• Ovarian cysts are closed, sac-like structures within the ovary that are filled with a liquid or semisolid substance.
• Ovarian cysts may not cause signs or symptoms. Larger cysts are more likely to cause signs and symptoms such as:
○ Pain in the abdomen, pelvis, sometimes radiating to the low back, is the most common symptom
○ The feeling of bloating or indigestion
○ Increased abdominal girth
○ Feeling an urge to have a bowel movement or having difficult, painful bowel movements
○ Pain during sexual intercourse (dyspareunia)
○ Pain in the lower right or left quadrant of the abdomen on one side
○ Nausea and vomiting
• Ovarian abscesses.
• There are many causes and types of ovarian cysts, for example, follicular cysts, “chocolate cysts,” dermoid cysts, and cysts due to polycystic ovary syndrome (PCOS).
• Most ovarian cysts are not cancerous.
• Most ovarian cysts are diagnosed with ultrasound or physical examination. Transvaginal ultrasound is a common way to examine ovarian cysts.
• The treatment of an ovarian cyst depends upon the cyst’s cause and varies from observation and monitoring to surgical treatment.
• Rupture of an ovarian cyst is a complication that sometimes produces severe pain and internal bleeding. A ruptured (burst) ovarian cyst usually causes pain on one side that comes on suddenly.
Many times ovarian cysts do not cause symptoms. When symptoms do occur, they may include the following:
• Pain during intercourse
• Unusual bleeding
• Abdominal fullness
• Breast pain
• Aching in the pelvic region
Most ovarian cysts are never noticed and resolve without women ever realizing that they are there. When a cyst causes symptoms, pain in the abdomen or pelvis is the most common one. The pain can generate from:
• rupture of the cyst,
• rapid growth and stretching,
• bleeding into the cyst, or
• twisting of the cyst around its blood supply (known as torsion).
Other symptoms may arise if the cyst has reached a large size as a result of pressure or distortion of adjacent anatomical structures. These other symptoms can include
• abdominal fullness, expansion of the abdomen, or bloating,
• low back pain,
• feeling full after eating only a small amount (early satiety),
• urinary urgency,
• difficulty with emptying the bladder,
• feeling an urge to defecate
• having painful bowel movements, or
• pain with sexual intercourse.
There are many causes of ovarian cysts, and most ovarian cysts are not cancerous.
• Follicular cysts: The most common type is a follicular cyst, which results from the growth of a follicle. A follicle is the normal fluid-filled sac that contains an egg. Follicular cysts form when the follicle grows larger than usual during the menstrual cycle and does not open to release the egg. Usually, follicular cysts resolve on their own over days to months. Follicular cysts can contain blood (hemorrhagic cysts) from leakage of blood into the egg sac.
• Corpus luteum cysts: A Corpus luteum cyst is related to the menstrual cycle. The corpus luteum is an area of tissue within the ovary. That occurs after an egg is released from a follicle. If a pregnancy doesn’t happen, the corpus luteum usually breaks down and disappears. It may, however, fill with fluid or blood and persist as a cyst on the ovary. Usually, this cyst is found on only one side, produces no symptoms, and resolves spontaneously.
• “Chocolate cysts:” Endometriosis is a condition in which cells that usually grow inside as a lining of the uterus (womb), instead grow outside of the uterus in other locations. The ovary is a common site for Endometriosis. When Endometriosis involves the ovary, the area of endometrial tissue may grow and bleed over time, forming a blood-filled cyst with red- or brown-colored contents called an endometrioma.
• Polycystic ovarian syndrome: The condition known as a polycystic ovarian syndrome (PCOS) is characterized by the presence of multiple small cysts within both ovaries. PCOS is associated with several hormonal problems and is the most common cause of infertility in women.
• Dermoid cysts (benign cystic teratomas): Both benign and malignant tumors of the ovary may also be cystic. Occasionally, the tissues of the ovary develop abnormally to form other body tissues such as hair or teeth. Cysts with these abnormal tissues are tumors called benign cystic teratomas or dermoid cysts.
• Tubo-ovarian abscesses: Infections of the pelvic organs can involve the ovaries and Fallopian tubes. In severe cases, pus-filled cystic spaces may be present on, in, or around the ovary or tubes.
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