Ovarian cysts are collections of fluid and/or tissue within the ovary. The presence of ovarian cysts is very common, usually in women of childbearing age, although they can also be seen after menopause.
There are different classifications, although it is common to separate them into two groups depending on what causes them: cysts with a functional cause and cysts with an organic cause.
The most common are functional cysts, which are formed by alterations in the ovulation process. They are absolutely benign, they are very frequent and they disappear on their own. We can distinguish:
- Follicular cyst: One of the functions of the ovary is to generate a small cyst called a follicle, which contains the egg. At the time of ovulation, the follicle ruptures to expel the egg. If the egg is not released, the follicle continues to grow and forms a follicular cyst. This cyst will reabsorb spontaneously in subsequent cycles.
- Luteal cyst: The rupture of the follicle at the time of ovulation can cause a small bleeding inside the follicle. Usually this small bruise will be reabsorbed in the following weeks.
The other type are organic cysts, which originate from an abnormal growth of some ovarian tissue; They usually don't go away on their own. According to their content, they are classified as:
- Serous cystadenoma: contains a clear fluid.
- Mucinous cystadenoma: contains a thick, mucous fluid.
- Teratoma or dermoid cyst: contains fat, hair, teeth, bone, etc.
- Endometrioma: contains a dark dense liquid, similar to chocolate, which is why they are called "chocolate cysts".
- Borderline ovarian cysts or ovarian cancer: its content is heterogeneous, solid and liquid.
The diagnosis of ovarian cysts is made by gynecological ultrasound, although sometimes it may be necessary to perform an MRI or a CT scan to differentiate the type of cyst. Blood tests to study specific markers can also help in the diagnosis.
In general, it is not necessary to carry out a specific treatment, since the majority produce mild symptoms and disappear on their own after six or seven weeks. Surgery may be necessary if they persist or if the cysts become complicated by causing bleeding or torsion of the ovary. In that case, the cyst or the entire ovary can be removed.
Birth control pills can help prevent the formation of functional cysts by preventing the growth of follicles.
- Knudsen UB, Tabor A, Mosgaard B, Andersen ES, Kjer JJ, Hahn-Pedersen S, Toftager-Larsen K, Mogensen O. Management of ovarian cysts. Acta Obstet Gynecol Scand. 2004 Nov;83(11):1012-21. doi:10.1111/j.0001-6349.2004.00607.x. PMID: 15488114.
- Doret M, Raudrant D. Functional ovarian cysts and the need to remove them. Eur J Obstet Gynecol Reprod Biol. 2001 Dec 10;100(1):1-4. doi: 10.1016/s0301-2115(01)00443-2. PMID: 11728647.
- Nowak-Psiorz I, Ciećwież SM, Brodowska A, Starczewski A. Treatment of ovarian endometrial cysts in the context of recurrence and fertility. Adv Clin Exp Med. 2019 Mar;28(3):407-413. doi: 10.17219/acem/90767. PMID: 30659784.
