If you’ve felt intermittent pain in your abdomen or experienced bloating and swelling in that area, any amount of Googling will make you wonder: Do I have an ovarian cyst?
It’s possible – ovarian cysts are common in women who have a regular menstrual cycle. Ovarian cysts are fluid-filled sacs that form on or in the ovary and, most times, don’t create complications or discomfort. According to WomensHealth.gov, “most women make at least one follicle (cyst) or corpus luteum cyst every month.” These are the most common forms.
“If they’re not on any type of hormonal contraceptive, women are going to make a follicle sac every month,” said Dr. Alyse Kelly-Jones, the founding provider of Novant Health Women’s Sexual Health & Wellness in Charlotte. “That happens when we ovulate. Our egg forms in a sac, that sac breaks open, the egg pops out. And then you can have a cyst remaining there. That is a normal function of the ovary.”
A follicular cyst results when the egg doesn’t pop out of its follicle sac. Corpus luteum cysts arise if the egg does pop out of its sac, but the sac fills with fluid. Both types can go away in weeks.
Ovarian cysts tend to be small without triggering symptoms. But if you are experiencing symptoms, here’s what to know:
Most ovarian cysts are benign
“Having an ovarian cyst doesn’t mean you have a disease, necessarily,” Kelly-Jones said. “You probably have a normally functioning ovary.”
So, when should you see your doctor?
You should feel comfortable contacting your doctor any time to discuss your symptoms, but especially if your symptoms don’t go away, or if you experience severe pain – that may indicate a rupture.
“Typically a cyst rupture has a sudden onset,” said Kelly-Jones, adding that a rupture usually requires pain management, not surgery. “Women have said it’s woken them up at night, for example. You can have associated symptoms like getting cold and clammy, the feeling of needing a bowel movement or doubling-over pain. That can go away fairly quickly within a few hours, but if it’s getting worse, then it’s time to potentially see someone.”
Rupture or not, an ultrasound is a likely next step for diagnostics
“A vaginal ultrasound is a really good diagnostic tool with the ovaries,” Kelly-Jones said. “It gives us the best resolution when looking at the ovaries and making sure they look fine and the blood flow to them is fine.”
Pain meds are one option for recurring cysts and ruptures
“If I have somebody who has these in a recurrent nature, I’m generally saying, OK, look out for these signs and symptoms,” Kelly-Jones said. “Take something anti-inflammatory, like 800 milligrams of Ibuprofen or a couple of Aleve. I’ve never had anybody have more than one a year. Although, once they know what it is, after they’ve had the first rupture episode, they know how to manage it.”
Certain types of cysts may require treatment
“A dermoid cyst is a benign but pathological cyst, which means that there’s something going wrong that needs to be treated,” Kelly-Jones said.
Benign endometriomas need to be treated as well – they’re spinoffs of a separate issue called endometriosis, when the uterine lining is growing outside the uterus.
“Then there are some cysts that are more concerning, that are precancerous or cancerous,” Kelly-Jones said. “They all look different on ultrasounds.”
Ovarian torsion is one (uncommon) condition that could require surgery
“Think about the cyst being on the end of the ovary, and it twists,” Kelly-Jones said. “The blood supply to the ovary is cut off, which causes pain. Those patients need surgery to untwist the ovary.”
Ovarian cysts alone won’t cause infertility.
“If it’s an ovarian cyst that’s an endometrioma, that patient has endometriosis, which is a condition that puts her at risk for infertility,” Kelly-Jones said. “Then there’s polycystic ovarian syndrome, the No. 1 endocrine problem in women that’s hallmarked by many little cysts on the ovaries, like preovulatory cysts. But if she’s experiencing a normal, rupturing ovarian cyst like a cyst of ovulation, that’s not going to put her at risk for infertility.”
Oral contraceptives can actually help prevent ovarian cysts.
“Birth control pills prevent ovulation a majority of the time, so they can help prevent cysts,” Kelly-Jones said. “If you prevent ovulation, you prevent cyst formation. That’s sometimes what we do if women have painful ovulation or recurrent ovarian cysts – we put them on birth control pills to manage that.”
IUDs are not intended to help prevent ovarian cysts – nor do they directly cause them.
“We think the intrauterine device works by changing the cervical mucus, by making the uterus an unfriendly environment to the sperm. It doesn’t prevent ovulation, per se. It may initially prevent it because the hormone level is higher at first. But over time, that’s not going to happen. So the package labeling may say ‘can cause ovarian cysts,’ but it’s really not the case. Women are just able to make cysts when they have an IUD, because they’re ovulating.”
Overall, don’t be too quick to blame your female parts. Especially if pain medication doesn’t alleviate symptoms.
“We pathologize women’s pain from the belly down as always being related to her female organs,” Kelly-Jones said. “She has bowels, she has a bladder, she has muscles down there. We need to look for other causes of the pain, rather than: it’s an ovarian cyst. So if somebody has a recurrent issue, it’s time to dig deeper to see if there’s something else going on.”