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Ovarian Cysts

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Overview

Ovaries are a part of the female reproductive system located in the lower abdomen. They are placed on both sides of the uterus. There are two ovaries that produce hormones progesterone and estrogen as well as eggs. Ovaries are responsible for controlling the development of female body characteristics such as hair, body shape, and breasts. They also regulate pregnancy and the menstrual cycle.

Over time, a fluid-filled structure or sac can be developed on one of the ovaries. This sac is called a cyst and many women, during their lifetime develops at least one cyst. Cysts are harmless and in most cases, they cause no pain or any symptoms. However, cysts may or may not represent a neoplasm or tumor. If it appears to be a tumor, it may be malignant or benign.

Sign & Symptoms

Some smaller cysts cause no symptoms. In these cases, you may not even know you have a cyst. Larger cysts may cause the following symptoms:

  • Pelvic pain or a dull ache in your back.
  • A feeling of fullness (bloating) in your lower belly.
  • Pain during intercourse.
  • Painful periods.
  • Nausea and/or vomiting

Some prolonged symptoms may be associated with a condition called Polycystic Ovary Syndrome (PCOS). This is a condition that causes irregular periods and other hormone-related problems, including obesity and infertility. Other symptoms of polycystic ovary syndrome include hirsutism (increased growth of body hair) and difficulty losing weight.

In most cases, ovarian cysts do not show any signs of discomfort. But the symptoms can appear if the cyst starts to grow. The symptoms are the signs of ovarian torsion or ruptured cyst. Both these complications are required to be taken seriously as it can have severe consequences on your health if not treated early.

What causes Ovarian Cysts?

There are several factors that cause ovarian cysts and most of them are not cancerous.


Tubo-ovarian abscesses:

It is an infection caused in the pelvic organs involving the fallopian tubes and the ovaries. This infection causes the formation of pus-filled cystic spaces around the ovaries and tubes.


Benign Cystic Teratomas:

Both malignant and benign tumors of the ovary may be cystic. The ovaries experience the abnormal tissue development forming cyst-like structures, but they are actually tumors.


Polycystic Ovarian Syndrome (PCOS):

This condition results in the formation of small and multiple cysts on both ovaries. This condition is associated with hormonal problems and can cause infertility in women.


PCOS/PCOD Polycystic Ovarian Disease

Polycystic Ovarian Disease (PCOD), also known as Polycystic Ovary Syndrome (PCOS) is a very common condition affecting 5% to 10% of women in the age group 12–45 years. It is a problem in which a woman’s hormones are out of balance. It can cause problems with menstrual periods and make it difficult for her to conceive. The principal features include no ovulation, irregular periods, acne, and hirsuitism. If not treated it can cause insulin-resistant diabetes, obesity, and high cholesterol leading to heart disease.


Expectations (Prognosis)

Women who have this condition can get pregnant with the right surgical or medical treatments. Pregnancies are usually normal.

Investigation & Diagnosis

Doctors follow a multitude of diagnostic procedures for testing and diagnosing ovarian cysts. It includes a routine pelvic examination, looking for a swelled-up ovary, and more.

In case, if the doctor feels like the conditions are worse, he/she may issue imaging tools for diagnosing ovarian cysts.

Ultrasound Device:

This tool is used for visualizing the ovaries


MRI:

This device is used to produce in-depth images of the internal organs


CT Scan:

This device is used to create cross-sectional images of the internal organs.


Blood Tests:

You may have a blood test that measures the level of a substance called CA 125. Several other blood tests also can be used to help identify whether a mass on the ovary is concerning for ovarian cancer.

Due to the fact that the cysts only appear for a few weeks or months, the doctor will not instantly recommend a treatment plan such as the ovarian cysts surgery. Instead, the doctor will repeat the diagnosis and tests for few more weeks to check whether the cyst is growing or diminishing.


Treatment Modalities

Treatment of ovarian cysts depends on the symptoms and their cause.

Functional ovarian cysts generally go away without treatment. Your doctor may give you medications containing hormones (such as birth control pills) to stop ovulation and prevent future cysts from forming. If you do not ovulate, you will not form functional cysts. In some cases, surgery may be necessary to remove a cyst.

Moreover, the doctor will consider the age and the size of your cyst to determine the treatment plan. It requires frequent monitoring to determine whether the cysts are functional or not. The cysts are prone to get ruptured and can cause significant bleeding. In this case, ovarian cysts surgery is required. Moreover, malignant and benign tumors also require surgical treatment.

The vital part of any kind of cyst treatment is observation. The doctors also evaluate blood tests like CA-125 to determine if the cyst poses any potential for cancer.

Surgical Treatment for Ovarian Cysts

Ovarian cysts can be easily removed via surgery either with laparotomy or with laparoscopy.


Laparoscopic Ovarian Cystectomy

It is one of the safest procedures considered and is used to treat simple ovarian cysts.


Laparoscopy Ovarian Drilling

This surgical treatment is followed if your ovaries are affected with multiple cysts.


Laparotomy

If you are feeling severe pain or in case of malignancy, then the doctor may perform an open abdominal incision.

Frequently asked questions

When should I consult my doctor?

Call your doctor if you notice any of the following-

  • Your menstrual periods are late, irregular, or painful.
  • Your abdominal pain doesn't go away.
  • Your abdomen becomes enlarged or swollen.
  • You have trouble urinating or emptying your bladder completely.
  • You have pain during intercourse.
  • You have feelings of fullness (bloating), pressure, or discomfort in your abdomen.
  • You lose/gain weight for no apparent reason.
  • You feel generally ill.

Can you still ovulate with an ovarian cyst?

Ovarian cysts can result in abnormal ovulation, ovulation dysfunction accounts for 25 percent of female infertility cases. Large ovarian cysts or those resulting from endometriosis or polycystic ovary syndrome (PCOS) can hamper a woman's fertility.

How long does a cyst stay on ovary?

Most cysts go away in 1 to 2 months without treatment or after 1 or 2 menstrual periods. Your doctor will recommend further testing or treatment if: Initial ultrasound doesn't clearly show what kind of cyst or growth is present, or both ovaries are affected.

What does an ovarian cyst burst feel like?

“Most do feel pain at the time of rupture and then some discomfort for a few days afterward. Usually, the symptoms can be relieved with over-the-counter medications.” Symptoms you may experience if you have a ruptured ovarian cyst include: Sudden, sharp pain in the lower belly or back.

Is it possible to prevent ovarian cysts?

Actually it is not possible, ovarian cysts can't be prevented. Most of the cyst don't cause symptoms and are not cancerous It subsides by themselves

When are women probably to have maximum chance of getting ovarian cysts?

Most functional ovarian cysts occur during childbearing years. And most of these cysts are not cancerous. Women who are past menopause with ovarian cysts possess a greater risk of ovarian cancer. At any age, if you think you've got a cyst, see your doctor for any pelvic exam.

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