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The most common types of ovarian cysts are functional cysts, dermoid cysts, and endometriomas. Functional cysts form when tissue in the ovary changes during the normal process of ovulation. There are two kinds of functional cysts: follicular and corpus luteum cysts. Follicular cysts develop when the matured follicle containing an egg fails to rupture and release the egg. Instead, the follicle grows larger and becomes a cyst. Functional cysts usually disappear on their own after a few menstrual cycles. The corpus luteum is a normal glandular mass that develops in an ovary every month after the mature follicle releases an egg. The corpus luteum can develop into a cyst if the opening through which the egg is released is sealed off. A corpus luteum cyst usually dissolves on its own within a few months.

WARNING!

Ruptured Ovarian Cyst

If you have severe pain in your lower abdomen, along with fever and vomiting, call 911 or your local emergency number, or go to the nearest hospital emergency department immediately. Excessive blood loss could cause symptoms of shock (see page 162)—including light-headedness, cold and clammy skin, and rapid breathing—and can be fatal.

Dermoid cysts are composed of different types of tissues—such as skin, hair, fat, and teeth—that are normally found in other parts of the body. Endometriomas are blood-filled cysts that develop when tissue from the endometrium (the lining of the uterus) grows in an ovary. Endometriomas can bleed during menstruation and are signs of endometriosis (see page 870).

Symptoms

Ovarian cysts seldom produce symptoms but may cause a dull ache in the lower abdomen, and pain during intercourse. Some cysts twist, bleed, or rupture, causing sudden sharp pain and internal bleeding, which is life-threatening. When a cyst affects hormone production, symptoms include irregular vaginal bleeding or an increase in body hair.

Common Ovarian Cysts

Functional cyst

The most common type of functional cyst occurs when an egg matures but the follicle fails to rupture and release it. The follicle continues to grow, enlarging the entire ovary. This type of cyst usually goes away on its own after one or two menstrual cycles.

Dermoid cyst

A dermoid cyst is made up of tissue—such as skin, hair, fat, and teeth—that is usually found in other parts of the body. Dermoid cysts are usually not cancerous, but doctors remove them for testing to make sure.

Endometrioma

Endometriomas are blood-filled cysts that develop when tissue from the endometrium (the lining of the uterus) grows in the ovary. Endometriomas that cause symptoms can be removed surgically.

Diagnosis

Some ovarian cysts are found during a routine pelvic examination. To find out what type of cyst you have, your doctor will probably order a pelvic and vaginal ultrasound to examine your ovaries. If the ultrasound shows an abnormality, the doctor may perform an outpatient surgical procedure called laparoscopy, using a lighted viewing instrument inserted through a tiny incision in your abdomen to examine the pelvic cavity. Depending on your risk factors, the doctor may recommend genetic testing (see page 953) for other diseases, such as ovarian cancer.

Treatment

Most ovarian cysts require no treatment. In many cases, the ultrasound shows a cyst that is obviously benign. You will need only regular follow-up pelvic examinations and ultrasounds until it goes away on its own. If a cyst is large or is causing symptoms, it can be treated with hormone therapy or surgery, depending on the size and type of cyst, your age, and your desire to have children. Doctors sometimes treat functional cysts with oral contraceptives. Large, solid, or persistent cysts are usually removed surgically. Sometimes a cyst can be removed without affecting the ovary, but if the cyst is very large, the only way to ensure complete removal may be to take out the entire ovary and, in some cases, the fallopian tube as well. Women can usually get pregnant with only one ovary and one fallopian tube.