Cyst

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What Are Ovarian Cysts?
Ovarian cysts are fluid-filled sacs or pockets within or on the surface of an ovary. The ovaries are two organs — each about the size and shape of an almond — located on each side of a woman’s uterus. Eggs (ova) develop and mature in the ovaries and are released in monthly cycles during a woman’s childbearing years.

Many women have ovarian cysts sometime during their life. Most cysts present little or no discomfort and are noncancerous (benign) and harmless.

However, some cysts produce severe symptoms that can be life-threatening. Knowing the symptoms and types of cysts that may signal a more significant problem, along with scheduling regular pelvic examinations, is the best way you can help ensure your health and avoid serious problems.

Signs and Symptoms
You can’t depend on symptoms alone to tell you if you have an ovarian cyst. In fact, you may have no symptoms at all, or if you do the symptoms may be similar to those of other conditions. Those conditions could include endometriosis, pelvic inflammatory disease, ectopic (outside the uterus) pregnancy or ovarian cancer. Even appendicitis and diverticulitis can produce symptoms that mimic an ovarian cyst.

Still, it’s important to be watchful of any symptoms or changes in your body and to know which symptoms are serious. If you have an ovarian cyst, you may experience the following symptoms:

• Menstrual irregularities
• Pelvic pain — constant or intermittent dull ache that may radiate to your lower back and thighs
• Pelvic pain shortly before your period begins or just before it ends
• Pelvic pain during intercourse (dyspareunia)
• Nausea, vomiting or breast tenderness similar to that experienced during pregnancy
• Fullness or heaviness in your abdomen
• Pressure on your rectum or bladder — difficulty emptying your bladder completely

The symptoms that signal the need for immediate medical attention include:

• Sudden, severe abdominal pain
• Pain accompanied by fever
• Vomiting

Causes
Your ovaries normally grow cyst like structures called follicles each month. Follicles are little "chemical factories" that produce the hormones estrogen and progesterone and release an egg when you ovulate.

Sometimes a normal monthly follicle just keeps growing. When that happens, it becomes known as a functional cyst. This means it started during the normal function of your menstrual cycle. There are two types of functional cysts:

• Follicular cyst. Ovulation initiates a complex chain reaction. The follicle holding your egg takes its cue from your brain’s pituitary gland via a hormone called luteinizing hormone (LH), which is necessary for conception. When everything goes according to plan, your egg is released and begins its journey down the fallopian tube in search of fertilization. A follicular cyst begins when LH doesn’t surge, and the chain reaction doesn’t start. The result is a follicle that doesn’t rupture or release its egg. Instead it grows and grows until it becomes a cyst. Follicular cysts are usually harmless, rarely cause pain and often disappear on their own within two or three menstrual cycles.
• Corpus luteum cyst. If LH does surge and your egg is released, another chain of events starts. The follicle then responds to LH by producing large quantities of estrogen and progesterone in preparation for conception. This change in the follicle is called the corpus luteum. However, sometimes after the egg’s release, its escape hole seals off and tissues accumulate inside, causing the corpus luteum to expand into a cyst. Although this cyst usually disappears on its own in a few weeks, it can grow to almost 4 inches in diameter and has the potential to bleed into itself or twist the ovary, causing pelvic or abdominal pain. If it fills with blood, the cyst may rupture, causing internal bleeding and sudden, sharp pain.