It is estimated that most women develop an ovarian cyst at some point in their lifetime, although only 8-18% are reported, since many ovarian cysts cause no symptoms and resolve on their own.

Some 5-10% of women will have exploratory surgery to investigate ovarian cysts, and of these, 13-21% turn out to be malignant rather than benign. Many women have experienced one or more ovarian cysts and most are benign and can be managed expectantly without surgery.

While many women may never know they developed a cyst, and most don’t require medical intervention, others experience pain that can range from mild to acute, and there are several serious conditions which can result from an untreated, severe, or large cyst.

Knowing when to seek medical help is crucial, especially for women who have painful ovulation or periods, and may attribute pain to their normal cycle.  

What are ovarian cysts?

An ovarian cyst typically consists of a sac or pouch of fluid or soft tissue that forms inside or on one of your ovaries. Ovarian cysts can be one of two forms – a physiologic or functional cyst related to ovulation (typically only present in women who are fertile), or a neoplastic or pathologic cyst.

Most ovarian cysts do not lead to ovarian cancer, but some cysts can be extremely painful and cause other serious conditions.

Functional ovarian cysts

Functional ovarian cysts are almost always benign, and can be caused during ovulation by one of two processes:

  • During ovulation, if your follicle fails to properly rupture and release an egg, the egg can become trapped in the follicle. The trapped egg will continue to grow, forming a follicular cyst.
  • If the egg does release, but the sac around it, called the corpus luteum, fails to dissolve, fluid can build up inside of it. The non-dissolving sac will swell, forming a corpus luteum cyst.

Functional ovarian cysts are typically non-malignant, resolve on their own, and don’t require medical attention. You might have no symptoms at all, or mild bloating and discomfort in your lower back or abdomen.  

Neoplastic Ovarian Cysts

Neoplastic ovarian cysts can be benign or malignant, are not connected to your menstrual cycle, and can occur both pre- and post-menopause. There are many type of neoplastic cysts, including:

  • Dermoid cysts, which are also called teratomas. Dermoid cysts form from embryonic cells, and can contain tissue such as fat, hair, skin, or teeth.
  • Cystadenomas, which develop on the surface of an ovary. These are often filled with a material which can be watery or thicker like a mucous.
  • Endometriomas, which occur if you have endometriosis. Uterine endometrial cells growing outside your uterus can form tissue attachments to your ovaries and when stimulated can form cysts.

Neoplastic cysts are still more likely to be benign than cancerous, but can grow quite large, even if you are postmenopausal. If an ovarian cyst ruptures, or causes the ovary to twist, severe pain, bleeding or infection can occur.

Signs You Should Seek Medical Attention for an Ovarian Cyst

If you have a history of ovarian cysts, or your OB/GYN has told you you may have an ovarian cyst, you may be experiencing some pain or discomfort. However, the symptoms of a serious health issue related to cysts should not be ignored.

You could need immediate medical attention for a cyst rupture or ovarian torsion if you experience sudden, sharp abdominal pain, which may or may not be accompanied by fever, nausea, or vomiting. For reasons unknown, ovarian cysts are almost twice as likely to present on the right ovary than the left, making them difficult to distinguish from appendix pain.  This may require a visit in the office to evaluate what might be causing the pain.

Dr. Hagberg can diagnose an ovarian cyst using a screening test like a pelvic ultrasound. Occasionally, a minimally invasive procedure known as laparoscopy is indicated to examine a cyst and remove it if necessary. Laparoscopic surgery involves a very small incision through which a tiny camera and tools can be inserted, to inspect the ovary and remove a cyst if necessary.

In most cases, ovarian cysts are not cancerous and will not affect fertility. If you experience periodic bloating, heaviness, or pain in your abdomen or lower back, and suspect you may have an ovarian cyst, you can book a consultation with Dr. Hagberg to find out whether or not a cyst exists and how it can be treated.