Ovarian Cysts

Ovarian cysts are fluid-filled sacs that develop on or within the ovaries. These structures can form during the normal menstrual cycle or due to underlying conditions. While many cysts resolve without intervention, some may grow larger or persist, potentially causing discomfort or complications. Most women develop at least one ovarian cyst during their reproductive years, with varying impacts on their daily activities and reproductive health.

Dr. Harvard Lin

Obstetrician & Gynaecologist

MBBS (SG) | MRCOG (UK) | MMed (OBGYN) (SG)

Symptoms Causes Types Diagnosis Treatment Prevention FAQ

Symptoms of Ovarian Cysts

Women with ovarian cysts may experience various symptoms, though some cysts remain asymptomatic until discovered during routine examinations.

Pelvic Pain: Persistent or intermittent pain in the lower abdomen, which may be sharp or dull. The pain can intensify during physical activity or menstruation.
Bloating: A sensation of fullness or heaviness in the abdomen. This occurs when larger cysts create pressure on surrounding organs.
Changes in Menstruation: Irregular periods or unusual spotting between periods. Some women may also experience heavier or lighter menstrual flow than usual.
Urinary Frequency: Increased need to urinate due to cyst pressure on the bladder, which can temporarily reduce bladder capacity.
Pain During Intercourse: Discomfort or pain during sexual activity, particularly in certain positions. This occurs when cysts are positioned where they can be compressed during intercourse.

Causes and Risk Factors

Several factors can influence the development of ovarian cysts, ranging from hormonal changes to underlying medical conditions.

Hormonal Fluctuations

Regular menstrual cycles involve the formation of functional cysts. These hormonal changes can sometimes lead to larger or persistent cysts.

Endometriosis

A condition where uterine tissue grows outside the uterus. Endometriosis can cause a specific type of ovarian cyst called an endometrioma.

Polycystic Ovary Syndrome (PCOS)

A hormonal disorder causing multiple small cysts to form on the ovaries. PCOS affects the regular release of eggs and hormone production.

Pregnancy

The cyst that releases progesterone early in pregnancy can remain on the ovary through the first trimester. These cysts typically resolve on their own.

Previous Ovarian Cysts

Women who have had ovarian cysts are more likely to develop them again. This pattern may indicate an underlying tendency toward cyst formation.

Types of Ovarian Cysts

Functional Cysts

Follicular cysts form when an egg-containing follicle fails to release an egg and continues growing. Corpus luteum cysts develop after an egg is released and the follicle fills with fluid. These cysts typically resolve within 2-3 menstrual cycles without treatment.
Dermoid Cysts

Also called teratomas, these cysts contain various types of body tissue, including hair, skin, or teeth. They develop from cells present from birth and can grow slowly over time. Dermoid cysts often require surgical removal to prevent complications.
Cystadenomas

These cysts develop from ovarian surface tissue and can be filled with watery (serous) or mucous (mucinous) material. They can grow quite large and may need surgical removal, especially if they cause symptoms or show concerning features on imaging.
Endometriomas

These cysts form when endometrial tissue grows within the ovaries. They often appear dark and are sometimes called chocolate cysts due to their appearance. Endometriomas can cause pain and may affect fertility if left untreated.

Diagnostic Methods

Physical Examination

The doctor performs a pelvic examination to check for tenderness or swelling in the ovarian area. This initial assessment helps determine if further testing is needed. The examination may reveal an enlarged ovary or signs of surrounding inflammation.

Ultrasound Imaging

Transvaginal or abdominal ultrasound provides detailed images of the cysts, showing their size, location, and composition. The ultrasound can distinguish between solid and fluid-filled cysts and help identify potentially concerning features. Regular ultrasound monitoring may be recommended for certain types of cysts.

Blood Tests

Specific blood tests check hormone levels and markers that might indicate other conditions. These tests may include CA-125 (a marker that can be elevated with certain types of cysts), hormone levels, and pregnancy tests when relevant.

Additional Imaging

In some cases, CT scans or MRIs might be used to provide more detailed images of complex cysts or to plan surgical treatment. These imaging methods can show the relationship between the cyst and surrounding structures more clearly.

Treatment Options

Treatment for ovarian cysts depends on factors including the cyst type, size, symptoms, and the patient’s age and health status.

Non-Surgical Treatment

Observation: Regular monitoring through ultrasound examinations tracks changes in cyst size and appearance. This approach suits asymptomatic, simple cysts that are likely to resolve naturally over several menstrual cycles.

Pain Management: Over-the-counter pain medications help manage discomfort and menstrual pain associated with ovarian cysts. These medications reduce inflammation and provide temporary symptom relief.

Hormonal Therapy: Birth control pills may prevent new functional cysts from forming. This treatment option suits women with recurrent functional cysts who are not trying to conceive.
Surgical Treatment

Laparoscopic Cystectomy: This minimally invasive procedure removes the cyst while preserving the ovary. The surgeon makes small incisions and uses specialised instruments to carefully excise the cyst from the ovarian tissue.

Oophorectomy: Complete removal of the affected ovary becomes necessary when the cyst is very large, complex, or suspicious of malignancy. This procedure may be performed through laparoscopy or traditional open surgery.

Emergency Surgery: Immediate surgical intervention addresses complications such as cyst rupture or ovarian torsion. These procedures prevent further complications and preserve ovarian function when possible.

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Prevention and Management

Regular gynaecological check-ups enable early detection of ovarian cysts through routine pelvic examinations. Maintaining a healthy weight and staying physically active may help regulate hormones and reduce the risk of certain types of cysts. Recording menstrual cycles and associated symptoms helps track patterns that may indicate cyst development. Women with recurring cysts benefit from working with their healthcare provider to develop a long-term management strategy that may include periodic monitoring and lifestyle modifications.

Frequently Asked Questions (FAQ)

Can ovarian cysts affect fertility?

Most ovarian cysts do not impact fertility. However, certain types, such as endometriomas or those associated with PCOS, may affect reproductive function. Treatment options consider fertility preservation when relevant.

How long do ovarian cysts typically last?

Functional cysts usually resolve within 2-3 menstrual cycles. Other types may persist longer or require intervention. Regular monitoring helps determine if a cyst is resolving or needs treatment.

What symptoms indicate a medical emergency?

Sudden severe abdominal pain, fever, vomiting, or signs of shock require immediate medical attention. These symptoms may indicate cyst rupture, torsion, or infection, all of which require urgent treatment.

Dr. Harvard Lin

Obstetrician & Gynaecologist

MBBS (SG)|MRCOG (UK)|MMed (OBGYN) (SG)

Dr. Lin has a clinical focus on female pelvic medicine and reconstructive surgery, encompassing the management of urinary incontinence, overactive bladder, and prolapse.

Dr. Lin completed his medical training at the National University of Singapore and obtained advanced certifications in Obstetrics and Gynaecology. He is a Member of the Royal College of Obstetricians and Gynaecologists in the UK.
Dr. Lin serves as a clinical tutor at NUS and contributes to laparoscopic and pelvic floor workshops. His research includes stem cell therapy, synthetic meshes, and translational medicine, with publications in peer-reviewed journals and textbooks.

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