Cysts refer to small, ﬂuid ﬁlled sacs which sometimes form in the ovaries for different reasons. In many cases, ovarian cysts are a natural process of the fertility cycle, and not something to be concerned about. The ovaries, part of a woman’s reproductive system, are organs that produce all the eggs a woman needs in her lifetime. They also make female sex hormones that support fertility and hormones for mental and cardiac health.
In most cases, these cysts are functional, meaning that they form as part of the menstrual cycle. Functional cysts form after the ovulation process. In a normal ovulation cycle, several small follicles grow in the ovaries. Typically, one of these follicles will grow to become the dominant one and release a mature egg during ovulation. The other follicles will then shrink. But when a follicle does not dissolve or when an egg fails to detach, a cyst is formed.
Another type of functional cyst is called a corpus luteum cyst. This is formed after ovulation, when a cyst forms from the remains of the follicle after the egg has moved into the fallopian tubes (called the corpus luteum). These functional ovarian cysts are actually very common and occur at all ages, and are most frequently found in women of child-bearing age, typically from age 20 to 40.
Other types of cysts
Non-functional cysts are usually more of a concern. Apart from the risks of cancer which is the fifth most common cancer among women, these cysts can often cause pain and affect fertility. One type of non-functional cyst is when tissue from the lining of the uterus grows in other areas of the body such as the ovaries. This condition is called endometriosis and causes abnormal menstruation and pain.
Another type is called cystadenomas, which are ﬂuid-ﬁlled cysts formed from the cells on the surface of the ovary. Dermoid cysts form during fetal development when an abnormal array of cells becomes trapped in the ovary, giving rise to tissue similar to that of hair, skin or teeth.
Polycystic ovaries, on the other hand, refer to ovaries with a mass of multiple follicles that do not go away on their own and are associated with hormonal complications and failure to ovulate.
While most ovarian cysts are harmless, some can cause problems if they bleed, rupture or become infected. Medical help is important for non-functional cysts as they can cause severe pain and infertility. Importantly, it is good to be aware of any changes in your menstrual cycle as the symptoms for ovarian cysts and ovarian cancer are similar. You should ask your doctor about doing a routine pelvic examination or an ultrasound if you experience unusual bleeding or pain during your period. These tests not only detect ovarian cysts and identify the type, but also spot ovarian cancer in its early stages.
The type of treatment depends on the type of cyst, its size and cancer risk, the age of the patient and the desire for future fertility. For cysts which are likely to be functional, treatment is typically a course of oral contraceptives or a simple hormonal treatment. In some cases, surgical removal of the cyst (cystectomy) may be needed. For women with polycystic ovaries, treatment may take the form of medication or surgery.