What are the signs and symptoms that you may have with an ovarian cyst?
You can't depend on symptoms
alone to tell you if you have an ovarian cyst. In fact, you'll likely have no
symptoms at all. Or if you do, the symptoms may be similar to those of other
conditions, such as endometriosis, pelvic inflammatory disease, ectopic
pregnancy or ovarian cancer. Even appendicitis and diverticulitis can produce
symptoms that mimic a ruptured ovarian cyst.
Investigations & Diagnosis
To identify the type of cyst, your doctor may perform the following procedures:
Pregnancy test. A positive pregnancy test may suggest that your cyst is a corpus luteum cyst, which can develop when the ruptured follicle that released your egg reseals and fills with fluid. This will also help to rule out a tubal pregnancy if it is negative.
Pelvic ultrasound. In this painless procedure, a wand-like device (transducer) is used to send and receive high-frequency sound waves (ultrasound) through your pelvic area, creating an image of your uterus and ovaries on a video screen. This image can then be photographed and analyzed by your doctor to confirm the presence of a cyst, help identify its location and determine whether it's solid, filled with fluid or mixed. A typical USG picture of a multiloculated cyst is shown here.
Laparoscopy. Using a laparoscope — a slim, lighted instrument inserted into your abdomen through a small incision — your doctor can see your ovaries and remove the ovarian cyst.
CA 125 blood test. Blood levels of a protein called cancer antigen 125 (CA 125) often are elevated in women with ovarian cancer. If you develop an ovarian cyst that is partially solid and you are at high risk of ovarian cancer, your doctor may test the level of CA 125 in your blood to determine whether your cyst could be cancerous. Elevated CA 125 levels can also indicate noncancerous conditions such as endometriosis, uterine fibroids and pelvic inflammatory disease.
The following complications are possible:
Treatment of ovarian cysts
Treatment depends on your age,
the type and size of your cyst, and your symptoms. Your doctor may suggest:
Birth control pills. Your doctor may recommend birth control pills to reduce the chance of new cysts developing in future menstrual cycles. Oral contraceptives offer the added benefit of significantly reducing your risk of ovarian cancer — the risk decreases the longer you take birth control pills.
Specific treatments. If you have a cyst because of endometriosis etc the treatment will be directed towards the primary disease.
Surgery. Your doctor may suggest removal of a cyst if it is large, doesn't look like a functional cyst, is growing or persists through two or three menstrual cycles. Cysts that cause pain or other symptoms may be removed. Some cysts can be removed without removing the ovary in a procedure known as a cystectomy. Your doctor may also suggest removal of the one affected ovary and leaving the other intact in a procedure known as oophorectomy. Both procedures may allow you to maintain your fertility if you're still in your childbearing years. Leaving at least one ovary intact also has the benefit of maintaining a source of estrogen production. If a cystic mass is cancerous, however, your doctor will advise a hysterectomy to remove both ovaries and your uterus. After menopause, the risk of a newly found cystic ovarian mass being cancerous increases. As a result, doctors more commonly recommend surgery when a cystic mass develops on the ovaries after menopause. This surgery may either be done in the conventional open manner - laparotomy or as a keyhole minimally invasive surgery - laparoscopy.