What are the symptoms of ovarian cysts?
Many women have ovarian cysts without having any symptoms. Sometimes, though, a cyst will cause these problems:
- pressure, fullness, or pain in the abdomen
- dull ache in the lower back and thighs
- problems passing urine completely
- pain during sexual intercourse
- weight gain
- painful menstrual periods and abnormal bleeding
- nausea or vomiting
- breast tenderness
If you have these symptoms, get help right away:
How are ovarian cysts found?
- pain with fever and vomiting
- sudden, severe abdominal pain
- faintness, dizziness, or weakness
- rapid breathing
Since ovarian cysts may not cause symptoms, they are usually found during a routine pelvic exam. During this exam, your doctor is able to feel the swelling of the cyst on your ovary. Once a cyst is found, the doctor may perform an ultrasound, which uses sound waves to create images of the body. With an ultrasound, the doctor can see how the cyst is shaped; its size and location; and whether it’s fluid-filled, solid, or mixed. A pregnancy test is also done. Hormone levels (such as LH, FSH, estradiol, and testosterone) may also be checked. Your doctor may want to do other tests as well.
How are cysts treated?
To find out if the cyst might be cancerous, your doctor may do a blood test to measure a substance in the blood called CA-125. The amount of this protein is higher if a woman has ovarian cancer. However, some ovarian cancers do not make enough CA-125 to be detected by the test. There are also non-cancerous diseases that increase the levels of CA-125, like uterine fibroids and endometriosis. These non-cancerous causes of increased CA-125 are more common in women under 35, while ovarian cancer is very uncommon in this age group. For this reason, the CA-125 test is recommended mostly for women over age 35, who are at high risk for the disease and have a cyst that is partially solid.
Watchful waiting. The patient waits and gets re-examined in one to three months to see if the cyst has changed in size. This is a common treatment option for women who are in their childbearing years, have no symptoms, and have a fluid-filled cyst. It also might be an option for postmenopausal women.
Surgery. If the cyst doesn’t go away after several menstrual periods, has gotten larger, looks unusual on the ultrasound, causes pain, or you’re postmenopausal, the doctor may want to remove it. There are two main surgical procedures:
Can ovarian cysts be prevented?
- Laparoscopy—if the cyst is small and looks benign on the ultrasound, your doctor may perform a laparoscopy. This procedure is done under general anesthesia. A very small incision is made above or below the navel, and a small instrument that acts like a telescope is inserted into the abdomen. If the cyst is small and looks benign, it can be removed.
- Laparotomy—if the cyst is large and looks suspicious, the doctor may perform a procedure called a laparotomy. This procedure involves making bigger incisions in the stomach to remove the cyst. While you are under general anesthesia, the doctor is able to have the cyst tested to find out if the tissue is cancerous. If it is cancerous, the doctor may need to remove the ovary and other tissues that may be affected, like the uterus or lymph nodes.
Ovarian cysts cannot be prevented. Fortunately, the vast majority of cysts don’t cause any symptoms, are not related to cancer, and go away on their own. A pelvic exam, possibly with an ultrasound, can help determine if a cyst is causing the problem. If a woman is not seeking pregnancy and develops functional cysts, frequently, future cysts may be prevented by taking oral contraceptives, Depo-Provera, or Norplant.
When are women most likely to have ovarian cysts?
Functional ovarian cysts usually occur during the childbearing years. Most often, cysts in women of this age group are not cancerous. Women who are past menopause (ages 50-70) with ovarian cysts have a higher risk of ovarian cancer. At any age, if you think you have a cyst, it’s important to tell your doctor.