An ovarian cyst is a fluid-filled sac within the ovary. Often they cause no symptoms. Occasionally they may produce bloating, lower abdominal pain, or lower back pain. If the cyst either breaks open or causes twisting of the ovary severe pain may occur. This may result in vomiting or feeling faint. The majority of cysts are, however, harmless.

Most ovarian cysts are related to ovulation being either follicular cysts or corpus luteum cysts. Other types include cysts due to endometriosis, dermoid cysts, and cystadenomas. Many small cysts occur in both ovaries in polycystic ovarian syndrome. Pelvic inflammatory disease may also result in cysts. Rarely cysts may be a form of ovarian cancer. Diagnosis is undertaken by pelvic examination with an ultrasound or other testing used to gather further details.

 

Signs and symptoms

Some or all of the following symptoms may be present, though it is possible not to experience any symptoms:

  • Abdominal pain. Dull aching pain within the abdomen or pelvis, especially during intercourse.
  • Uterine bleeding. Pain during or shortly after beginning or end of menstrual period; irregular periods, or abnormal uterine bleeding or spotting.
  • Fullness, heaviness, pressure, swelling, or bloating in the abdomen.
  • When a cyst ruptures from the ovary, there may be sudden and sharp pain in the lower abdomen on one side.
  • Change in frequency or ease of urination (such as inability to fully empty the bladder), or difficulty with bowel movements due to pressure on adjacent pelvic anatomy.
  • Constitutional symptoms such as fatigue, headaches
  • Nausea or vomiting
  • Weight gain

Other symptoms may depend on the cause of the cysts:

Symptoms that may occur if the cause of the cysts is polycystic ovarian syndrome (PCOS) may include increased facial hair or body hair, acne, obesity and infertility.

If the cause is endometriosis, then periods may be heavy, and intercourse painful.

 

Diagnosis

  • A 2cm left ovarian cyst as seen on ultrasound
  • Ovarian cysts are usually diagnosed by either ultrasound, CT scan or MRI, and correlated with clinical presentation and endocrinologic tests as appropriate.

 

Surgery

Although most cases of ovarian cysts involve monitoring, some cases require surgery. This may involve removing the cyst, or one or both ovaries. Technique is typically laparoscopic, unless the cyst is particularly large, or if pre-operative imaging suggests malignancy or complex anatomy.