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What are ovarian cysts? — Ovarian cysts are fluid-filled sacs that develop on or in an ovary (figure 1). The ovaries are part of your reproductive system. If you are still having a monthly period, your ovaries release an egg about once a month.
Often, an ovarian cyst will go away on its own. Sometimes, the cyst gets bigger, breaks open, or causes the ovary to twist. If this happens, you might need surgery.
Many people worry about cancer when they learn that they have ovarian cysts. But most of the time, cysts are not cancer.
What are the symptoms of ovarian cysts? — You might have no symptoms. If you do have symptoms, they can include pain or pressure in your lower belly on 1 side. The pain can be dull or sharp, and it can come and go.
It is common for ovarian cysts to break open or "rupture." This does not always cause symptoms. But if a cyst breaks open and releases a lot of blood and fluid into your belly, it can be very painful.
Other times, a cyst can cause the ovary to twist. This can be a serious problem and needs to be treated right away. Symptoms can include:
●Sudden, intense pain in your lower belly – Pain is usually on 1 side and doesn't go away. It might make you double over or be unable to walk.
●Nausea or vomiting
What causes ovarian cysts? — There are many possible causes of ovarian cysts. The most common causes include:
●Ovulation or pregnancy – Ovulation is when an egg is released from the ovary each month. For this to happen, the ovary grows a sac, called a "follicle." Sometimes, a follicle grows but does not release an egg and instead forms a cyst. Or if you get pregnant after the egg is released, a cyst can stay on the ovary for weeks or months. These kinds of cysts are not harmful and usually go away on their own.
●Dermoid cysts – These are a common type of cyst. They sometimes have teeth, hair, or fat in them. That might sound strange. Dermoid cysts are normally not harmful to your health, but your doctor might want to remove them with surgery.
●Polycystic ovary syndrome ("PCOS") – In this condition, the ovary grows many small cysts, instead of 1 big follicle that goes away each month. These cysts usually do not go away, but the cysts themselves do not need to be treated or removed. PCOS does sometimes require treatment with medicine for reasons unrelated to the cysts.
●Endometriosis – Endometriosis is a condition where tissue normally found in the uterus grows outside of the uterus. Endometriosis can also form cysts on the ovary. People with endometriosis might have belly pain during their periods or at other times, pain in the belly during sex, or trouble getting pregnant.
●Cancer – Cancer is the cause of ovarian cysts in less than 1 in 100 cases. Ovarian cancer is most likely to affect older people who have been through menopause (no longer have a monthly period) or who have a family history of ovarian cancer.
How big is an ovarian cyst? — Cysts are usually 1 to 2 inches (2.5 to 5 cm) wide. But they can be bigger.
Is there a test for ovarian cysts? — Yes. Common tests include:
●Imaging tests – The most common is a pelvic ultrasound. This test uses sound waves to make pictures of your uterus and ovaries. The pictures can show if you have cysts. It can also show where they are and how big they are. Your doctor might also take pictures with an MRI or a CT scan.
●Blood tests – These can check for pregnancy or the possibility of cancer.
How are ovarian cysts treated? — It depends on what is causing your cysts and what your symptoms are. Possible treatments include:
●Waiting – Your doctor might want to do an ultrasound every couple of months. Your cysts might stay the same size, get smaller, or even go away. In those cases, you usually don't need to do anything to treat them. If cysts grow or change, you might need treatment.
While waiting, your doctor might have you use over-the-counter medicines to help with pain. Examples include acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), and naproxen (sample brand name: Aleve).
●Birth control pills – This medicine can stop some types of new cysts from forming.
●Surgery – This can involve removing a cyst or the whole ovary.
What if I want to get pregnant? — That depends on what is causing your ovarian cysts. Most people with cysts are able to get pregnant. Even if 1 of your ovaries is removed, it is usually still possible to get pregnant. If you can't get pregnant, medicines or new technologies can help. If you want to have a baby, talk with your doctor about your options.
When should I call the doctor? — Call your doctor right away or go to the emergency department if you have ovarian cysts and have:
●Sudden, severe pain in your lower belly
●Nausea or vomiting
You should also call your doctor or nurse if:
●You have new or worsening pain.
●You have pain when you urinate.
●You have pain with sex.
●You miss a period or have bleeding between periods.
Patient education: Ovarian cysts (Beyond the Basics)
Patient education: Endometriosis (Beyond the Basics)
Patient education: Polycystic ovary syndrome (PCOS) (Beyond the Basics)
Patient education: Treatment of ovarian cancer (Beyond the Basics)
Patient education: Screening for ovarian cancer (Beyond the Basics)
Patient education: Hormonal methods of birth control (Beyond the Basics)
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