To start off, what are ovarian cysts?
Ovarian cysts are pouches or sacs filled with fluid that develop in the ovaries or on their surface. Many women have ovarian cysts at some point in their life. These cysts usually cause no symptoms and/or pain and disappear on their own, without the need for treatment.
Causes & Types of Ovarian Cysts
There are several types of ovarian cysts. Most arise as a result of the menstrual cycle and are called functional or physiologic cysts, which can be follicular or corpus luteal cysts.
Follicular (or corpus luteal cysts)
During the normal menstrual cycle, follicles develop on the ovaries and produce hormones, leading to the release of an egg from the ovaries during ovulation. However, abnormalities in this process, such as the follicle not bursting or the failure to release the egg, lead to the formation of a follicular cyst. These cysts usually do not cause pain and resolve quickly.
Upon release of the egg, the follicle starts producing estrogen and progesterone. At this stage it is called the corpus luteum. When it doesn’t dissolve, either 14 days after ovulation with no fertilization or 14 weeks in the case of pregnancy, a corpus luteal cyst will form. If bleeding occurs inside the cyst due to necrosis, the cyst is called a hemorrhagic corpus luteal cyst. Hemorrhagic corpus luteal cysts can be confused with endometriomas.
Dermoid cysts (teratomas), cystadenomas & ovarian torsion
Cysts that do not form as part of the normal menstrual cycle include dermoid cysts (teratomas), cystadenomas, cancers, and endometriomas.
Teratomas contain abnormal tissues, such as hair, fat and teeth. Although rare, they can become cancerous.
Cystadenomas are benign ovarian tumors that usually develop on the outside of the ovary. Sometimes, these can get very large and develop into cancer.
Ovarian torsion—the twisting of the ovary that can decrease and even cut the blood flow to the ovary—can occur when large cysts move the ovary out of place. The symptoms for this medical issue, which can be very serious, include extreme pain. Patients should go to the hospital for treatment that may include laparoscopic detorsion in order to preserve ovarian function.
Endometriomas (chocolate cysts)
Endometriomas are a type of cyst that contain endometriosis tissue and can lead to the spreading of endometriosis to other areas of the abdominal cavity and pelvis, as well as causing an ovarian torsion. Endometriomas are also known as “chocolate cysts” due to tissue and blood that lead to the formation of a brown fluid. On his website, Dr. Tamer Seckin explains the process of endometrioma formation and the spread of endometriosis in great detail.
Risk factors, symptoms, and diagnosis
You may be prone to forming an ovarian cyst if you experience hormonal problems, have had previous ovarian cysts, if you’re pregnant, if you’ve had a severe pelvic infection, or if you have endometriosis.
Symptoms include menstrual pain, pelvic pain in general, irregular and/or painful menstrual periods, bloating, nausea, bladder and bowel dysfunction and pain, lower back pain, and fatigue. While general pelvic pain can have various causes, intense and sudden pelvic pain is a major symptom of ovarian cyst rupture and should be checked immediately by a doctor.
Diagnosis can be done through several techniques, including transvaginal ultrasonography, magnetic resonance imaging (MRI), CAT scan, laparoscopy, and cancer antigen 125 (CA 125) protein blood test.