Ovarian Cysts: Causes, Symptoms, and Treatment Options

Introduction

The ovaries are two organs that are located on either side of the uterus in the lower abdomen. In addition to the eggs, they produce progesterone and oestrogen. Ovarian cysts are sacs filled with fluid that can be formed either in one ovary or both ovaries. Many of them are very transitory and will go away on their own, but others may get worse, causing discomfort or interrupting reproductive functions.

Though cysts are quite normal during a woman’s reproductive years and are more likely to develop around the time of ovulation, they should not be ignored. Symptoms such as chronic or complicated ovarian cysts can result in several consequences, such as rupture, torsion, reproductive difficulties, and so on, necessitating the need for medical attention. Seeking safe treatment is important so that women can effectively reduce ovarian cyst symptoms and protect their reproductive health.

What is an Ovarian Cyst?

Ovarian cysts are fluid-filled lumps that develop on the surface of an ovary or in the ovarian tissue. Cysts primarily occur during the reproductive years; however, they can occur at any age. Rarely, a cyst may be a sign of cancer. Some cysts can also become cancerous over time, especially after menopause. Sometimes they may burst or twist, causing pain, bleeding, or both. Ultimately, if there is a ruptured cyst or a torsion, doctors may treat it as a medical emergency.

Key points to understand about ovarian cysts:

• Fluid-filled sac on or in the ovary - often benign, or relatively harmless, some can cause pain or complicate things.
• More common in fertile years - often related to ovulation.
• Most are functional ovarian cysts - and they form naturally and usually resolve without medical intervention.
• Some will require medical management, or surgical management - especially in larger, painful or persistent cases.

Symptoms of Ovarian Cysts

Symptoms of an ovarian cyst are uncommon unless the cyst is twisted, ruptured, or is large enough for a woman to touch it. Symptoms of ovarian cysts typically include abdominal bloating, pressure, discomfort, or swelling, which is particularly noticeable on the side of the abdomen where the cyst is located. Other possible symptoms include:

• The primary sign that every woman might notice is the persistent ache in the pelvis. In addition to being localised on one side of the lower abdomen, pain can be either dull and moderate in intensity or acute and of high intensity.
• Ovarian cysts in or on your ovaries can make your abdomen feel swollen or bloated, and therefore, you may experience fullness or pressure in the lower abdomen.
• While experiencing some discomfort during menstruation or sexual intercourse is normal, persistent and severe pain can be indicative of large ovarian cysts that cause inflammation.
• Ovarian cysts sometimes may disrupt hormonal balance, resulting in changes in the menstrual cycle. Women may experience heavier, lighter, or irregular periods, and if the problem persists, it becomes necessary to determine the cause.
• Large cysts can put pressure on your bladder, arousing the need to urinate more frequently.
• Sudden and intense pain (possible cyst rupture or ovarian torsion).

Recognising ovarian cyst symptoms early can lead to the prevention of serious complications.

Causes and Risk Factors

Although there are different causes of ovarian cysts, certain risk factors may increase the likelihood of developing a cyst.

• Hormonal imbalance - The changes in hormone levels may result in the appearance of functional cysts that are linked with the menstrual cycle.
• Pregnancy - Cysts can appear on the ovaries during the early stage of pregnancy to help support pregnancy until the placenta is developed. It appears when the ovulation-formed follicle stays in your ovary for the duration of your pregnancy.
• Endometriosis - The condition in which the tissue that typically lies inside the uterus grows outside it is called endometriosis. These ovarian-attached tissues can occasionally develop into a cyst on their own.
• Severe pelvic infections - If these infections have spread to the ovaries as well as the fallopian tubes, they can result in cysts.
• History of ovarian cysts - The history of ovarian cysts raises the risk of their recurrence.

These factors highlight the importance of regular check-ups for women prone to ovarian cysts.

Ovarian Cysts and Fertility

Ovarian cysts do not always lead to infertility. Functional ovarian cysts normally melt on their own without disturbing conception. Still, some groups can affect reproductive health:

• Endometriomas - These are associated with endometriosis and may lead to damage to ovarian tissue.
• Polycystic Ovary Syndrome (PCOS) - It is characterised by many small cysts, and also irregular ovulation and infertility related to it.
• Large or complex cysts - These can cause the disturbance of normal ovarian function.

Nevertheless, assisted reproductive methods such as IUI and IVF, which can be used as a solution when ovarian cysts and infertility issues are combined, are effective in attaining conception.

Diagnosis of Ovarian Cysts

To determine if an ovarian cyst is safe or needs treatment, it is imperative that the cyst be correctly identified. Doctors gather several readings and tests to determine the type and size of the cyst and to find the potential risk that might be involved.

Common diagnostic methods include:

• Pelvic examination - It is a physical check-up to detect swelling or tenderness in the ovaries.
• Ultrasound scan - It produces pictures of the ovaries to give an idea of the cyst’s size, shape, and texture.
• Blood tests - These provide information on the levels of hormones and can also look for markers to eliminate the suspicion of cancer.
• Laparoscopy - It is a minimally invasive procedure used in complicated cases for both diagnosis and treatment.

Treatment Options for Ovarian Cysts

The treatment will vary based on the type of cyst, its size, the symptoms, and whether the fertility aspects are considered. The majority of cysts typically resolve without treatment; however, some cysts may require treatment.

Primary treatment approaches include:

1. Watchful Waiting

   Typically, the majority of small functional ovarian cysts tend to resolve or disappear because of the body's natural process. In some cases, doctors do not take action straight away, but instead suggest several ultrasound scans to monitor and assess any changes before deciding on the necessary treatment.

2. Medications

   Medications cannot remove any existing cysts, but can prevent the production of new cysts in females by affecting the hormonal byproducts that are used when stabilising and increasing the ovulation cycle activity.

3. Surgery

   When cysts get too large, do not go away, or cause terrible pain, surgery is required.

   • Cystectomy – gets rid of the cyst while the ovary remains untouched, ensuring the safety of your reproductive system.
   • Oophorectomy - aims at removing the affected part if the damage is severe; however, the other ovary takes over to support reproduction in most cases.

   Minimally invasive laparoscopic surgery is probably the best option, which ensures that the patient will recover quickly and will feel a minimum of pain.

Conclusion

Ovarian cysts should not be taken lightly, particularly if you are experiencing symptoms like pelvic pain, bloating or irregular cycles. Delayed diagnosis could lead to problems such as rupture of a cyst, torsion of an ovary, or a situation in which the woman is unable to become pregnant.