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Do you occasionally experience discomfort in the form of lower abdominal pain, distension, or pressure in your abdominal region? If so, then there is a possibility that  you might be confronting an ovarian cyst. Although typically innocuous, these cysts can arise due to hormonal fluctuations and may present complications if not addressed in a timely manner.

Ovarian cysts have historically generated confusion, apprehension, and unease among women. Nevertheless, the past few decades have witnessed significant advancements in medical science, enabling a more comprehensive understanding of these cysts—their nature, impact on our well-being, and requisite treatment options when necessary.

In this article, we will delve into an in-depth analysis of ovarian cysts, empowering you to recognize their symptoms and make well-informed decisions regarding your health. We will explore the aetiology or probable causes of ovarian cysts, discuss the various treatment modalities available for managing this condition, address potential complications, and offer guidance on preventive measures and self-care strategies.

Book a consultation with Dr. Pam Tan today.

What is an ovarian cyst?

An ovarian cyst refers to a fluid-filled sac that develops on or within the ovary. While numerous types exist, the majority are benign and often resolve spontaneously without intervention. However, certain ovarian cysts may result in complications, necessitating surgical procedures.

What are the types of ovarian cysts?

Ovarian cysts can be categorised based on their origin, composition, or distinguishing features. The most prevalent types of ovarian cysts encompass:

1. Functional cysts

Functional cysts represent the most frequent type of ovarian cyst and emerge in response to physiological changes occurring during the menstrual cycle. These cysts develop when a follicle fails to release the ovum, leading to its continued growth and eventual cyst formation. Although the presence of a cyst may be disconcerting, it indicates that the ovaries are functioning appropriately. Typically, functional cysts diminish in size over time, often within three menstrual cycles, even in the absence of medical treatment.

Functional cysts, otherwise known as simple cysts, are further divided into two types:

  • Follicular cysts. These cysts develop when a follicle (the ovary’s structure containing an egg) doesn’t rupture and release the egg as it should during ovulation. Instead, the follicle continues to grow and forms a cyst.
  • Corpus luteum cysts. These cysts develop when the corpus luteum (the structure that forms after the follicle releases an egg) fills with fluid and doesn’t dissolve as it should. This can cause a cyst to form.

2. Other cysts

  • Dermoid cysts. These cysts develop from cells that are present in the ovaries from birth. They can contain hair, skin, and other tissues usually found on the body.
  • Endometriomas. These cysts develop due to endometriosis, a condition in which tissue like the lining of the uterus grows outside the uterus.
  • Cystadenomas. These cysts develop from the cells on the surface of the ovary and are typically filled with a watery or mucous-like fluid.
  • Polycystic ovaries. This condition is characterised by multiple small cysts on the ovaries and can be associated with hormonal imbalances and fertility issues.
  • Ovarian cancer. Unlike the conditions above, ovarian cancer tumours are often mixed tissue or solid masses containing cancer cells.

What are the risk factors associated with ovarian cysts?

Certain women exhibit a heightened susceptibility to developing ovarian cysts, particularly those in their reproductive years, are pregnant or experiencing hormonal imbalances, affected by endometriosis, or have a familial history of the condition. Additionally, women who have previously experienced ovarian cysts or are undergoing fertility treatments may face an elevated risk.

Although some risk factors for ovarian cysts, such as age and genetic predisposition, remain beyond one’s control, others can be mitigated through lifestyle modifications and appropriate medical interventions. If you have concerns about your likelihood of developing ovarian cysts, it is crucial to consult your healthcare professional.

What are the signs and symptoms of ovarian cysts?

Generally, smaller cysts are asymptomatic or cause no symptoms. In most instances, women with ovarian cysts may be totally unaware of their presence. Nonetheless, such cysts may be detected during routine pelvic examinations or diagnostic imaging tests.

However, ovarian cysts can also cause symptoms such as:

  • Abdominal or pelvic pain
  • Bloating or swelling
  • Changes in the menstrual cycle
  • Pain during sexual intercourse
  • Urinary problems like frequent urination or difficulty emptying the bladder
  • Digestive issues, like nausea, vomiting, or constipation

What size of the ovarian cyst is dangerous?

The size of an ovarian cyst does not necessarily serve as an indicator of its potential danger. The majority of ovarian cysts are benign and resolve spontaneously without causing harm. Nevertheless, specific cyst types may evoke greater concern, irrespective of size.

For instance, solid ovarian cysts or those with irregular borders may warrant more attention than simple cysts containing clear fluid. Furthermore, cysts that endure for several months or exhibit growth over time may necessitate further assessment.

In general, any ovarian cyst that precipitates symptoms such as discomfort, bloating, or alterations in the menstrual cycle should be evaluated by a healthcare professional, regardless of size. Moreover, any cyst exceeding 5 centimetres (approximately 2 inches) or displaying features suggestive of risks of malignancy, such as solid constituents or thick walls, may demand additional testing or intervention.

What are the warning signs of a ruptured ovarian cyst?

The warning signs of a ruptured ovarian cyst warrant careful attention, as they may indicate a potentially serious medical condition. The symptoms enumerated below warrant immediate evaluation by a healthcare professional. It is crucial to consult a healthcare provider if any of these warning signs are present, as timely intervention is essential to mitigate complications and ensure appropriate management.

[*] The abdominopelvic cavity is situated between the diaphragm and the pelvic floor, encompassing both the abdominal and pelvic cavities. The parietal peritoneum lines the walls of this cavity, while the visceral peritoneum envelops the abdominal organs, specifically the stomach, liver, spleen, and portions of the small and large intestines. Organs located within the visceral peritoneum are referred to as “intraperitoneal,” whereas those outside of it are designated as “retroperitoneal.”

How are ovarian cysts diagnosed?

Ovarian cysts are typically diagnosed through a medical history, physical examination, and imaging tests. The following are some standard methods used to diagnose ovarian cysts:

  • Pelvic exam. A healthcare provider will feel the ovaries and uterus during a pelvic exam for abnormalities, such as cysts.
  • Ultrasound. This imaging test uses high-frequency sound waves to create images of the ovaries and other pelvic organs. Ultrasound can help determine an ovarian cyst’s size, location, and characteristics.
  • Imaging tests. Imaging tests, such as CT scans or magnetic resonance imaging (MRI), can provide more detailed images of the ovaries and surrounding structures.
  • Blood tests. Blood tests may be done to measure certain tumor (cancer) markers or hormones, such as estrogen and progesterone, which can be associated with ovarian cysts.

If an ovarian cyst is discovered, the doctor may recommend additional tests to determine whether the cyst is benign or malignant. Sometimes, a surgery may be necessary to remove the cyst and determine its nature.

How are ovarian cysts treated?

In many cases, ovarian cysts do not require treatment and may resolve independently without causing any harm. However, if a cyst is causing symptoms or is deemed potentially cancerous, the healthcare provider may recommend one or more of the following treatments:

  • Watchful waiting. In cases where the cyst is small and not causing symptoms, the healthcare provider may recommend monitoring the cyst with regular pelvic exams or imaging tests.
  • Medications. Hormonal birth control pills may be prescribed to help regulate the menstrual cycle and prevent the development of new cysts. Also, pain relievers may be recommended to alleviate any pain or discomfort.
  • Surgery. If the cyst is large, causing severe symptoms, or is suspected to be cancerous, surgery may be necessary to remove the cyst or the entire ovary. In some cases, the surgeon may perform minimally invasive laparoscopic surgery. In other cases, open surgery may be necessary.

What is the outlook for ovarian cysts?

The prognosis for ovarian cysts is contingent upon various factors, including the cyst’s type, size or dimensions, characteristics, the presence of symptoms, and any underlying medical conditions.

The majority of ovarian cysts are benign and do not contribute to long-term health complications. Simple cysts, characterised by clear fluid and dimensions less than 5 centimetres, typically resolve spontaneously within several weeks or months without necessitating medical intervention.

Nevertheless, in certain instances, ovarian cysts may provoke complications or are indicative of more severe health issues. For example, large or rapidly expanding cysts may elicit pain or discomfort, while ruptured or torsed (twisted) cysts can induce acute pain and potentially life-threatening complications.

In rare circumstances, ovarian cysts may exhibit malignancy or cancerous properties. Furthermore, the risk of malignancy escalates with factors such as age, familial history of ovarian cancer, and other considerations.

The Takeaway

Closely monitoring your health is crucial for preventing further complications should you develop an ovarian cyst. For instance, undergoing periodic pelvic ultrasounds can help monitor cyst size and ensure existing cysts do not worsen.

Receiving an ovarian cyst diagnosis can understandably be distressing; however, staying well-informed about your reproductive health is vital to proactively safeguarding your well-being. Equipped with the right knowledge and a conscientious approach to self-care, you can safely manage any ovarian cyst occurrences and gain a better understanding of your overall health.At the Dr. Pamela Tan Clinic, we offer professional guidance and medical intervention for women experiencing ovarian cysts. We are here to help you overcome this health concern and understand its impact, so you can make informed decisions on how to move forward. To schedule an appointment with us, please call +65 6254 2878 or send a message here.

Dr Pamela Tan
About Dr Pamela Tan

Dr Pamela Tan is a board certified obstetrician and gynecologist in Singapore. She finished her undergraduate studies at the National University of Singapore and earned her post-graduate degree at the Royal College of Obstetricians and Gynaecologists in the UK. She is an accredited specialist by the Specialist Accreditation Board (Ministry of Health), and a fellow of the Academy of Medicine, Singapore. She subspecialises in colposcopy and is certified to perform Level 3 minimally invasive keyhole surgeries such as laparoscopic hysterectomy, myomectomy and cystectomy. Dr Pam also supports the natural birthing method and she strives to provide a personalised care and treatment for each patient.