Ovarian Cyst - Should I Worry?

Author : Dr. Monica Sachdeva

Date : 23 Nov 2019

Ultrasound has become a cornerstone in women with pelvic problems. Many times we find ovarian cysts in ultrasound which results in switching on of "Panic" button.

A question arises, Should I worry and when to worry?

What are Ovarian Cysts?

Ovarian cysts come in two colours, functional cysts and nonfunctional cysts. Functional cysts are usually the "Normal"  kind. They arise in a functioning ovary. These functional cysts come in two types. Follicular cysts that have the eggs and corpus luteum cysts are the follicular cyst which converts after ovulation.

 The Follicular cyst is filled with clear fluid, doesn't have much of the blood supply, and occasionally can get pretty big. The important thing is to leave it alone. These cysts usually go away after a few weeks.

 After ovulation, the follicular cyst becomes a corpus luteum cyst. It is a progesterone factory whose job it is to make the hormones to prepare the uterus for pregnancy. If no pregnancy occurs with ovulation, then these cysts go away in about two weeks. These cysts are very active in making hormones, and they have an abundant blood supply. 

Sometimes there can be bleeding and internal haemorrhage, which leads to an emergency. Usually, the cyst goes on its own but sometimes if bleeding is heavy, surgery may be required. We know we don't have to worry because these are the good cysts. 

Now, when to worry if there is an ovarian cyst?

When there are nonfunctional cysts or neoplastic new tissue cysts, any of the tissues in the ovary can grow to make a cyst and can get big. These cysts are of different types, depending on the kind of cells. Serous cysts, mucinous cysts, dermoid cysts are some examples.

These cysts should be operated and removed. Pathological examination is critical because ultrasound can not tell the nature of the cyst.

Some have hair, teeth and other kinds of tissues, and they can be diagnosed by ultrasound. They sound scary but are not malignant.

Some non-functional cysts are ovarian cancer and can be confirmed by pathological examination only.That's why we should remove non-functional cysts. 

Ovarian cancer has no symptoms initially, so can't be detected early. When cancerous ovarian cyst gets bigger then it causes pressure and pain. This is the reason any cyst which is growing and is abnormal in nature, it should be removed.

Once menses stop and there is an ovarian cyst, we should suspect an abnormality.

Medical records and ultrasound suggesting ovarian cyst, especially nonfunctional, should be preserved for future reference. Ovarian cysts are of different flavours, and it's essential to differentiate their true nature as it is rightly said: " a stitch in time saves nine."

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