Ovarian cyst is a small fluid or semi-solid material filled sac (similar to blisters) produced in or on the surface of the ovaries. Ovarian cysts are part of the normal menstrual cycle, therefore they develop and disappear regularly with menstruation. Any ovarian follicle which is larger than 2 cm can be termed as an ovarian cyst. It can be as small as a pea or as big as a muskmelon. Ovarian cysts develop with symptoms like acute abdominal pain or with no symptoms at all. Though, majority of the ovarian cysts are harmless, some of them may be cancerous or can cause a serious medical problem. Therefore, proper diagnosis of the cyst must be done on time. Ovarian cysts can be divided into two basic types, depending on their characteristics and causes. They are Functional Ovarian Cysts and Abnormal Ovarian Cysts.
Functional Ovarian Cysts
Functional cysts are the most commonly observed cysts in women. In functional cysts, a sac is formed on the surface of the woman's ovary during ovulation, which holds a maturing egg. Once the egg is released, the sac disappears. But sometimes, if the sac closes before or after the egg is released, it can swell up with semi-solid material or fluid. This cyst rarely occurs in case of menopausal women because of the obvious reason that the eggs are no longer produced. Normally, functional ovarian cysts do not have any symptoms and disappear without medical treatment. There are three types of functional ovarian cysts. They are Corpus Luteum, Graafian Follicle Cysts and Hemorrhagic Cysts.
•Corpus Luteum Cyst: It is a type of functional cyst, which develops during the second half of the menstrual cycle. It is asymptomatic. When the egg is released from the follicle, it becomes a secretory gland which produces large quantities of estrogen and progesterone to prepare the uterus for conception. This follicle is then known as corpus luteum. And if the egg is not fertilized, then it breaks down and disappears within a few weeks. A luteal cyst is formed when this follicle doesn't disappear when it should and gets filled with either blood or fluid. It can grow up to 10 cm in diameter. It is capable of causing abdominal or pelvic pain and bleeding or twisting of the ovary. It is not observed among women who take birth control pills, as it prevents ovulation, whereas certain fertility drugs increase their frequency.
•Graafian Follicle Cyst: It is a common type of ovarian cyst also known as follicular cyst. When ovulation fails or when a mature follicle collapses on itself, it becomes a cyst. It can grow up to 3 cm in diameter. Usually, it is painless and disappears in 2-3 menstrual cycles without medication. But sometimes, this type of cyst can cause excruciating pain in the area where it is located.
•Hemorrhagic Cyst: It is also called a blood cyst. When a very small blood vessel in the wall of the cyst bursts, the blood enters the cyst. Most women have this problem at some stage of their lives. They do not always require medical treatment. Unlike the other cysts of this category, hemorrhagic cysts show symptoms like abdominal pain or burning sensation of the pelvic area due to blood leakage. It becomes more painful if the cyst ruptures and the blood enters the abdominal cavity. Sometimes, surgery is required to remove the cysts. In some cases, even if the cyst ruptures, it disappears without surgery.
Abnormal Ovarian Cysts
These are the types of cysts which are developed due to the abnormal growth of cells. However, they are not always cancerous. In some cases, they burst, which requires an emergency surgery. There are no known causes of these cysts.
•Dermoid Cyst (Teratomas): This is an abnormal type of cyst, more tumorous rather than a simple one. It is sometimes referred to as mature cystic teratoma. It is rarely of malignant type. This cyst is observed in women of all ages, especially during their prime reproductive years. It develops from the ovarian cells known as totipotential germ cell. This is a fundamental cell responsible for the growth of a variety of other tissues, such as hair, teeth and bones. The cyst may contain solid tissues like thyroid, fat, and occasionally, bone, cartilage or hair. Dermoid cyst is similar to those present on skin tissue. The size of a dermoid cyst ranges from ? inch to 17 inches in diameter. Bigger the size, higher the chances of its rupturing. Blood supply may also get blocked due to twisting of a dermoid cyst.
•Endometrial Cyst: An endometrial cyst is formed when the invasion of ovary takes place. In endometrial cysts, a small part of the endometrial tissue bleeds, falls off, gets transplanted, and grows inside the ovaries. They are not common and can be traced only after medical examination. These cysts are usually dark in color, and their size ranges from 0.75 to 8 inches. It shows symptoms like increased belly size, fatigue, pain in bowel movements, pain before and after menstruation, irregular menstrual periods, pain during intercourse etc. They are also known as Chocolate Cysts.
•Cystadenoma Cyst: It is a benign cyst that develops from the ovarian tissue. It is usually filled with a mucous type fluid material. It develops on the outer surface of the ovaries from the ovarian cells. It is capable of growing to a large size, and in few cases, it is attached to the ovary by stem. If it gets twisted on the stem and ruptures, it needs emergency surgical removal. It can grow up to more than 12 inches in diameter. This is the reason why they interfere with the other abdominal organs.
•Polycystic Ovary or Multiple Cysts: Polycystic ovaries or Multiple cysts are related to those women whose menstruation cycle is irregular. Ovaries of women who don't ovulate regularly enlarge to twice the normal size. Such ovaries contain a large number of small cysts. Technically, they are very small egg follicles, not cysts. In such cases, hormonal imbalance or malfunctioning of the organ system is commonly observed. It causes pregnancy-related problems as the cysts cause enlarged ovaries and form a thick outer covering, which prevents ovulation. It is very commonly found in women. About 4-7% of women face this problem. It is different from Polycystic Ovarian Syndrome (PCOS) in which other symptoms like cardiovascular and metabolic risks like high BP, type 2 diabetes and glucose tolerance are present along with the ovarian cysts.
Proper and timely diagnosis of the cyst and appropriate medication helps in treating ovarian cysts without causing any serious health problem.