Ovarian cysts

22 February 2017.

An ovarian cyst is a fluid-filled sac that develops on a woman’s ovary. They’re very common and don’t usually cause any symptoms [1]. Most ovarian cysts occur naturally and disappear in a few months without needing any treatment [1].

An ovarian cyst usually only causes symptoms if it splits (ruptures), is very large, or blocks the blood supply to the ovaries. In these cases, you may have [1]:

  • pelvic pain – this can range from a dull, heavy sensation to a sudden, severe and sharp pain
  • pain during sex
  • difficulty emptying your bowels
  • a frequent need to urinate
  • abnormal bleeding: heavy periods, irregular periods or lighter periods than normal
  • bloating and a swollen tummy
  • feeling very full after only eating a little
  • difficulty getting pregnant – although fertility is unaffected in most women with ovarian cysts (see ovarian cysts and fertility)

Ovarian cysts often develop naturally in people who menstruate. They can also affect women who have been through the menopause. There are two types of ovarian cyst [2];

1. Functional cysts

Functional ovarian cysts are linked to the menstrual cycle. They affect people who haven’t been through the menopause, and are very common. Each month, a menstruating person’s ovaries release an egg, which travels down the fallopian tubes into the womb (uterus).

Each egg forms inside the ovary in a structure known as a follicle. The follicle contains fluid that protects the egg as it grows and it bursts when the egg is released. However, sometimes a follicle doesn’t release an egg, or it doesn’t discharge its fluid and shrink after the egg is released. If this happens, the follicle can swell and become a cyst.

Functional cysts are non-cancerous (benign) and are usually harmless, although they can sometimes cause symptoms such as pelvic pain. Most will disappear in a few months without needing any treatment.

2. Pathological cysts

Pathological cysts are cysts caused by abnormal cell growth and aren’t related to the menstrual cycle. They can develop before and after the menopause.

Pathological cysts develop from either the cells used to create eggs or the cells that cover the outer part of the ovary. They can sometimes burst or grow very large and block the blood supply to the ovaries. Pathological cysts are usually non-cancerous, but a small number are cancerous (malignant) and so may need to be surgically removed.

Conditions that cause ovarian cysts

In some cases, ovarian cysts are caused by an underlying condition such as endometriosis. Endometriosis occurs when pieces of the tissue that line the womb (endometrium) are found outside the womb in the fallopian tubes, ovaries, bladder, bowel, vagina or rectum. Blood-filled cysts can sometimes form in this tissue.

Polycystic ovary syndrome (PCOS) is a condition that causes lots of small, harmless cysts to develop on your ovaries. The cysts are small egg follicles that don’t grow to ovulation and are the result of altered hormone levels.

See your doctor if you have persistent symptoms of an ovarian cyst.

If you are in the UK and have sudden, severe pelvic pain you should immediately contact either:


In most cases, ovarian cysts disappear in a few months without the need for treatment [2].

Whether treatment is needed will depend on:

  • its size and appearance
  • whether you have any symptoms
  • whether you’ve had the menopause – as post-menopausal women have a slightly higher risk of ovarian cancer

Watchful waiting

In most cases, a policy of “watchful waiting” is recommended [2].

This means you won’t receive immediate treatment, but you may have an ultrasound scan a few weeks or months later to check if the cyst has gone.

Women who have been through the menopause may be advised to have ultrasound scans and blood tests every four months for a year, as they have a slightly higher risk of ovarian cancer.

If the scans show that the cyst has disappeared, further tests and treatment aren’t usually necessary. Surgery may be recommended if the cyst is still there.

Surgery

Large or persistent ovarian cysts, or cysts that are causing symptoms, usually need to be surgically removed.

Surgery is also normally recommended if there are concerns that the cyst could be cancerous or could become cancerous [2].

Prevention

Taking oestrogen-based hormonal medication (e.g. combined contraceptive pills/ devices) prevents ovulation, which means that ovarian cysts are less likely to develop [3]. However, hormonal medication is unable to treat an ovarian cyst, once formed [3].

Make sure that your thyroid gland is fully functioning (ask your doctor to test this) because an under-active thyroid increases the likelihood of ovarian cyst formation [4].

If you are prone to functional ovarian cysts, but do not wish to (or are unable to) take hormonal medication, you may be able to  prevent abnormal cyst formation through changes to your diet;

Try a hormone-balancing diet– As outlined in this blog, a vegetable-based ‘anti-inflammatory’ diet can significantly improve all hormone-related symptoms;

1. Eat lots of fresh fruit and vegetables
2. Eat lots of fibre (and drink water with it)
3. Eat oily foods (mainly unsaturated fats)
4. Reduce meat and dairy products
5. Avoid sugary foods and drinks
6. Avoid caffeine
7. Avoid alcohol
8. Take nutritional supplements e.g. you could try taking Iodine (max 0.5 mg per day) and Selenium (max 0.2 mg per day) to help encourage healthy menstrual cyst formation [5].


If you have any suggestions, or tips, for managing or preventing ovarian cysts- please let us know– we can share them with others!


Further information:

NHS information on ovarian cysts: http://www.nhs.uk/conditions/ovarian-cyst/Pages/Introduction.aspx


Page last reviewed and updated: June 2018


References:

1. NHS. (2016) Ovarian cysts- causes. [ONLINE] Available at: http://www.nhs.uk/Conditions/Ovarian-cyst/Pages/Causes.aspx. [Accessed 2 August 2017].

2. NHS. (2016) Ovarian cysts- treatment. [ONLINE] Available at: http://www.nhs.uk/Conditions/Ovarian-cyst/Pages/Treatment.aspx. [Accessed 2 August 2017].

3. Grimes DA, Jones LB, Lopez LM, Schulz KF. (2014) Oral contraceptives for functional ovarian cysts. Cochrane Database Syst Rev. Apr 29;(4):CD006134. doi: 10.1002/14651858.CD006134.pub5. Review. PubMed PMID: 24782304.

4. Dharmshaktu P, Kutiyal A, Dhanwal D. (2013) Vanishing large ovarian cyst with thyroxine therapy. Endocrinol Diabetes Metab Case Rep. 2013:130050. doi: 10.1530/EDM-13-0050. Epub  Nov 1. PubMed PMID: 24683475; PubMed Central PMCID: PMC3965274.

5. Briden, L. (2015) Period Repair Manual; Natural Treatment for Better Hormones and Better Periods Amazon pp 207-210


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