Follicular cysts are fluid-filled sacs that develop on or within an ovary. These cysts commonly arise as a normal part of the monthly menstrual cycle in individuals of reproductive age. While the presence of an ovarian cyst might initially cause concern, most follicular cysts are benign and typically resolve without intervention. They are a frequent occurrence, often going unnoticed due to a lack of symptoms.
Understanding Follicular Cysts
Each month, during the menstrual cycle, a small sac called a follicle develops on an ovary. This follicle houses a developing egg and produces hormones like estrogen, preparing the uterine lining for a potential pregnancy. Around the middle of the cycle, the mature egg is released from the follicle in a process known as ovulation.
A follicular cyst forms when this process is disrupted, and the follicle fails to rupture and release its egg. Instead, the fluid within the follicle remains and can continue to accumulate, causing the sac to enlarge and become a cyst. These are classified as functional cysts, indicating they arise from the normal functioning of the ovary, rather than abnormal cell growth.
Follicular cysts are non-cancerous and common. They have thin walls and are unilocular, meaning they contain a single fluid-filled chamber. These cysts disappear on their own within a few menstrual cycles, often within one to three months, as the body reabsorbs the fluid.
Recognizing Symptoms
Many follicular cysts do not cause any noticeable symptoms and are often discovered incidentally during a routine pelvic exam or imaging for an unrelated reason. If a cyst grows larger or ruptures, it can lead to a range of symptoms. A common sign is pelvic pain or discomfort, which may be a dull ache or a sharp sensation, often localized to one side of the lower abdomen.
Other symptoms include a feeling of pressure or bloating in the lower abdomen, particularly on the side where the cyst is located. Some individuals may experience changes in their menstrual cycle, such as irregular periods or spotting. Pain during sexual intercourse or discomfort during bowel movements can also occur. Nausea, vomiting, or breast tenderness are possible symptoms associated with larger cysts or complications.
Diagnosis and Management
Diagnosing a follicular cyst begins with a review of medical history and a physical pelvic examination. If a cyst is suspected, imaging tests are performed to confirm its presence and assess its characteristics. A transvaginal ultrasound is the most common imaging method, providing detailed images of the ovaries to determine the cyst’s size, shape, and internal features. Follicular cysts on ultrasound appear as thin-walled, fluid-filled sacs, ranging from 3 to 8 centimeters in size.
For most follicular cysts, the primary management approach is watchful waiting. Since these cysts resolve spontaneously, healthcare providers recommend monitoring the cyst with follow-up ultrasounds over a few menstrual cycles, within a few weeks or months, to observe if it shrinks or disappears. Pain management, with over-the-counter pain relievers, may be suggested for discomfort. For large cysts, those causing persistent symptoms, or if there are concerns about their nature, hormonal birth control may be considered to prevent new cysts from forming. Rarely, surgical removal may be necessary for very large, persistent cysts, or those causing severe complications.
When to Seek Medical Attention
While most follicular cysts are harmless, certain symptoms warrant immediate medical evaluation. Seek prompt medical attention if you experience sudden, severe abdominal or pelvic pain. This pain may be accompanied by nausea, vomiting, or fever. Other concerning signs include dizziness, lightheadedness, or rapid breathing, which could indicate a ruptured cyst with internal bleeding or ovarian torsion, a condition where the ovary twists, cutting off its blood supply. Do not attempt to self-diagnose these symptoms; professional medical advice is crucial for diagnosis and timely intervention.