Ovarian Cysts

By: Bradley G. Goldberg, M.D.

 Ovarian cysts are common in women between 15 and 45 years of age. Although there are several different types of cysts, most are small fluid-filled sacs that grow within the ovaries. It is important to realize that not all ovarian cysts are abnormal. In fact, most women will form a cyst on their ovaries each month as a normal process of the menstrual cycle. These fall into the category of "functional cysts".

It is within these functional cysts that the woman’s developing egg is growing and awaiting to be released. These normal cysts can sometimes reach sizes up to 3 inches in diameter. They are benign, which means they are not cancerous and will not spread to other parts of the body, and usually do not cause any symptoms or require surgery. Most of the time these cysts will resolve on their own.

Sometimes however, these cysts may not dissolve normally, and could cause problems with pain if they grow too large or if they twist on their blood supply. For this reason, women experiencing these problems should be closely followed by their doctor.

When these functional cysts are small, it is reasonable to treat the woman with hormones (such as the birth control pill), pain medications, and close surveillance. However, if the cyst is larger than 8 centimeters (about 3 inches), if there is significant pain, or if there is the suspicion of malignancy, surgery is usually required. The vast majority of the time the surgery will be a laparoscopy or "belly-button surgery" in which case the woman can go home within hours after her surgery.

Ovarian cysts can often be detected when your doctor performs a pelvic exam, however ultrasound is the gold-standard for the making the diagnosis. Ultrasound is a test that uses sound waves to create pictures of your internal organs on a TV monitor, a concept similar to the sonar used on submarines. If your physician suspects a cyst, an ultrasound will likely be ordered.

Remember, many ovarian cysts do not cause problems and will go away on their own. Sometimes however, therapy consisting of either hormonal treatment or surgery will be required. Your physician will help you understand your particular situation.

Bibliography

1.  Novak’s Gynecology, Twelfth Edition, Jonathan S. Berek, M.D., Williams & Wilkins Baltimore, 1996.

2.  "Most Ovarian Cysts Are Not Cancer," Vicki Seltzer, M.D., Woman’s Health, December 22, 1997.

3.  "Ovarian Cysts," ACOG Patient Education Pamphlet, December 1993.

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