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An ovary can frequently become enlarged by a cyst - a fluid-filled compartment or sac formed by an envelope of ovarian tissue. These enlargements distinguish cysts from solid tumors that may also cause an increase in ovarian size. A cyst in an ovary may be part of the ovary's normal function, or it may be part of a tumor. These cysts may cause pain and pressure symptoms, or may be completely 'silent'. Those cysts that have not caused pain are usually found during gynecologic exam or ultrasound.
A follicular cyst is one in which the egg-making follicle of the ovary enlarges and fills with fluid. A corpus luteum cyst is a yellow mass of tissue that forms from the follicle after ovulation. These types of cysts come and go each month and are associated with normal ovarian function.
Types of Cyst - Functional cysts - are the most common type. These cysts are related to variations in the normal function of the ovaries. For example, they form when an egg fails to release as it should during normal ovulation. They can last 4-6 weeks. Rarely do they secrete hormones.
- Abnormal or neoplastic cysts - result from cell growth and are mostly benign. In rare cases, they can be cancerous. Abnormal cysts require medical treatment by your doctor. Examples include:
- Dermoid cyst - which consists of a growth filled with various types of tissue such as fatty material, hair, teeth, bits of bone and cartilage.
- Polycystic ovaries - caused by a buildup of multiple small cysts which cause hormonal imbalances that can result in irregular periods, body hair growth and infertility. Polycystic Ovary Syndrome, a separate condition, causes follicular cysts to develop as a result of pituitary overproduction of luteinizing hormone in an attempt to initiate ovulation.
Women with healthy ovaries normally release an egg from a small ovarian cyst each month. The small cyst becomes a corpus luteum cyst and then lasts for two to three weeks waiting to support a new pregnancy. If pregnancy does not occur, the woman will experience a menstrual period as part of the process of the disappearing corpus luteum cyst. These normal cysts, also called functional cysts, are usually only 2-3cm in size but may reach 6-8cm if filled with blood or lots of fluid. Functional cysts resolve within one to two menstrual cycles and so can be identified by their disappearing behavior. Their presence explains why women of reproductive age have small cysts in the ovary all the time. What is not as common are functional cysts that grow so fast as to cause pain, or so large as to be easily felt on exam.
Causes & Development; Risk Factors Ovarian cysts may result from corpus luteum cysts, malignancy or dermoid cysts.
They are most common between the ages of 20 and 35 and in women who have endometriosis, pelvic inflammatory disease (PID) or the eating disorder bulimia. Those who take a drug for epilepsy called Valporate are also at increased risk.
Signs & Symptoms Symptoms include:- A feeling of fullness or swelling of the abdomen.
- Weight gain.
- A dull constant ache on either or both sides of the pelvis.
- Pain during intercourse.
- Delayed, irregular or painful menstrual periods.
- Increased facial hair.
- Sharp, severe abdominal pain, fever and/or vomiting. This may be caused by a bleeding cyst or one that breaks or twists.
Diagnosis & Tests Your doctor may order a pelvic ultrasound if a mass is found during the pelvic exam. The ultrasound will evaluate the ovaries and any suspected cysts. Functional cysts are characterized by being fluid-filled and composed of one single sac or chamber. The ultrasound can identify the cyst as being single-chambered. Confirming a functional cyst means it will not likely need treatment and should simply be observed. If that cyst does persist over two to three months, then it should be re-evaluated and treated.
Treatment & Prevention When an ovarian cyst is found, the first important decision to be made is whether this cyst will go away without treatment. Spontaneous resolution is expected and normal for the functional cysts related to ovulation.
Any ovarian growth with multiple cystic areas or mixed solid and cystic features should be considered a tumor and possibly a malignancy. These should be surgically removed to determine the exact diagnosis. When a functional cyst or simple benign tumor is identified, the ovary can be preserved for younger women because only the cyst is removed in those cases.
Prognosis Ovarian cysts are common and will resolve over time, thus confirming that they were functional cysts instead of something more serious.
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Signs, symptoms & indicators of Ovarian Cysts:
Conditions that suggest Ovarian Cysts:
Risk factors for Ovarian Cysts:
Recommendations and treatments for Ovarian Cysts:
KEY |  | Weak or unproven link |  |  | Strong or generally accepted link |  |  | Proven definite or direct link |  |  | May do some good |  |  | Likely to help |
GLOSSARY
Abdomen (Abdominal) That part of the body between the chest and the hips that contains the stomach, intestines, liver, bladder, pancreas and other organs.
Benign Literally: innocent; not malignant. Often used to refer to cells that are not cancerous; they tend to grow slowly and don't spread (metastasize) like cancer tumors do.
Bulimia Nervosa (Bulimia) An eating disorder characterized by lack of control - abnormal eating behavior including dieting, vomiting, purging and particularly bingeing that is usually associated with normal weight or obesity (unlike anorexics, who tend to be considerably underweight). The syndrome is associated with guilt, depressed mood, low self-esteem and sometimes with childhood sexual abuse, alcoholism or promiscuity.
Centimeter (Centimeters, cm) A metric unit of length equaling one hundredth of a meter, or ten millimeters. There are 2.54 millimeters in one inch.
Corpus Luteum Yellow endocrine body formed in the ovary that secretes estrogen.
Cysts (Cyst) A closed pocket or pouch of tissue; a cyst may form within any tissue in the body and can be filled with air, fluid, pus, or other material. Cysts within the lung generally are air-filled, while cysts involving the lymph system or kidneys are fluid filled. Cysts under the skin are benign, extremely common, movable lumps. These may develop as a result of infection, clogging of sebaceous glands, developmental abnormalities or around foreign bodies.
Endometriosis A condition whereby endometrial tissue builds up in parts of the uterus where it does not belong or areas outside of the uterus, forming 'ectopic implants'. Unlike the normal tissue lining the uterus, ectopic tissue has no place to shed in response to a decline in estrogen and progesterone. This results in debris and blood accumulating at the site of the implant leading to inflammation, scarring and adhesions that ultimately cause symptoms and complications. Symptoms typically occur in a cyclic fashion with menstrual periods, the most common being pelvic pain and cramping before and during periods; pain during intercourse; inability to conceive; fatigue; painful urination during periods; gastrointestinal symptoms such as diarrhea, constipation, and nausea.
Epilepsy Chronic brain disorder associated with some seizures and, typically, alteration of consciousness.
Hormones (Hormone) Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Luteinizing Hormone Anterior pituitary hormone stimulating estrogen production by the ovary; promoting formation of progesterone by the corpus luteum in women and stimulating testosterone release in men.
Menstruation (Menses, Menstrual, Menstrual Cycle, Menstrual Cycles, Menstrual Flow, Menstrual Phase, Monthly Cycle) The periodic discharge of blood, tissue fluid and mucus from the endometrium (lining of the uterus) that usually lasts from 3 - 5 days. It is caused by a sudden reduction in estrogens and progesterone.
Ovarian Cysts (Ovarian Cyst) These occur in two forms, namely "functional" and "organic". Symptoms may not be present but can include pressure or pain in the abdomen, problems with urine flow or pain during sexual intercourse. Rarely, a very large cyst can become twisted and stop its own blood supply, possibly causing nausea, fever or severe abdominal pain. Functional ovarian cysts form part of the normal functioning of the ovary and are always benign. They may be either "follicular cysts", produced by all menstruating women every month and reaching up to 2-3cm in diameter before they rupture at ovulation, or "corpus luteum cysts", which appear after ovulation and may grow to produce "hemorrhagic cysts" if ovulation does not occur or is delayed. Rupture of such a cyst can sometimes cause painful ovulation or bleeding, which is often moderate and resolves by itself. Organic ovarian cysts may be benign or malignant and are not linked to the functioning of the ovary. They occur as either "dermoid cysts", which are benign tumors that may nevertheless recur on either ovary and contain elements derived from the skin (hairs, sebum, teeth), or other organic cysts.
Ovary (Ovaries) Ovaries are about the size of an almond and lie on either side of the lower abdomen beside the uterus. They usually produce one egg each month and whether the egg is fertilized or not, the reproductive process follows a monthly cycle, with constant changes in various hormone levels, preparing another opportunity for conception. The ovary is responsible for most of the estrogen production in women. At menopause (sometime after middle-age), egg production ceases and hormone levels drop significantly.
Pelvic Inflammatory Disease (PID, Salpingitis) A purulent (pus-like) vaginal discharge with fever and lower abdominal pain. Salpingitis: Inflammation of the fallopian tubes.
Pelvis The lower part of the abdomen between the hip bones. Organs in a woman's pelvis include the uterus, vagina, ovaries, fallopian tubes, bladder and rectum.
Progesterone This is the hormone secreted after ovulation by the corpus luteum. It is a steroid (similar to a cholesterol), enters receptive cells to stimulate their growth, and acts as an anabolic agent. Estrogen should be viewed as the primary coat underneath all the cycles during a woman's reproductive years, with progesterone, its antagonist, surging for ten or twelve days in ovulatory months. Most of the actions of progesterone cannot occur without estrogen having previously induced the growth of progesterone-receptive binding sites.
Syndrome A medical condition characterized by a collection of related symptoms (what the patient feels) and signs (what a doctor can observe or measure).
Ultrasound Ultrasound testing uses sound waves projected into the body to produce an image of internal organs, structures, tumors, etc. In this procedure, a gel is applied to the patient's skin, and a small device that emits ultrasonic pulses is slowly passed over the area. The sonic image produced is viewed on a monitor.
Last updated: Nov 14, 2009
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