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OVERVIEW

What is an ovarian cyst?

An ovarian cyst is a fluid-filled sac in or on the ovary. There are several types of ovarian cysts. Many ovarian cysts are noncancerous cysts that occur as a result of ovulation (the release of an egg from the ovary). These are called functional cysts.

SYMPTOMS

What are the symptoms of a functional cyst?

Often functional cysts do not cause any symptoms (you may not even know you have one), but other times they can cause abdominal pain, bloating, menstrual irregularities, nausea and vomiting. Other symptoms include feeling full after eating just a little and constipation

If you are menopausal and are not having periods, you shouldn’t form functional cysts, but it is possible for you to form other types of ovarian cysts. You should contact your health care provider if you experience any of the symptoms of an ovarian cyst.

DIAGNOSIS & TESTS

How does my health care provider know I have an ovarian cyst?

Often times, your health care provider will feel a cyst during your physical exam. If you do have a cyst, your health care provider will probably want you to have an ultrasound so they can look at the cyst. What your health care provider decides to do after that depends on your age, the way the cyst looks on the ultrasound and if you’re having symptoms.

What is an ultrasound?

An ultrasound uses sound waves to make pictures of organs in the body. It’s a good way for your health care provider to look at your ovaries. This kind of ultrasound can be done either through your abdomen or your vagina. Neither type is painful. The ultrasound usually lasts about 30 minutes. It will give your health care provider valuable information about the size and the appearance of your cyst.

Are there any other tests I might have?

Your health care provider might test the level of a protein called CA-125 in your blood. Sometimes this blood test is done in women who have an ovarian cyst to see if their cyst could be cancerous. A normal CA-125 level is less than 35. However, this test is not always an accurate way to tell if a woman has ovarian cancer. For example, some women who do have ovarian cancer have a normal CA-125 level. Also, this level can sometimes be high in women who do not have cancer, particularly if they are in their childbearing years. For these reasons, the CA-125 blood test is only recommended for women who show signs or symptoms of ovarian cancer or who have genetic mutations that increase the risk of ovarian cancer.

TREATMENT

How are functional cysts treated?

Functional cysts normally shrink on their own over time, usually in about 1 to 3 months. If you have a functional cyst, your health care provider may want to check you again in 1 to 3 months to make sure the cyst has gotten smaller. If you develop functional cysts often, your health care provider may want you to take birth control pills so you won’t ovulate. If you don’t ovulate, you won’t form functional cysts.

Do I need surgery for an ovarian cyst?

The treatment for ovarian cysts depends on several things, such as your age, whether you are having periods, the size of the cyst, its appearance and your symptoms.

If you’re having periods, only mild symptoms and the cyst is functional, you probably won’t need to have surgery. If the cyst doesn’t go away after several menstrual periods, if it gets larger or if it doesn’t look like a functional cyst on the ultrasound, your health care provider may want you to have an operation to remove it. There are many different types of ovarian cysts in women of childbearing age that do require surgery. Fortunately, cysts in women of this age are almost always benign (noncancerous).

If you’re past menopause and have an ovarian cyst, your health care provider will probably want you to have surgery. Ovarian cancer is rare, but women 50 to 79 years of age are at greater risk. Women who are diagnosed at an early stage do much better than women who are diagnosed later.

What type of surgery would I need?

If the cyst is small (about the size of a plum or smaller) and if it looks benign on the ultrasound, your health care provider may decide to do a laparoscopy. This type of surgery is done with a lighted instrument called a laparoscope that’s like a slender telescope. This is put into your abdomen through a small incision (cut) just above or just below your navel (belly button). With the laparoscope, your health care provider can see your organs. Often the cyst can be removed through small incisions at the pubic hair line.

If the cyst looks too big to remove with the laparoscope or if it looks suspicious in any way, your health care provider will probably do a laparotomy. A laparotomy uses a bigger incision to remove the cyst or possibly the entire affected ovary and fallopian tube. While you are under general anesthesia (which puts you in a sleep-like state) the cyst can be tested to find out if it is cancer. If it is cancer, your health care provider may need to remove both of the ovaries, the uterus, a fold of fatty tissue called the omentum and some lymph nodes. It’s very important that you talk to your health care provider about all of this before the surgery. Your health care provider will also talk to you about the risks of each kind of surgery, how long you are likely to be in the hospital and how long it will be before you can go back to your normal activities.

QUESTIONS TO ASK YOUR HEALTH CARE PROVIDER

• Do I need an ultrasound?
• What kind of cyst do I have?
• If it’s a functional cyst, do I need any treatment?
• How will I know if my functional cyst is getting worse?
• If I have another type of cyst, what are my treatment options? Will I need surgery?
• Am I at risk of having another ovarian cyst in the future?
• I’m menopausal. Am I at risk for ovarian cancer?