarian cysts make you gain weight (cyst on ovary weight gain)? There isn’t a definite yes or no for this question. In some rare cases the cysts can become significantly big which in turn might make the bloating more uncomfortable, leading to a false impression of weight gain. However, hormonal changes due to ovarian cysts can actually interfere with your fat metabolism.

What happens if a cyst bursts (cyst on ovary burst)? Usually, nothing, especially if the cyst is small. Sometimes, though, it can cause severe pain and bleeding.

Causes and types of cyst on ovary

There are many causes for cysts to form on or in your ovaries and they make it easier to classify the cysts into functional and non-functional.

Functional cysts are related to the normal way the ovaries work and are typically harmless, going away in their own. There are two types of functional cysts:

• follicular cysts – we discussed earlier about the moment when each month, an egg is released from a follicle and starts travelling to the uterus; when the follicle doesn’t rupture releasing the egg and it starts to grow, this is when a follicular cyst if formed;
• corpus luteum cysts – if the egg is released from the follicle, the remaining follicle is called corpus luteum and it’s responsible for a short period of time for secreting estrogen and progesterone; if somehow fluid starts to accumulate in this corpus luteum, it eventually grows into a cyst.

Non-functional cysts can have different causes that usually involve some sort of medical condition:

• endometrioma or “chocolate” cysts – these are cysts filled with blood that can have a brown-ish aspect; the cause for these cysts is endometriosis which is a condition that causes cells and tissues to grow outside of the ovary (cyst on ovary endometriosis);
• polycystic ovarian syndrome (PCOS) – this medical condition refers to the presence of more than one cyst in the ovaries;
• dermoid cysts – sometimes, the tissues of the ovaries transform into abnormal formations that are considered to be benign tumors.

Can ovarian cysts cause infertility (cyst on ovary can you get pregnant)? Functional and dermoid cysts don’t typically affect the woman’s fertility. Endometriomas or cysts resulting from PCOS can affect fertility, especially because of the hormonal imbalance they cause.

Can you get ovarian cysts after menopause (cyst on ovary after menopause)? While it’s more common for cysts to form before menopause, women that have gone through menopause can still develop ovarian cysts, which in most cases are dermoid cysts. Also, even if at younger ages cancerous cysts are extremely rare, at older ages they become more prevalent.

Size of an Ovarian cyst

Size of an ovarian cyst can be very different depending on the type of cyst and it can also serve as an indicator for whether or not surgery is needed for removal of the cyst. Usually, surgery isn’t recommended in case a cyst is smaller than approximately 50 mm, but this also depends on the type of cyst (if it’s cancerous, it might be necessary to remove it anyway). When we talk about the functional cysts, they usually reach 2 to 5 cm, and ovulation occurs when they are about 2 to 3 cm (cyst on ovary 3 cm; cyst on ovary 4 cm). Sometimes though, these cysts can go up to even 8 to 12 cm in size.

Ovarian cysts vs. polycystic ovarian syndrome – cyst on ovary PCOS

These are two medical conditions that are related because they share similar symptoms, meaning that it’s difficult to know which is which or whether you have a few ovarian cysts or PCOS.

PCOS means that the ovaries have a significantly large number of cysts on them. This is not exactly a harmful condition, but it can cause a severe hormonal imbalance that can in turn lead to more serious problems, such as extremely irregular menstruations, reduced fertility, excessive pilosity, hair loss or weight gain.

The easiest way to differentiate between ovarian cysts and PCOS is through testing hormone levels since is the main consequence of PCOS, but not present in case of ovarian cysts.

Cyst on ovary diagnosis

Suspicion of ovarian cysts can be checked by a gynecologist-obstetrician during a pelvic exam. For a diagnosis to be made, the healthcare professional will use ultrasound imaging (cyst on ovary ultrasound), a CT scan (cyst on ovary CT scan) or an MRI scan.

Cyst on ovary treatment

How to treat a cyst on an ovary? We’ve seen so far that ovarian cysts are very common. In fact, it’s safe to say that almost every woman at reproductive age will have functional cysts that they don’t even know about because of the absence of symptoms. However, treatment for this condition depends on its cause and also the presence of symptoms. Functional cysts, if discovered, are usually monitored frequently and in case they rupture, they will require medical attention and treatment. If the cysts turn out to be tumors, either benign or malignant, the best course of action is to have them surgically removed.

Conclusion

Is a cyst on ovary dangerous? Ovarian cysts are very common and most of the time women don’t even know they have them. There are several types of ovarian cysts, the most prevalent ones being functional and harmless, sometimes causing no symptoms. However, if the cysts are non-functional or even turn into tumors, surgery is the way to go to remove them. Going for an annual check-up is a way of keeping an eye on your reproductive health, which can help diagnose early on any sort of abnormality that could degenerate into a serious condition.