by Ugo Ugboh

Ovarian cysts are fluid-filled sacs or pockets that develop in or on the surface of an ovary. While they are often harmless and may resolve on their own, some cysts can cause significant discomfort and complications if left untreated. Understanding ovarian cysts is essential for early detection and management.

What are ovarian cysts?
Ovarian cysts are a common gynaecological condition affecting women of all ages. Most ovarian cysts are functional, meaning they occur as part of the menstrual cycle and are usually not harmful. However, some cysts may indicate underlying health issues that require medical attention.

Types of ovarian cysts
Ovarian cysts are categorized into three main types based on their cause and nature: functional cysts, pathological cysts, and those associated with polycystic ovary syndrome (PCOS).

Functional cysts
Functional cysts are the most common type of ovarian cysts and are directly linked to the menstrual cycle. These cysts are usually harmless and resolve on their own within a few menstrual cycles. They are not caused by disease but by normal ovary functions.

a. Follicular cysts: A follicle is a sac in the ovary that holds a developing egg. Normally, during ovulation, the follicle bursts open to release the egg. A follicular cyst forms when the follicle does not rupture and instead continues to grow. These cysts are generally painless and may go unnoticed unless they grow large, causing bloating or mild discomfort.

b. Corpus luteum cysts: After ovulation, the empty follicle transforms into a structure called the corpus luteum, which produces hormones to support pregnancy if conception occurs. A corpus luteum cyst forms when this structure seals off and fills with fluid instead of breaking down as usual. These cysts may cause mild pain or irregular bleeding. In rare cases, they can grow large, rupture, or cause ovarian torsion (twisting of the ovary).

Pathological cysts
Pathological cysts are less common and are caused by abnormal cell growth, rather than normal ovary functions. These cysts may require medical attention, as some can grow large or become cancerous.

a. Dermoid cysts (mature cystic teratomas): Dermoid cysts form from embryonic cells and may contain tissues such as hair, skin, teeth, or even fat. These cysts are typically benign (non-cancerous) and can develop in women of any age, though they are most common in younger women. Dermoid cysts can grow large, causing discomfort or pressure in the abdomen. Surgical removal is often necessary if they cause symptoms.

b. Cystadenomas: These cysts develop from the surface of the ovary. They can be filled with a watery fluid (serous cystadenomas) or a thick, mucous-like substance (mucinous cystadenomas). Cystadenomas can grow to a significant size, sometimes causing abdominal swelling or pain. They are typically non-cancerous but may require removal to prevent complications.

c. Endometriomas: Endometriomas develop in women with endometriosis, a condition where the tissue lining the uterus (endometrium) grows outside the uterus. These cysts form when this tissue attaches to the ovaries. Endometriomas, also called “chocolate cysts”, are filled with thick, dark blood. They can cause severe pelvic pain, particularly during menstruation or intercourse.

Polycystic ovary syndrome (PCOS)
PCOS is a hormonal disorder characterized by the presence of multiple small, underdeveloped follicles (sometimes called cysts) on the ovaries. Unlike other types of cysts, these are not true cysts but rather immature follicles that fail to release eggs regularly. In PCOS, the ovaries produce higher levels of androgens (male hormones), disrupting the normal menstrual cycle and ovulation process. This hormonal imbalance leads to the formation of multiple tiny cyst-like structures.

Symptoms of ovarian cysts
Ovarian cysts often have no symptoms, especially if they are small. However, larger cysts or those causing complications may lead to:
• Pelvic pain, often sharp or sudden.
• Abdominal bloating or swelling.
• Pain during intercourse.
• Irregular menstrual cycles.
• Frequent urination or difficulty emptying.
the bladder.
• Nausea or vomiting, especially if the
cyst ruptures.

Causes of ovarian cysts
• Hormonal imbalances.
• Endometriosis.
• Pregnancy (functional cysts may form.
during early pregnancy).
• Severe pelvic infections.
• Previous ovarian cysts.

Complications of ovarian cysts
While most cysts are benign, some may lead to complications:
• Rupture: Can cause severe pain and internal bleeding.
• Ovarian torsion: When a large cyst causes the ovary to twist, cutting off blood supply. This requires immediate medical attention.
• Cancer: Rare, but some cysts may be cancerous, especially in postmenopausal women.

Diagnosis
To diagnose an ovarian cyst, healthcare providers may use:
• Pelvic exam: To feel for abnormalities.
• Ultrasound: To determine the cyst’s size, location, and type.
• Blood tests: To check for markers like CA-125 in cases where ovarian cancer is suspected.
• Laparoscopy: A surgical procedure to examine or remove cysts.

Preventive measures
While ovarian cysts cannot always be prevented, some steps can help reduce risk: • Regular pelvic exams to detect changes early.
• Maintaining a healthy weight.
• Managing underlying conditions like PCOS.
• Discussing persistent symptoms with a doctor.

When to see a doctor
Seek immediate medical care if you experience:
• Sudden, severe pelvic pain.
• Pain accompanied by fever or vomiting. • Symptoms of shock, such as dizziness,
fainting, or rapid breathing.

Conclusion
Ovarian cysts are often harmless, but understanding their symptoms and causes is vital for timely intervention. Regular check-ups and prompt attention to unusual symptoms can help ensure better health outcomes. If you suspect an ovarian cyst, consult a healthcare professional for an accurate diagnosis and appropriate treatment plan.

By raising awareness about ovarian cysts, we can empower women to take proactive steps toward their reproductive health.