Ovarian cysts

What are ovarian cysts?

Ovarian cysts are fluid-filled sacs that are formed in the ovaries (ovaries are two small organs on each side of the womb or the uterus that produce hormones and an egg each month) which produce hormones and an egg each month. These are common in women in their reproductive years.

What are the types of ovarian cysts?

Most of these cysts are non-cancerous (benign). The various types of cysts are:

• Functional cyst
  This is the most common type. It is formed due to an aberration in the development of an egg. In a normal course a mature follicle ruptures in the ovary to release the egg and then forms a mass called the Corpus Luteum. If pregnancy does not occur in that cycle, the Corpus luteum normally disintegrates. If this does not happen then a functional cyst is formed. The functional cysts normally do not produce any symptoms and disappear within one-three menstrual cycles.
  
• Dermoid cyst
  These are ovarian cysts filled with cheesy material and may have various types of tissue including hair and skin in them.
  
• Cystadenoma
  These are cysts which develop from the outer surface of the ovary. Majority of them are benign (non- cancerous).
  
• Endometrial or chocolate cyst
  Sometimes clusters of cells normally found in the lining of the uterus (endometrial cells) attach themselves to the ovary causing an endometrial cyst to form. This is a dark and red-brown coloured cyst and hence is also called chocolate cyst.
  
• Polycystic ovary
  In this condition the ovaries have multiple small cysts. These result from hormonal imbalance. These women are usually overweight and can have excessive facial hair and difficulty in conceiving.

What are the symptoms?

Ovarian cysts usually do not cause any symptoms. However if the symptoms occur, they are:

• A feeling of fullness in the stomach or a slight pain.
• Irregular or painful periods

How are ovarian cysts diagnosed?

They may be detected by a pelvic examination which could be confirmed by other tests.

Ultrasound is a test in which sound waves are used to create pictures of the organs found inside the body. It can be used to confirm the presence of the cyst and many times the nature of the cyst.

What is the treatment?

The treatment depends upon the size and type of the cyst, the women’s age and overall health, her future pregnancy plans and the symptoms that she is experiencing. The treatment options include:

• Expectant – Where the cysts are small (< 8 cm) and appear functional, they can be observed for 2-3 months as many of them resolve. In the past hormones have also been given particularly with irregular periods. Currently their use is not found to be of any benefit.
  
• Surgery – can be decided upon if the cyst does not disappear on its own or is causing severe pain or bleeding or if the cyst is of a type which requires surgery (Dermoid, Endometrial, Cystadenoma). Surgery can be through laparoscope or conventional (by an incision on the tummy), depending on the size & type of cyst patient profile and expertise of surgeon.
  
• Treatment of Polycystic ovaries – This depends upon the requirement of the patient, her symptoms and profile. Weight reduction in an overweight patient constitutes the most important treatment. The other treatments can be hormonal for regularising the periods and for excessive facial hair as well as ovulation induction (aiding in producing an egg) in case of infertility.