|
Getting your Trinity Audio player ready...
|
Full Text
During the last summer, Emerald Stone (pseudonym) was elated to discover she was pregnant with her second child, but this joy was soon cut short. The night of the same day she tested positive for being pregnant, Ms Stone was hit with a weirdly sharp and uncomfortable abdominal pain. What could this be? She remembered amidst the pain that she did not feel this much pain even when she went into labour for her first.
A few hours passed, and the pain subsided, allowing her to get some sleep before the next working day of the week. Although she thought that episode was over and she could handle her day, she was forced to go to the clinic later that day. At first, the doctors suspected it was an ectopic pregnancy, but after some tests and scans, it was discovered she had ovarian cysts.
What is that? Why do I have it? What could the cause be? Would it affect the new bundle of joy growing inside of me? These and many other questions flooded Ms Stone’s mind.
She had never heard of ovarian cysts before, and that made her confused and scared. After several research and consultations, she ended up undergoing a cystectomy because of the size of the cyst and the rate at which it was growing,
A lot of women, just like Ms Stone, have little or no idea about ovarian cysts and how they can form in a woman’s body. I was in a conversation some weeks back and mentioned it, thinking it was something familiar, but I was shocked at the number of women in the room who did not know what this was. As a gynaecologist friend said, many women do not know about this until there is an issue.
This article will provide all the necessary information and clarification about ovarian cysts.
What is an Ovarian Cyst?
An ovarian cyst is a fluid-filled sac that develops within an ovary (a pair of small, oval-shaped organs in the pelvis). The ovaries are part of the female reproductive system, which produces eggs and hormones. Every month, one of the ovaries releases an egg and produces estrogen and progesterone hormones that regulate the menstrual cycle.
A cyst can vary in size from below a centimetre and sometimes be even larger, growing up to 10cm. Ovarian cysts are common, and this study in northern Nigeria shows an increase in the number of ovarian cysts cases over ten years.
According to a study published in 2016 by the Tropical Journal for Obstetrics and Gynaecology, Ovarian cyst accidents constitute about 3%–5% of gynaecological admissions, with an incidence of 3%–10%. Most ovarian cysts occur naturally and disappear in a few months without treatment.
What are the causes of ovarian cysts?
Ovulation, according to the Cleaveland Clinic, is the leading cause of ovarian cysts. However, some factors trigger its development. These factors include abnormal cell reproduction, endometriosis and Pelvic inflammatory disease (PID).
A typical cell reproduction can cause cysts like dermoids and cystadenomas to form. In the case of endometriosis, cysts often form on the ovary in its advanced stages.
Severe pelvic infections can spread to the ovaries, causing cysts to form.
Who is at risk of developing an ovarian cyst?
Ovarian cysts are common in women of childbearing age, but younger women can also develop one. The 2016 study earlier mentioned revealed that most of the cases of ovarian cyst accidents were in the reproductive age group.
It is also not common in women who have reached menopause. So, every woman with an ovary is at risk of this. However, a person’s chances increase based on their age (ovarian cysts are more common if you haven’t gone through menopause). Ovarian cysts are likely to form or remain during pregnancy.
What are the symptoms of ovarian cysts?
Most ovarian cysts do not have any symptoms and usually go away without treatment. However, when they are prolonged, become large, rupture, twist or block the blood supply to the ovaries, they cause symptoms. These symptoms include intermittent pelvic pain, abdominal heaviness/fullness/pressure, bloating, pain during sex, difficulty emptying the bowels, frequent need to urinate, and heavy/irregular/lighter periods.
When these symptoms advance to sudden or severe abdominal or pelvic pain, pain with fever or vomiting or signs of shock like cold, clammy skin, lightheadedness, or weakness, it is time to visit the hospital.
What are the main types of ovarian cysts?
Several reasons can lead to the formation of a cyst, hence their types. The two major types of ovarian cysts are functional and pathological ovarian cysts.
- Functional/simple ovarian cysts
Functional cysts, also called simple cysts, are the most common type of ovarian cysts and are not disease-related. They occur as a result of ovulation, which involves the release of an egg from the ovary.
These cysts can indicate that your ovaries are functioning as they should, hence the functional cysts.
Functional cysts are expected to shrink over time, usually within 60 days, without specific treatment.
There are two forms of functional cysts: follicular cysts and corpus luteum cysts. Ideally, a small sac in the ovary, called a follicle, releases an egg each month as part of the menstrual cycle. A follicular cyst occurs when the follicle doesn’t release an egg and instead fills up with fluid and grows bigger.
After the follicle releases an egg in a regular cycle process, it forms a hormone-producing group of cells called the corpus luteum. However, a cyst can form when fluid collects in the corpus luteum, causing it to grow.
- Pathological ovarian cysts
These types are much less common and form due to abnormal cell growth. These ovarian cysts aren’t formed as part of a typical menstrual cycle or ovulation. There are three forms: Dermoid cysts, Endometriomas and Cystadenomas.
Dermoid cysts are sac-like growths on the ovaries which can contain hair, fat, and other tissue. Endometriomas are a form of ovarian cysts that develops when tissues that usually grow inside the uterus develop outside the uterus and attach to the ovaries. These are also called chocolate cysts and may affect people with severe endometriosis.
Cystadenomas, on the other hand, are growths that develop on the outer surface of the ovaries and may be filled with a watery liquid or a mucous material. Cystadenomas often attach themselves to the ovary by a stalk and can grow immensely. Most of these types are benign, therefore, not cancerous, but they would still need to be surgically removed.
Both dermoid cysts and cystadenomas can grow exceptionally large and cause ovarian torsion. Torsion is a painful twisting of the ovary caused by the growth blocking the blood supply.
NOTE: Conditions like the Polycystic Ovary Syndrome (PCOS), in which the ovaries form many small cysts, can also cause the ovaries to enlarge. If left untreated, polycystic ovaries can result in infertility.
How are ovarian cysts diagnosed and treated?
An ovarian cyst can be detected during a routine pelvic exam or when you present with symptoms that suggest an ovarian cyst. This will lead to an ultrasound to confirm the presence of a cyst.
An ultrasound imaging test uses high-frequency sound waves to produce an image of your internal organs. They help determine a cyst’s size, location, shape, and composition (solid or fluid-filled).
A Computerized Tomography (CT) scan, which uses a body imaging device to create cross-sectional images of internal organs or a Magnetic Resonance Imaging (MRI), which uses magnetic fields to produce in-depth images of internal organs, can be used to diagnose ovarian cysts.
Your doctor may not immediately recommend a treatment plan because most cysts disappear independently after a few weeks or months. So, the first call of action is close monitoring and repeated scans or tests within the first few weeks or months.
Treatment will be considered if follow-up tests show no improvements or the cyst continues to increase. Whether an ovarian cyst needs to be treated will depend on its size and appearance, your symptoms, or if you have been through menopause. This is because if you are postmenopausal, the risk of ovarian cancer is slightly higher.
If there are concerns the cyst could be cancerous, the doctor will request some blood tests to look for high levels of chemicals that can indicate ovarian cancer.
The last option for treating ovarian cysts is surgery if they’re large or put the patient at risk of ovarian cancer.
Ovarian cyst in pregnancy
According to Penn Medicine, Ovarian cysts are common during early pregnancy and are usually harmless, just like most ovarian cysts. According to an article by Baby Centre, the most common type of ovarian cyst during pregnancy is a corpus luteum cyst, where rather than shrinking, the follicle that released the egg fills with fluid and remains on the ovary.
These cysts usually go away by the middle of the second trimester. However, it calls for attention if it continues to grow throughout the pregnancy because of the risk of rupture, torsion or problems during childbirth (if it’s a large mass obstructing the abdomen or pelvis).
This is why Penn Medicine recommends that women stay under the care of an obstetrician/gynaecologist during their pregnancy and throughout their life.
A 2015 study on the management of ovarian cysts and cancer in pregnancy reveals that the most common pregnancy-associated ovarian masses are functional cysts like the corpus luteum of pregnancy and theca-lutein cysts. Most of these cysts are believed to resolve after the first 14-16 weeks of gestation, but some, like the theca lutein cysts, can persist until after delivery.
If and when necessary, an ovarian cyst can be safely removed during pregnancy. If you need surgery, you may be able to have minimally invasive laparoscopic surgery through tiny incisions, but in some cases, regular abdominal surgery is necessary.
Conclusion
Ovarian cyst is a condition every woman with an ovary is at risk of developing but regular pelvic exams can help reduce your chances of experiencing problems with a cyst.
