Symptoms and complications of ovarian cyst

Do you know that according to a recent study, nearly 1 in every 4 women in India develops an ovarian cyst at some point in her lifetime? Worldwide, the incidence of ovarian cysts varies from 8% to 18% in pre & post-menopausal women. 

Don’t worry, not all of these cysts are problematic and only a few will need surgery or any other kind of treatment. 

What is an ovarian cyst?

An ovarian cyst is a sac filled with fluid/ blood/ mucinous or other content and is found within the ovary.

Very often, an ovarian cyst is harmless & causes little or no discomfort and one doesn’t even notice any change or ill effects in the body. In most of these cases, they disappear on their own, without the requirement of any kind of treatment.

However, sometimes complications may arise and an ovarian cyst may get ruptured or twisted within the abdomen leading to an emergency situation requiring urgent treatment.

This is why it is important to get a regular pelvic examination & ultrasound done by an experienced doctor to detect the potential signals of ovarian cyst which can cause serious problems.

Who is more likely to get an ovarian cyst?

As mentioned earlier, any woman can develop an ovarian cyst, which can remain unnoticed in her lifetime. But there are a few conditions that increase the risk of developing an ovarian cyst. These conditions are

• Fertility medications - if you are on any fertility drug which is used to cause ovulation then the chances of developing an ovarian cyst are higher.
• Endometriosis - Endometriosis is a condition in which the cells of the uterine lining ie Endometrial cells are found outside the uterus. These cells undergo similar changes as the uterine lining during the menstrual cycle & bleed monthly. This may lead to a collection of blood & the formation of cysts if these cells are present on or within the substance of the ovary.
• Severe pelvic infection - if your pelvic infection starts to spread to the ovaries it can also increase your chances of developing an ovarian cyst.
• The Previous history of an ovarian cyst - according to experts if you have a history of an ovarian cyst there are more chances to develop a new ovarian cyst.

Types of ovarian cysts

Ovarian cysts are a common occurrence and it is important to remember that not all of them are cancerous. The ovarian cysts can be either Physiological ( meaning that they are a result of the normal physiological processes in the body) or Pathological ( meaning that they are formed due to some abnormal pathological process in the body).
 

Physiological ovarian cysts

Physiological ovarian cysts can be of two types-

• Follicular cysts.
• Corpus luteum cysts.

Every month a follicle containing an egg grows & matures in one of the two ovaries and is finally released from the ovary to be picked up by the fallopian tube for fertilization. After releasing the egg, the follicle transforms into a corpus luteum that eventually degenerates gets absorbed in the substance of the ovary.

Sometimes, the follicle fails to rupture & just keeps growing. This leads to the formation of a follicular cyst.

Occasionally, the corpus luteum does not degenerate or involute and continues to grow thus forming a corpus luteum cyst. 
 

Pathological ovarian cysts

Sometimes, certain diseases or dysfunction of ovarian function can lead to the formation of cysts in the ovaries. These can be of various types.

• Haemorrhagic cyst- These are formed when there is bleeding within the follicular cyst or corpus luteum cyst.
• Dermoid cyst- These are formed from the cells of the ovary & contain teeth, hair, bone, cartilage, etc. They are mostly benign only very rarely turn cancerous.
• Endometriotic cyst- These are formed due to the presence of endometrial cells in the ovaries and contain chocolate coloured fluid /blood. They are mostly non-cancerous.
• Cystadenoma- These cysts contain watery fluid & can sometimes grow to a very large size without causing evident symptoms.
• Malignant ovarian cysts- These are cysts that are produced due to the cancerous transformation of the cells of the ovary. It is essential to detect Ovarian cancer at an early stage for successful treatment and hence you should seek a specialist medical opinion if an ovarian cyst is detected. 

Symptoms of ovarian cyst

Very often, the ovarian cysts may not cause any symptoms and the physiological or functional cysts may actually resolve spontaneously without being noticed. However, sometimes the ovarian cysts may persist & continue to grow and cause symptoms if they become very large in size, or rupture /get twisted. The symptoms caused by ovarian cysts may include

• Severe pelvic pain. 
• Feeling of heaviness, bloating, or swelling in the lower abdomen.
• Feeling of Nausea & vomiting.
• Pain during sex.
• Difficulty in urination or defaecation.
• A sudden increase in weight.
• Frequent urination.
• Severe cramps during menstrual periods.

Apart from the above symptoms, a ruptured or twisted ovarian cyst may cause acute symptoms and may have life threatening consequences. Hence you should seek urgent medical help if you experience

• Dizziness or fainting.
• A sudden sharp pelvic pain.
• High fever.
• Severe pain with vomiting.
• A rapid increase in the rate of breathing or breathlessness.
• Sudden sweating with the skin turning cold /clammy.

Complications of an ovarian cyst

Most ovarian cysts resolve within a few months but sometimes, they may continue to grow & lead to a number of complications. It is important to be aware of the possible complications so that you may seek medical help well within time and avoid risky situations. Some of the complications of an ovarian cyst include

• Ovarian Torsion – Sometimes, if the ovarian cyst becomes sufficiently large and is freely mobile, it may get twisted and also cause the ovary to be twisted on its stalk. This is called ovarian torsion and is an extremely painful condition. Symptoms of ovarian torsion are sudden pain in the lower abdomen, feeling of nausea and vomiting, or fainting. In severe cases of ovarian torsion, the blood vessels of the ovary may get twisted & compressed, thus blocking the blood supply to the ovary.  This may lead to loss of the functional tissue in the ovary. 
• Cyst Rupture – Sometimes, an ovarian cyst may enlarge & rupture within the abdomen. This leads to bleeding from the ruptured wall of the cyst and can cause excessive blood loss leading to fainting & risk to the life of the woman. Rupture of an ovarian cyst may lead to sharp pain, nausea, fainting, cold & clammy skin, and an increase in the rate of breathing in extreme cases.
• Transformation of Normal Cyst Into Cancerous One – Ovarian cysts are usually benign but sometimes, some of the ovarian cysts may become cancerous and in such cases, early detection & treatment is imperative for a cure. 
• Infertility – Cysts in the ovaries can interfere with ovulation and make it difficult for a woman to conceive. Sometimes, Endometriotic cysts may enlarge, bleed and lead to distortion of the fallopian tubes leading to blockage of the tubes & infertility. Proper medical advice for medication or surgery is required in such cases and should not be delayed if you are trying to conceive.

Prevention of complications of the ovarian cyst

The formation of ovarian cysts is an internal process and unfortunately, there is no foolproof method to completely avoid the formation of ovarian cysts.

However, a regular medical examination & pelvic examination can help in the early detection of the ovarian cyst and prevent the development of complications in an ovarian cyst.

You should notify your doctor if you see any one of the following symptoms

• Irregular menstrual cycle.
• Pain in the lower abdomen.
• Loss of appetite.
• Unexpected weight loss or weight gain.
• The fullness of the abdomen.

The treatment of physiological cysts, small endometriotic or haemorrhgic cysts may require simple painkillers or hormonal medications while a dermoid or malignant cyst may require surgery. 

A complication like torsion of an ovarian cyst or a ruptured ovarian cyst with excessive bleeding in the abdomen may require urgent surgery. 

It is important to seek medical advice early to avoid complications if you notice any of the symptoms discussed above.

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