Ovarian cyst is any fluid filled sac within the ovary.
Sx
Often, they cause no Sx
Occasionally, they may produce bloating, lower abdominal pain, or lower back pain
If the cyst either breaks open (called ruptured ovarian cyst) or causes twisting of the ovary (called ovarian torsion), severe pain may occur. This may result in vomiting or feeling faint
The majority of cysts are, however, harmless
Pathophysiology
Most ovarian cysts are related to ovulation being either:
Follicular cysts
Corpus luteum cysts
Other types include cysts due to:
Endometrioma (cysts due to endometriosis)
Dermoid cysts
Cystadenomas (i.e. a type of cystic adenoma)
Many small cysts occur in both ovaries, called PCOS (polycystic ovarian syndrome)
PID (pelvic inflammatory disease) may also result in cysts
Rarely, cysts may be a form of ovarian cancer
Classification
Functional cysts, which are a normal part of the menstrual cycle, including:
Ovary with many cysts, which may be found in normal women, or in PCOS
Chocolate cysts, which are cysts caused by endometriosis
Hemorrhagic ovarian cyst
Dermoid cyst
Ovarian serous cystadenoma
Ovarian mucinous cystadenoma
Paraovarian cyst
Cystic adenofibroma
Borerline tumoral cyst
Dx
Pelvic exam
U/S
Other testing used to gain further details
Tx
Often cysts are simply observed over time
If it causes pain, drugs e.g. paracetamol or ibuprofen may be used
Hormonal birth control may be used to prevent further cysts in thoe who are frequently affected. However, evidence doesn't suport birth control as a Tx of current cysts
If they do not go away after several months, get larger, look unusual, or cause pain, they may be removed by surgery
Epidemiology
Most women of reproductive age develop small cysts each month
Large cysts that cause problems occur in about 8% of women before menopause
Ovarian cysts are present in about 16% of women after menopause and if present are more likely to be cancer
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