Ovarian Cyst

An ovarian cyst is any collection of fluid, surrounded by a very thin wall, within an ovary. Any ovarian follicle that is larger than about two centimeters is termed an ovarian cyst. An ovarian cyst can be as small as a pea, or larger than an orange.

Most ovarian cysts are functional in nature, and harmless (benign).[1] In the US, ovarian cysts are found in nearly all premenopausal women, and in up to 14.8% of postmenopausal women.

Ovarian cysts affect women of all ages. They occur most often, however, during a woman's childbearing years.

Some ovarian cysts cause problems, such as bleeding and pain. Surgery may be required to remove cysts larger than 5 centimeters in diameter.

Most functional ovarian cysts cause no symptoms and go away without treatment in 1 to 2 months or after 1 to 2 menstrual periods. Some cysts grow as large as 4 in. (10.2 cm) in diameter before they shrink or rupture. A rupturing functional cyst can cause some temporary discomfort or pain.

Functional ovarian cysts do not cause ovarian cancer. But your doctor must rule out other possible types of ovarian cysts or growths before diagnosing a functional cyst. This may involve another exam in 6 or 8 weeks, a pelvic ultrasound, or possibly a laparoscopy procedure to closely examine the cyst and its ovary.

Cysts after menopause: After menopause, ovarian cancer risk increases. This is why all postmenopausal ovarian growths are carefully checked for signs of cancer. Some doctors will recommend removing the ovaries (oophorectomy) when any kind of cyst develops on an ovary after menopause. But the trend in medicine seems to be moving away from surgery for small and simple cysts in postmenopausal women. In the five years after menopause, some women will still have functional ovarian cysts now and then. Some postmenopausal ovarian cysts, called unilocular cysts, which have thin walls and one compartment, are rarely linked to cancer.

A functional ovarian cyst is a sac that forms on the surface of a woman’s ovary during ovulation. It holds a maturing egg. Usually the sac goes away after the egg is released. If an egg is not released, or if the sac closes up after the egg is released, the sac can swell up with fluid.

Functional ovarian cysts are different than ovarian growths caused by other problems, such as cancer. Most of these cysts are harmless. They do not cause symptoms, and they go away without treatment. But if a cyst becomes large, it can twist, rupture, or bleed and can be very painful.

 Ovarian cysts affect women of all ages. The vast majority of ovarian cysts are considered functional (or physiologic). In other words, they have nothing to do with disease. Most ovarian cysts are benign, meaning they are not cancerous, and many disappear on their own in a matter of weeks without treatment. Cysts occur most often during a woman's childbearing years

causes of functional ovarian cysts?

A functional ovarian cyst forms because of slight changes in the way the ovary makes or releases an egg. There are two types of these cysts:

 A follicular cyst occurs when a sac on the ovary does not release an egg, and the sac swells up with fluid.

A luteal cyst occurs when the sac releases an egg and then reseals and fills with fluid.

 The symptoms?

Most functional ovarian cysts do not cause symptoms. The larger the cyst is, the more likely it is to cause symptoms. Symptoms can include:

 Pain or aching in your lower belly, usually when you are in the middle of your menstrual cycle. 

A delay in the start of your menstrual period.

Vaginal bleeding when you are not having your period.

Some functional ovarian cysts can twist or break open (rupture) and bleed. Symptoms include: 

Sudden, severe pain, often with nausea and vomiting (possible sign of a twisted cyst).

Pain during or after sex (possible sign of a ruptured cyst).

If you have these symptoms, call your doctor right away. Some ruptured cysts bleed enough that treatment is needed to prevent heavy blood loss. 

Diagnosis

Your doctor may find an ovarian cyst during a routine pelvic exam. He or she may then use a pelvic ultrasound to make sure that the cyst is filled with fluid. In a few months, after you have been through 2 or 3 menstrual cycles, your doctor will recheck you. The cyst is likely to go away on its own during this time. 

 If you see your doctor for pelvic pain or bleeding, you'll be checked for problems that may be causing your symptoms. Your doctor will ask you about your symptoms and menstrual periods. He or she will do a pelvic exam and may do a pelvic ultrasound. 

Treatment

Most functional ovarian cysts go away without treatment. Your doctor may suggest using heat and medicine to relieve minor pain. If a large cyst bleeds or causes severe pain, you can have surgery to remove it. 

Your doctor may suggest that you take birth control pills, which stop ovulation. This may prevent new cysts from forming.

 TYPES

Follicular cyst: This type of simple cyst can form when ovulation does not occur or when a mature follicle involutes (collapses on itself). It usually forms at the time of ovulation and can grow to about 2.3 inches in diameter. The rupture of this type of cyst can create sharp severe pain on the side of the ovary on which the cyst appears. This sharp pain (sometimes called mittelschmerz) occurs in the middle of the menstrual cycle, during ovulation. About one-fourth of women with this type of cyst experience pain. Usually, these cysts produce no symptoms and disappear by themselves within a few months. A woman's doctor monitors these to make sure they disappear and looks at treatment options if they do not.

 Corpus luteum cyst: This type of functional ovarian cyst occurs after an egg has been released from a follicle. After this happens, the follicle becomes what is known as a corpus luteum. If a pregnancy doesn't occur, the corpus luteum usually breaks down and disappears. It may, however, fill with fluid or blood and persist on the ovary. Usually, this cyst is found on only one side and produces no symptoms. 

Hemorrhagic cyst: This type of functional cyst occurs when bleeding occurs within a cyst. Symptoms such as abdominal pain on one side of the body may be present with this type of cyst. 

Dermoid cyst: This is an abnormal cyst that usually affects younger women and may grow to 6 inches in diameter. It is a type of benign tumor sometimes referred to as mature cystic teratoma. This cyst is similar to those present on skin tissue and can contain fat and occasionally bone, hair, and cartilage. 

The ultrasound image of this cyst type can vary because of the spectrum of contents, but a CT scan and magnetic resonance imaging (MRI) can show the presence of fat and dense calcifications. 

 They can become inflamed. They can also twist around (a condition known as ovarian torsion), causing severe abdominal pain.

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