Dr Jyothi Khanna is a gynaecologist and obstetrician with Aster Medical Centre at its Al Rayyan branch
By Dr Jyoti Khanna
Every woman should be fully aware of her gynaecological organs and any conditions and issues related to them, one of them being the ovaries. Ovary plays a vital role in the menstrual cycle of every woman after the onset of puberty.
Women have two ovaries about the shape and size of almonds that are located on either side of the uterus. Ovaries are responsible for the release of hormones named estrogen and progesterone that cause menstruation. Every month, the ovaries release eggs that pass through the fallopian tube to get fertilised. This cycle is called ovulation.
One of the conditions affecting ovaries is ovarian cysts, which are fluid-filled sacs or pockets within or on the surface of an ovary. Many women are diagnosed with ovarian cyst at least once during their lifetime. Most ovarian cysts cause little to no discomfort and pain and are completely harmless.
Causes of Ovarian Cyst
Cysts are fluid-filled sacs that can form in the ovaries. They are particularly common during the childbearing years. However these cysts, especially the ones that rupture, can lead to some very serious symptoms.
There several types of cysts. The most common one is the functional cyst which forms during ovulation. The formation of the functional cyst takes place when either of the egg is not released or the sac — follicle — in which the egg forms, does not dissolve after the egg is released.
Other types of cysts are
l Polycystic Ovary Syndrome: The follicles in which the eggs normally mature fail to open and form cysts.
l Endometriosis: In women with endometriosis, tissue from the lining of the uterus grows in other areas of the body. This includes the ovaries. It can cause cyclical pain and may cause infertility.
l Cystadenomas: These cysts form out of cells on the surface of the ovary. They are often watery or mucus material.
l Dermoid cysts: This type of cyst contains tissue similar to that in other parts of the body. That includes skin, hair, and teeth.
There are chances that dermoid and cystadenomas can become large causing the ovary to move out from its usual position to pelvis. This increases the risk of what it is called the twisting of the ovary or ovarian torsion.
Symptoms
Usually, cysts don’t cause much pain or discomfort and go away on their own. But, a large cyst might cause abdominal discomfort and if this large cyst presses onto your bladder, one might feel the need to urinate frequently.
The symptoms of ovarian cyst are:
l Pain or a dull ache at the lower back and the thighs
l Pelvic pain just before the periods starts or just before it ends.
l Pelvic pain during intercourse.
l Pain during bowel movements.
l Nausea, vomiting or breast tenderness like the symptoms experienced during pregnancy.
l Feeling full and heavy in the abdomen.
l Constant pressure on the bladder that causes urination frequently or difficulty in emptying the bladder completely.
When to approach a doctor?
One should seek medical attention when there is severe abdominal pain or pelvic pain or the pain accompanied by fever and vomiting. If the signs include shock such as cold, clammy skin, rapid breathing, light headedness or weakness, consider it as emergency.”
Some women may develop less common type of cysts that might not produce any symptoms. Cystic ovarian masses that develop after the menopause might be malignant (cancerous) and that is the reason it is very important to conduct regular pelvic exams.
Complications
Complications related to the ovarian cyst are:
l Ovarian Torsion: Sometimes the cyst becomes large and causes the ovary to move from its position to the pelvis. This drastically increase the chance of painful twisting of the ovary called ovary torsion.
l l Rupture: A cyst that ruptures can cause severe pain and internal bleeding.
l l Haemorrhage or bleeding inside the cyst.
Diagnosis, tests and treatments
A cyst is usually found during a regular pelvic exam. If a cyst is suspected, the doctor asks the patient to go for further tests to determine what type of cyst it is and if it requires further treatment. CT scan, MRI may be required to detect the cyst.
Treatment depends upon the size, shape and the symptoms. USG diagnoses most of the ovarian cysts. Regular USG examinations which will show if the cyst has disappeared on its own. Doctors also recommend birth control pills to reduce the risk of developing more cysts in the future menstrual cycles. Surgery is also another option if the cyst is large, is growing and persists through two to three menstrual cycles. Removal of the affected ovary is also an alternative which is called Oophorectomy. If the cystic mass is cancerous, the doctor will advise on complete hysterectomy or removal of ovaries, fallopian tubes and uterus along with chemotherapy or radiotherapy.
Prevention
There are no prevention measures as such to reduce the risk of cysts in the ovary. Regular pelvic examinations can help in early detection of cysts in the ovary. Being alert about the monthly menstrual cycle will surely help every woman be aware of the concern.
