About seven percent of women have one or more cysts in the ovary, usually accidentally discovered by ultrasound. Fortunately, these fluid-filled cavities are rarely a cause for concern, often disappearing on their own. Ovarian cysts can occur at any age, singly or in large numbers, on one or both ovaries. They do not grow from proliferations of cells, but from the accumulation of tissue fluid. They are the most common benign tumors on the ovary.
How do ovarian cysts develop?
The vast majority of cysts develop from the normal hormonal function of the ovary. They are therefore also called functional cysts. They occur predominantly in women at sexual maturity, and especially often in puberty and menopause, ie in times when the interplay of hormones undergoes a major change.
- The most common form is the follicular cyst. It is more likely to develop in young women during a menstrual cycle in the development of a fertilizable egg in the ovary. The follike, ripens, but does not burst to release the egg. Ovulation therefore stops, and the follicle continues to grow due to fluid accumulation. Over 90 percent of follicular cysts spontaneously regress or burst in the course of one or two menstrual cycles.
- Other functional cysts are the yellow-body cysts (corpus luteum cysts), which develop as a result of hemorrhage (often in pregnancy), and usually regress spontaneously.
- Another form is the lutein cysts, which often occur in both ovaries, which are mainly the result of increased production of a specific hormone (HCG). They can also be the result of hormone treatment in the case of an unfulfilled desire to have a baby, and usually recede when hormone treatment is discontinued.
- Polycystic Ovaries (PCO) are numerous ovarian cysts that are a major feature of PCO syndrome (a disease of its own).
Cysts, which grow independently of ovarian function and develop through secretion, are less common. They are called organic cysts or retention cysts. They also form a cavity, but for example, contains glandular secretions or chocolate-colored thickened blood breakdown products (chocolate cyst), but also once hair, teeth or other body tissues (dermoid cyst). Chocolate cysts develop during endometriosis; Dermoid cysts rarely become malignant over time.
How do ovarian cysts express themselves?
Most ovarian cysts are unremarkable and are discovered by chance during an ultrasound scan. If a cyst becomes noticeable, then it is usually quite large and thus presses on surrounding tissue or organs. The complaints are often diffuse, often there is a feeling of pressure or unilateral pulling pain in the abdomen. Even irregular or heavy menstrual bleeding occur.
A special case are large, stalked cysts that rotate around their stems and can suddenly cause severe pain. In addition, cysts can rupture (ovarian cyst rupture) and lead to bleeding in the ovary or the free abdominal cavity. The resulting acute abdomen in such cases is a life-threatening complication requiring intensive care.
In pregnancy, ovarian cysts of 6 cm or more have an increased risk of complications and miscarriage; Therefore, surgery is usually recommended at the beginning of the second trimester of pregnancy.