Ovarian Cysts: What Now?

Ovarian cysts – that sounds worrying at first. However, they usually disappear on their own after a while.

What is ovarian cysts?

Ovarian cysts are blisters on the ovaries that are filled with fluid. They are benign in 98 percent of cases and regress on their own.

So-called functional cysts can be caused by hormone fluctuations in the cycle, but also by hormone therapy or endometriosis. They can grow up to ten centimetres in size and rarely cause complications.

There are also benign tumours such as multi-chamber cystadenomas, which in extreme cases can grow the size of a football, and dermoid cysts. The latter are tumours that develop as a result of congenital maldevelopment, can reach a diameter of up to 25 centimetres and occur mainly in young girls.

Who gets ovarian cysts?

In every sexually mature woman, cysts can form on the ovaries. Cysts most often occur in connection with hormonal changes: in women shortly after puberty and before menopause.

Which complaints should make me sit up and take notice?

Small cysts usually cause no discomfort and are only discovered by chance. From a size of about four centimetres, there can be pulling abdominal pain, back pain or pain during sex. Menstruation is also often painful.

Sometimes the cysts rotate around their own axis and cut off the ovary from the blood supply. Then there is sudden, severe pain, nausea, palpitations and sweating. If such a stem rotation is not operated quickly, the ovary can die.

Rarely it can happen that a cyst bursts. This leads to severe pain and nausea, but the symptoms usually subside quickly. The procedure is usually not dangerous – the fluid from inside the cyst is absorbed by the tissue.

How does the doctor determine whether I am affected?

Ovarian cysts are often discovered more by chance during a palpation at the gynaecologist. If the doctor finds something suspicious, an ultrasound is the next step to a diagnosis. Blood tests help to determine the type of cyst more precisely.

Sometimes a laparoscopy is necessary to determine whether the cyst is benign or malignant. The doctor makes a small incision in the abdominal wall, looks inside the abdomen with an endoscope and takes a piece of tissue from the cyst. The examination in the laboratory then provides final certainty.

How can ovarian cysts be treated?

In most cases, functional cysts regress on their own after a while. If they do not cause any symptoms, it is therefore sufficient to wait two to four months and have a doctor examine you after each menstrual period.

If the cyst does not disappear on its own or causes symptoms, a progestogen-rich pill or hormone therapy with a progestin can help. If the cyst does not recede even after hormone therapy, or if there is a suspicion that it could be malignant, surgery is necessary. In many cases this can be done by laparoscopy. If there is heavy bleeding or adhesions and if the cyst is malignant, it is removed by abdominal incision. Dermoid cysts and multi-chamber cystadenomas are always removed as a precautionary measure, as they are more likely to degenerate.

How can I protect myself?

Probably the contraceptive pill reduces the likelihood of cysts forming. However, today’s pills are often very low doses and therefore have little protective effect.