Life & Work

Dealing with ovarian cysts

pain

Some cysts can become very painful and turn into a medical emergency. PHOTO | FILE

Finding out that one has an ovarian cyst can be a very scary experience for a woman. For many years, the female reproductive system was shrouded in mystery and it is not unusual to find that many women still don’t know exactly how their bodies function.

The first time most woman get to hear of ovarian cysts is when they visit their gynaecologist for a check-up and often by the time they are leaving the office, they still don’t understand what having such a cyst means.

How do my ovaries look and work?

Ovaries are the ‘storage containers’ for eggs in your body. They are about the size of a peach seed. In women who are still in their reproductive age, the ovary releases a single egg (sometimes two – one from each side) which then travels down the fallopian tubes in ‘search of a mate’ (sperm).

If the egg meets a sperm, pregnancy occurs. If it does not, you go on to have your menstrual cycle. The ovaries are also producers of the female reproductive hormones, oestrogen and progesterone. These hormones are important in giving you your feminine features and in determining your fertility.

What exactly are ovarian cysts?

A cyst is a fluid filled sac (think of what a blister looks like, it will help you get a rough idea of what cysts looklike). It can occur in any part of the body including the skin, lungs, kidneys, brain, liver and in this case, the ovaries.

Are all cysts harmful?

There are different types of cysts, the majority of which are harmless.

Functional cysts

These are harmless cysts which are related to the reproductive cycle. They occur as a result of the egg being released and often disappear on their own rarely causing any symptoms.

Dermoid cysts

These are cysts which contain odd contents such as hair, parts of teeth or bone, fatty tissue, etc. Although this sounds bizarre, one must remember that the eggs in the ovary have the potential to turn into any tissue (that is why they can form a baby). These types of cysts are more common in younger women and tend to run in families. As scary as they sound, dermoid cysts are not cancerous.

Cystadenomas

These cysts develop from cells which cover the outer part of the ovary. They are not related to the menstrual cycle and they can sometimes grow to become very large.

‘Chocolate cysts’

These are medically known as ‘endometriomas’ and occur when tissue lining the uterus is wrongly located on the ovary (endometriosis). This tissue usually causes the ovary to bleed monthly during the menstrual cycle and sometimes the blood gets trapped in a cyst. The blood then becomes dark over time giving it the appearance of chocolate hence the name.

Polycystic ovary syndrome (PCOS)

Polycystic means ‘many cysts’. If you have PCOS, it means you have developed many tiny cysts in both your ovaries. The cysts are thought to be caused by a hormonal imbalance. PCOS is associated with period problems, reduced fertility, hair growth, obesity and acne.

What does one feel if you have an ovarian cyst?

Often times, ovarian cysts do not cause any symptoms. However, sometimes they can cause issues such as abdominal bloating or swelling, pelvic pain before or during the menstrual cycle, pain in the lower back or thighs, painful intercourse, painful bowel movements (or constipation) and urinary issues (if the cyst is very large). Some cysts also have hormonal influence and may cause you to gain weight and have tender breasts.

How can I find out if I have a cyst?

First, you need to see your gynaecologist. He or she will take a detailed history of your symptoms, your sexual history, contraceptive use and issues related to child-bearing and menstruation.

Once this is done, he or she may then perform an ultrasound to see if you have a cyst. The advantage of ultrasound is that it is quick, has no radiation and can be performed in the doctor’s office. Once, the gynaecologist sees the cyst, she can estimate its size and see if it has any unusual features.

Should I worry about cancer if I have a cyst?

Most ovarian cysts are non-cancerous. There are, however, concerns about cysts that occur in post-menopausal women as these can be cancerous. In these women, several blood tests are done to rule out possible cancer.

In addition, they may undergo more extensive scans such as CT scans to try and check for signs of possible cancer. In rare cases, young women also get ovarian cancer and so the appearance of the cyst on the ultrasound scan is also very important and may help determine whether or not you need further investigation.

How are ovarian cysts treated?

Treatment usually depends on your age, the type of cyst and your symptoms. In most cases, the cysts are monitored until they disappear on their own. If pain is a problem, over-the-counter painkillers may be used.

If you get recurrent symptomatic cysts, your doctor may put you on hormonal therapy (like oral contraceptives) to stop you ovulating and help prevent cyst formation.

However, some ovarian cysts need surgery. This usually involves either getting rid of the cyst and keeping the ovary intact or surgically removing the ovary if cancer is suspected. Sometimes, very large cysts or those which have something like a stalk joining them can cause the ovary to twist on itself or the cyst can twist on its own stalk.

This is a very painful medical emergency which, if not attended to immediately, can lead to loss of your ovary. If a very large cyst ruptures, it can cause heavy internal bleeding which would require urgent surgical intervention.