Ovarian Cysts

Sometimes girls are told that they have a cyst on their ovaries. Fortunately most go away without any treatment. Read on to understand more.

What are Ovaries?

You have two, small, grape-shaped organs called ovaries inside of your abdomen (belly) on either side of your uterus. When you are born, your ovaries are already filled with millions of eggs. When you reach puberty and are becoming a woman, chemical signals from the pituitary gland in your brain “tell” your ovaries to ripen an egg. Usually, once a month an egg is released from a fluid filled sac in the ovary so it can travel through the fallopian tube to the uterus. This is called ovulation, which is part of your monthly cycle.

What are ovarian cysts?

A cyst is a fluid-filled sac that develops in the ovary and usually dissolves after ovulation. There are different types of cysts.

Follicular cyst - A follicular cyst develops each month and contains the small egg within it. The sac ruptures during ovulation and the egg comes out of the cyst. Sometimes the cyst can grow larger than the normal size which is up to 3 cm. If the sac that holds the egg doesn’t break open to release the egg, it can grow, anywhere in size from 1 inch to 4 inches across. Usually this type of cyst disappears in one to three months and often does not cause pain. Your health care provider (HCP) may discover that you have a follicular cyst during a pelvic exam or by a test called an ultrasound.

Corpus luteum cyst - A corpus luteum cyst is normal and usually forms each month after the egg breaks out or ovulates. This type of cyst usually disappears by itself in a few weeks, but it can grow 3-4 inches across, and may bleed inside of the cyst or your belly. This type of cyst can cause pain in your abdomen (belly).

Polycystic Ovary Syndrome (PCOS) - pronounced “poly-sis-stick” “o-va-ree” syndrome actually means many cysts in the ovary. Some girls with this condition have lots of tiny cysts or bumps, inside of their ovaries, and others do not. This type of ovarian cyst is not harmful, does not have to be removed, and almost never causes pain.

Female Reproductive Anatomy

I have pain on my side every month or so, is this normal?

Some girls and women experience pain on one side or the other below their belly button about 2 weeks before they get their periods. Others do not. This is called “Mittelschmerz” - pain or discomfort with ovulation. This kind of pain is mild to moderate and usually lasts anywhere from 1 hour to 1-2 days. However, if you have severe pain it could be caused by other problems, so you should check with your health care provider or go to a nearby emergency room.

How are ovarian cysts diagnosed?

Because most ovarian cysts do not cause symptoms and go away on their own, they may be completely unnoticed. If you have pain or irregular periods that prompt you to see your health care provider (HCP), you may need to have a pelvic ultrasound to see if you might have a cyst. If you have a cyst, it will be visible on the ultrasound.

What is a pelvic ultrasound?

A pelvic ultrasound is a test that uses sound waves to make a picture of your reproductive organs (i.e. ovaries and uterus) and bladder (where your urine is stored). It is usually necessary to have a full bladder before the procedure. This means you will need to drink a lot of water before you arrive for the test. The test itself is not painful, but you may feel a little uncomfortable since your bladder will be full until you pass urine (pee) after the test.

You will lie on your back on an exam table while the technician places a warm gel on your lower belly with something that looks like a microphone. The technician will gently move this microphone-like instrument over your belly. The instrument actually makes a picture by picking up sound waves. From these pictures your health care provider will know if you have an ovarian cyst. If you have a cyst, your health care provider will most likely repeat the pelvic ultrasound in about 2-8 weeks to make sure that the cyst is getting smaller or is gone completely.

What happens if I have an ovarian cyst?

Because most ovarian cysts usually go away on their own, you don’t need to worry if you have one. Your health care provider will treat any abdominal or belly pain that you might have. Pain in your abdomen can last for several weeks, but should never be so severe that you can’t walk or that you pass out. Your HCP might also tell you not to exercise or participate in sports until the cyst becomes small or goes away completely. This is because vigorous activity might cause your ovary to twist on itself which is a condition that requires emergency care.

Can ovarian cysts be dangerous?

An ovarian cyst usually doesn’t cause any problems, but occasionally it may cause the ovary to twist on its root. This is called “torsion”. Torsion blocks the blood from going to the ovary. If this were to happen, you would have severe abdominal pain and you might feel like throwing up or even feel like passing out. If you have any of these symptoms, you should see your HCP immediately or go to the closest hospital emergency room.

Sometimes an ovarian cyst may not go away on its own and needs to be removed. In this case, a surgeon would remove the cyst while leaving the rest of the ovary in place. Very rarely this type of cyst might be related to another problem, such as a benign tumor or very, very rarely cancer.

Can ovarian cysts be prevented?

If you have a large ovarian cyst or a history of developing ovarian cysts, your HCP may prescribe birth control pills to prevent your body from ovulating. This lowers your chances of forming new cysts in the future, but doesn’t make the cyst you already have go away any faster. Talk to your HCP to find out if birth control pills are right for you.

“Ovarian cysts can be common in girls and women who have started their periods. Most of the time ovarian cysts do not cause any problems and disappear on their own. Sometimes, however, your HCP will need to keep an eye on the cyst until it goes away. Surgery is rarely needed. Talk with your HCP if you have irregular periods, or pain in your belly that doesn’t go away”.

Written and reviewed by the CYWH Staff at Boston Children's Hospital

Source: youngwomenshealth.org