Occasional irregularity in periods, and pain and cramps during menstruation is common in women. But if these are present for a long time and are associated with other symptoms like pain in the pelvic region that is radiating to the thighs and lower back, pelvic pain during sexual intercourse and bowel movements, nausea, vomiting, and a feeling of heaviness in your stomach, then there is a chance that you may be having an Ovarian cyst.

Ovaries are one of the organs in female reproductive system. They are almond shaped and are situated on either side of the uterus. Ova or eggs are released by these ovaries that help in childbirth. When a fluid filled sac develops over or within the ovaries then it is known as an ovarian cyst. Most of the ovarian cysts are harmless but if the ovarian cyst ruptures, there could be serious consequences that you need to look out for.

Types of Ovarian Cysts

Ovarian cysts are of three types. Some are non cancerous and harmless, while others may be a cause of concern.

Functional cysts are non cancerous, and occur due to the normal physiological process of release of ovum or egg from the ovary, a process known as ovulation. Due to functional cysts you may experience symptoms like irregular menstrual periods, vomiting, nausea, and abdominal pain. These cysts shrink in 1to 3 months time on their own.

These are of two types- Corpus luteum cysts and follicular cysts. If the sac (follicle that holds the egg) does not dissolve after the ovum or egg is released, then corpus luteum cysts are formed. Following the release of the egg, the sac seals itself and fluid starts building up inside. These cysts grow up to 4 inches and disappear in a few weeks. They are not cancerous, but they may twist and cause bleeding in the ovary causing pain. The risk of getting these cysts increases when drugs such as serophene or clomid are taken. When the sac does not break open to release the egg, follicle cysts are formed that disappear in 1-3 months.

The other types of ovarian cysts are dermoid cysts, cystadenomas, and endometriomas. These are less common forms of ovarian cysts. Dermoid cysts are formed from specialized cells that can grow and differentiate into other kinds of cells like hair, teeth or skin. These may be asymptomatic when small in size, but can cause pain if enlarge.

Cystadenomas develop from ovarian tissue and may be filled with watery fluid or sticky mucus.

Endometriomas are a result of endometriosis which means that cells of the uterus grow on other organs. All these cysts have a potential to become large and cause twisting of the ovaries, which is a very painful condition.

Symptoms

There are a few ovary cyst symptoms:

• Irregular menstrual cycle
• Pelvic pain during sexual intercourse
• Dull constant pelvic pain radiating to thighs and lower back, pain during and after periods
• Pressure and pain during bowel movements
• Breast tenderness
• Nausea
• Vomiting
• Heaviness in abdomen
• Difficulty in emptying bladder completely

Diagnosis

In addition to taking a complete medical history, the doctor may advise certain tests or procedures to determine the type of ovarian cyst present.

The doctor uses the sonogram to check for any abnormalities in the ovary. In a sonogram, the sound waves are used to take pictures of the internal structures in the body. The sonogram of the ovaries is taken through vagina or abdomen and it lasts for 30 minutes duration. By studying the images of the ovary got through sonogram, the doctor studies the appearance and size of the cyst.

A pregnancy test may be done. If the pregnancy test turns positive it is an indication of a corpus luteum cyst which develops when the ruptured follicle is sealed with fluid after release of egg.

Laparoscopy may be advised in some women. In this procedure the doctor can not only view the ovaries, but also can remove the ovarian cyst present on the ovaries with the help of an instrument inserted through an abdominal incision.

If the doctor wants to know if the ovarian cyst is cancerous in nature, the CA 125 blood test will be conducted in which the levels of protein called as Cancer antigen 125 (CA 125) is checked. If the levels are elevated then it suggests ovarian cancer.

Treatment

The ovarian cysts treatment depends on the type and size of the cysts, symptoms experienced and your age. Since most of the cysts disappear within 1 to 3 months, the doctor would wait and watch, and re examine after 3 months.

In post menopausal women who have fluid filled cysts that are less than 2 cms, regular monitoring with ultrasound is done.

To reduce the chance of new cysts the doctor may prescribe oral contraceptive pills. These also reduce the risk of ovarian cancer.

If the cyst is large and growing in size, then surgery is recommended. In a procedure called as Cystectomy, the cyst is removed without removal of the ovaries.

If a single affected ovary needs to be removed, then the procedure is known as oophorectomy.

In case of a cancerous cyst, the doctor may perform hysterectomy in which uterus and both the ovaries are removed. This is generally recommended after menopause (cessation of periods between 45 to 55 years of age).

A laparotomy procedure is used to remove the entire affected fallopian tube and ovary.