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Q&A About Ovarian Cysts

  • If you’re a woman with ovaries, chances are you’ve had an ovarian cyst at some point in your life—they’re very common. It’s possible that you never even knew it. Most of the time they’re harmless, don’t cause symptoms, and go away on their own. While most ovarian cysts will never develop into cancer, it still pays to know the answers to some frequently asked questions about ovarian cysts.

    Q: What exactly are ovarian cysts?

    A: They are fluid-filled sacs that develop on or in the ovary. Many women get them. Women who are menstruating often develop at least one cyst a month. Cysts are less common after menopause.

    Ovarian cysts vary in size and can range from less than one centimeter (about one-half inch) to larger than 10 centimeters (4 inches).

    Q: What causes ovarian cysts?

    A: The most common causes include:

    • Hormones. Drugs that help with ovulation can cause cysts. Hormonal problems can trigger them too. Most hormone-related cysts go away on their own.
    • Pregnancy. A cyst usually develops early in pregnancy. It’s there to help support the pregnancy before the placenta forms.
    • Endometriosis. Women with this condition can develop cysts called endometriomas. This type of cyst can cause pain during menstruation and sex.
    • Severe pelvic infection. Cysts can form when infections spread to the ovaries and fallopian tubes.

    Q: Can ovarian cysts be a sign of cancer?

    Most ovarian cysts are benign and are not caused by cancer. “And benign cysts don’t increase the risk of cancer,” said Christine Chu, MD, a gynecologic oncologist at Fox Chase Cancer Center.

    It’s rare for cancer to be the cause of an ovarian cyst in premenopausal women. Cysts on or around the ovary are somewhat more likely to be cancerous in postmenopausal women.

    If an ovarian cyst is cancer, it means the cancerous cells inside the ovary have multiplied in an uncontrolled way to form a tumor. If not treated, these tumor cells can spread to nearby tissues and to other places in the body.

    Q: What are the symptoms?

    A: Since most ovarian cysts are small, they typically don’t cause symptoms. But if they grow, you may have symptoms.

    “Ovarian cysts are tough because they can be quite large before there are any symptoms,” Chu said. “A lot of the symptoms can be very nonspecific—pelvic pain, pelvic discomfort, pressure on the bladder or rectum, discomfort with intercourse. Or you can have no symptoms at all. But, if you have any symptoms that are persistent, or worsen over time, you should call your physician.”

    Q: How are ovarian cysts diagnosed and treated?

    A: Sometimes, cysts can be detected during a routine pelvic exam or when you’re being examined for symptoms. Your doctor may order a pelvic ultrasound to confirm the diagnosis. And one or more blood tests may be done to pinpoint the cause of a cyst.

    Ovarian cysts don’t always require treatment. For premenopausal women, cysts usually go away on their own within a month or two. That’s typically not true in postmenopausal women; ovarian cysts tend to hang around longer in this group.

    If a cyst is painful, large, or suspicious for cancer, treatment usually means removal.

    “Ovarian cysts can’t be biopsied like you can biopsy skin or the cervix,” Chu explained. “You have to surgically remove them either by cystectomy (removing only the cyst) or oophorectomy (the entire ovary).”

    If a cyst isn’t causing problems, monitoring any symptoms and repeating ultrasounds is a common approach.

    “The most important take-away message about ovarian cysts is to not panic,” Chu said. “Management of cysts really depends on a person’s age and how a cyst looks. A lot of cysts can be followed with scans to make sure they are going away or not growing.”

    If you are concerned after receiving a diagnosis of an ovarian cyst or are having unusual symptoms that are worrisome, it is a good idea to see a specialist