What Is An Ovarian Cyst? What Causes Ovarian Cysts?
An ovarian cyst is an accumulation of fluid within an ovary that is surrounded by a very thin wall. Any ovarian follicle that is larger than approximately two centimeters. These can range widely in size; from being as small as a pea to larger than an orange – in rare cases these can become so large that the woman looks pregnant.
The majority of ovarian cysts are benign (harmless). According to the Centers for Disease Control and Prevention (CDC), USA, most premenopausal women and up to 14.8% of postmenopausal women are found to have ovarian cysts.
They typically occur most frequently during a female’s reproductive years (childbearing years). However, ovarian cysts may affect a woman of any age. In some cases, these cause pain and bleeding. If the cyst is over 5 centimeters in diameter it may need to be surgically removed.
There are two main types:
- Functional ovarian cysts – the most common type. These harmless cysts form part of the female’s normal menstrual cycle and are short-lived.
- Pathological cysts – these are cysts than grow in the ovaries; they may be harmless (benign) or cancerous (malignant).
What is a cyst?
It is a closed sac-like structure – an abnormal pocket of fluid, similar to a blister – that contains either liquid, gaseous, or semi-solid material. It is located within a tissue, and can develop anywhere in the body and may vary in size – some are so tiny they can only be observed through a microscope, while others may become so large that they displace normal organs.
In anatomy, it can also refer to any normal bag or sac in the body, such as the bladder. In this text, cyst refers to an abnormal sac or pocket in the body that contains either liquid, gaseous or semi-solid substances.
It is not a normal part of the tissue where it is located. It has a distinct membrane and division on nearby tissue – Its outer or capsular portion is called the cyst wall. If the sac is filled with pus it is not a cyst, it is an abscess. Some cysts are solid and may be called tumors (pathological cysts). The word tumor does not necessarily mean it is cancerous – a tumor is a medical term for a swelling.
According to Medilexicon’s medical dictionary:
An ovarian cyst is “a cystic tumor of the ovary, either nonneoplastic (follicle, lutein, germinal inclusion, or endometrial) or neoplastic; usually restricted to benign cysts, mucinous serous cystadenoma, or dermoid cysts.”
What are its signs and symptoms?
A symptom is something the patient feels and reports, while a sign is something other people, such as the doctor detect. For example, pain may be a symptom while a rash may be a sign.
In the vast majority of cases, ovarian cysts are small and benign (harmless); there will be no signs or symptoms.
Even if there are symptoms, they alone cannot determine whether a patient has it. There are several other conditions with similar signs and symptoms, including endometriosis, pelvic inflammatory disease, ectopic pregnancy or ovarian cancer. A ruptured ovarian cyst may present similar signs and symptoms to those of appendicitis or diverticulitis.
The signs and symptoms may include:
- Irregular menstruation – periods may also become painful, heavier or lighter than normal.
- A pain in the pelvis. This may be persistent pain or an intermittent dull ache that may spread to the lower back and thighs.
- Pelvic pain may appear just before menstruation begins
- Pelvic pain may occur just before menstruation ends
- Dyspareunia – pelvic pain during sexual intercourse. Some women may experience pain and discomfort in the abdomen after sex.
- Pain when passing a stool (doing a poo)
- Pressure on the bowels
- Some pregnancy symptoms, including breast tenderness and/or nausea
- Bloating, swelling, or heaviness in the abdomen
- Problems fully emptying the bladder
- Pressure on the rectum or bladder – the patient may have to go to the toilet more often, either to urinate or pass a stool.
- Hormonal abnormalities – in some rare cases the body produces abnormal amounts of hormones, resulting in changes in the way the breasts and body hair grow.
Complicated signs and symptoms
Torsion – the stem of an ovary can become twisted if the cyst is growing on the stem, blocking the blood supply to the cyst and causing severe pain in the lower abdomen.
Bursting – if the ovarian cyst bursts the patient will experience severe pain in the lower abdomen. If the cyst is infected pain will be worse. There may also be bleeding.
Cancer – in rarer cases an ovarian cyst may be an early form of ovarian cancer.
What are the causes?
Functional ovarian cysts – there are six types:
Follicular – the most common type of ovarian cyst. A female human has two ovaries, small round organs which release an egg every month. The egg moves into the uterus (womb), where it can be fertilized by a male sperm. The egg is formed in a follicle which contains fluid to protect the growing egg. When the egg is released the follicle bursts.
In some cases, the follicle either does not shed its fluid and shrink after releasing the egg, or does not release the egg. The follicle swells with fluid, becoming a follicular ovarian cyst. Typically, one cyst appears at any one time and normally goes away within a few weeks (without treatment).
Luteal ovarian – these are much less common. After an egg has been released it leaves tissue behind (corpus luteum). Luteal cysts can develop when the corpus luteum fills with blood. In most cases, this type of cyst goes away within a few months. However, it may sometimes split (rupture), causing sudden pain and internal bleeding.
Pathological – dermoid cysts are the most common type of pathological cyst for women under 30 years of age. Cystadenomas are more common among women aged over 40 years.
Dermoid (cystic teratomas) – this is a bizarre tumor, usually benign. This type of cyst develops from a totipotential germ cell (a primary oocyte) – in other words, the cell can give rise to all orders of cells necessary to form mature tissues. Dermoid cysts contain hair, skin, bone and other tissues (sometimes even teeth). A totipotential germ cell has the ability to develop in any direction. They are formed from cells that make eggs. These type of cysts need to be removed surgically.
Cystadenomas – these develop from cells that cover the outer part of the ovary. Some are filled with a thick, mucous substance, while others contain a watery liquid. Rather than growing inside the ovary itself, cystadenomas are usually attached to an ovary by a stalk. By existing outside the ovary they have the potential to grow considerably. Although they are rarely cancerous, they need to be removed surgically.
The following conditions may increase the risk of developing them:
Endometriosis – a condition in which cells that are normally found inside the uterus (endometrial cells) are found growing outside of the uterus. That is, the lining of the inside of the uterus is found outside of it. Endometrial cells are the cells that shed every month during menstruation, and so endometriosis is most likely to affect women during their childbearing years. Women with this condition have a higher risk of developing ovarian cysts.
Polycystic ovarian syndrome (PCOS) – in this condition many small and harmless cysts develop on the ovaries, caused by a problem with hormone balance produced by the ovaries. People with PCOS have a higher risk of developing them.
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