The ovaries are part of the female reproductive system. They are located on each side of the uterus in the lower abdominal area. Women have two ovaries that produce eggs, as well as the hormones estrogen and progesterone. Sometimes, a fluid-filled sac called a cyst will develop on one of the ovaries. Many women will develop at least one cyst during their lifetime. In most cases, cysts are painless and cause no symptoms.
Ovarian cysts do not usually cause any symptoms. However, symptoms can appear as the cyst grows. Symptoms may include:
- Abdominal bloating or swelling
- Painful bowel movements
- Pelvic pain before or during the menstrual cycle
- Painful intercourse
- Pain in the lower back or thighs
- Breast tenderness
- Nausea and vomiting
Severe symptoms of an ovarian cyst that require immediate medical attention include:
- Severe or sharp pelvic pain
- Faintness or dizziness
- Rapid breathing
These symptoms can indicate a ruptured cyst or an ovarian torsion. Both complications can have serious consequences if not treated early.
Your doctor can detect an ovarian cyst during a routine pelvic examination. They may notice swelling on one of your ovaries and order an ultrasound test to confirm the presence of a cyst.
Imaging tools used to diagnose ovarian cysts include a CT Scan, MRI and Ultrasound. Ultrasound tests help determine the size, location, shape, and composition (solid or fluid filled) of a cyst. Because the majority of cysts spontaneously resolve after a few weeks or months, your doctor may not immediately recommend a treatment plan. Instead, they may repeat the ultrasound test in a few weeks or months to check your condition.
If there aren’t any changes in your condition or if the cyst increases in size, your doctor will request additional tests to determine other causes of your symptoms.
Some ovarian cysts may resolve on its own over time, and in some situations it may be appropriate to wait 6-8 weeks to repeat an ultrasound scan to see if the ovarian cyst is persistent before deciding further management. In the setting of recurrent ovarian cysts, your doctor can prescribe oral contraceptives which stop ovulation. This may help to prevent the development of new cysts.
If your ovarian cyst is small and diagnostic imaging and tumour markers are not suspicious for cancer, your gynaecologist may surgically remove the cyst by performing keyhole surgery (Laparoscopy). If you have a large cyst, a laparotomy (incision in your abdomen) may be required to surgically remove the cyst safely.
An intraoperative diagnosis may be made by the pathologist (through a process known as “Frozen Section”), and if the ovarian cyst is determined to be cancerous, a staging operation can be performed as definitive treatment for women who have completed their families (including hysterectomy, removal of both of your ovaries and fallopian tubes).