Ovarian cysts are common, fluid-filled sacs that develop on or within an ovary. While many are asymptomatic and resolve without intervention, some can cause discomfort and pain. Understanding their nature and potential impact can help individuals recognize when medical attention is necessary. This guide explores how these cysts form, how they can lead to pain, and other associated symptoms.
What Are Ovarian Cysts?
Ovarian cysts are fluid-filled sacs that develop on or inside an ovary. They are very common, with most women experiencing at least one during their lifetime. The most frequent types are functional cysts, which form as a normal part of the menstrual cycle. These include follicular cysts, which arise when a follicle does not release its egg, and corpus luteum cysts, which form if the egg-releasing sac fills with fluid instead of shrinking. Most ovarian cysts are benign and usually disappear on their own within a few months.
How Ovarian Cysts Cause Pain
Ovarian cysts can cause pain through several mechanisms, depending on their size, type, and complications. Large cysts can exert pressure on surrounding organs like the bladder or bowel, leading to a dull ache or feeling of fullness in the pelvis or abdomen. Cysts over 10 centimeters are more likely to cause this discomfort, and their fluid can contribute to a sensation of heaviness.
Sudden, sharp, severe pain, often localized to one side of the lower abdomen, can signal a ruptured ovarian cyst. When a cyst bursts, its contents (fluid or blood) can irritate the abdominal cavity lining, causing intense pain. Another cause of acute pain is ovarian torsion, where a cyst causes the ovary to twist around its ligaments, cutting off blood supply. This results in excruciating, sudden pain, often with nausea and vomiting. Some cysts, known as endometriomas or “chocolate cysts,” are filled with old blood and are associated with endometriosis, a condition that can cause chronic pelvic pain.
Other Symptoms Associated with Ovarian Cysts
Beyond direct pain, ovarian cysts can cause other symptoms affecting daily comfort and bodily functions. Many individuals report bloating or abdominal swelling, sometimes accompanied by a persistent feeling of pressure or heaviness in the pelvic area. These sensations often occur due to the cyst’s size or its presence within the confined space of the pelvis.
Ovarian cysts can also disrupt the menstrual cycle, leading to irregular periods, unusually heavy bleeding, or unexpected spotting. This interference often stems from hormonal imbalances caused by the cyst. Some individuals experience pain during sexual intercourse, particularly with larger cysts or if a cyst ruptures. Pressure from cysts on the bladder can lead to frequent urination, while pressure on the bowel may cause difficulty with bowel movements or pain during defecation.
When to Seek Medical Help
Seek immediate medical care if you experience sudden, severe pelvic or abdominal pain, particularly if it is sharp or intense. Urgent evaluation is warranted if pain is combined with fever, vomiting, or signs of shock like dizziness, weakness, fainting, or rapid breathing. These symptoms could indicate a ruptured cyst with internal bleeding or ovarian torsion, requiring prompt intervention.
Additionally, any unexplained heavy vaginal bleeding or pain that steadily worsens merits a medical consultation. Always consult a healthcare provider for new or concerning pelvic symptoms.
Diagnosis and Treatment Options
Diagnosing an ovarian cyst typically begins with a pelvic exam, where a healthcare provider may detect swelling. The most common and effective diagnostic tool is an ultrasound, which uses sound waves to create images of the pelvic organs. An ultrasound can determine the cyst’s size, location, and whether it is fluid-filled or solid, often utilizing a transvaginal approach for clearer images. Blood tests, such as a CA125 test, may be ordered if cancer is suspected, although elevated CA125 levels can also result from non-cancerous conditions. In some instances, an MRI or CT scan might be used for a more detailed assessment of larger or complex cysts.
Treatment approaches for ovarian cysts vary depending on the cyst’s type, size, symptoms, and the individual’s menopausal status. For many small, benign, functional cysts that cause no or minimal symptoms, “watchful waiting” is often recommended. This involves monitoring the cyst with follow-up ultrasounds to ensure it resolves on its own, which many do within a few months. Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can help manage mild pain. Hormonal birth control may be prescribed to prevent the formation of new cysts, although it does not shrink existing ones.
Surgical intervention becomes necessary for cysts that are large, persistent, symptomatic, or if there is concern about malignancy or complications like ovarian torsion. Two primary surgical methods are employed: laparoscopy and laparotomy. Laparoscopy, also known as keyhole surgery, is a minimally invasive procedure where small incisions are made in the abdomen to remove the cyst, often allowing for a quicker recovery. If a cyst is very large, appears suspicious for cancer, or if other complications are present, a laparotomy may be performed, involving a larger abdominal incision. An ovarian cystectomy, which removes only the cyst while preserving the ovary, is a common goal, especially for those wishing to maintain fertility.