Ovarian cysts are categorized as benign or malignant and today, I am going to discuss benign ovarian cysts because they are so much more common than malignant ovarian cysts. Benign ovarian cysts are either physiologic – meaning that they are normal – or pathologic – meaning that they are abnormal.
The Most Common Benign Ovarian Cysts
The most common physiologic ovarian cysts are follicular cysts and luteal cysts. These cysts occur every month if a woman is still ovulating. The follicular cyst is a fluid-filled collection on the ovary that contains the maturing egg. This cyst usually develops slowly over a two-week interval and it produces estrogen primarily. When it reaches about an inch in diameter it ruptures, releases the egg and then shifts to producing primarily progesterone. This cyst is then known as a luteal cyst. The luteal cyst typically resolves in about 2 weeks if no pregnancy occurs and this is when the progesterone levels decline, causing the menstrual cycle to occur.
There are rarely any symptoms from these cysts unless there is significant bleeding when the follicular cyst ruptures to release the egg. If this occurs, there is usually a rapid onset of severe pain which may be accompanied by nausea, vomiting, and lightheadedness. In rare cases, the bleeding may not stop which can result in an emergent surgery to stop the bleeding.
Post Menopausal Ovarian Cysts
Postmenopausal ovarian cysts are much less common and are often physiologic cysts that represent small fluid collections within the ovary. They are rarely symptomatic and they are typically monitored with intermittent ultrasounds to make sure they are not growing which could indicate that they may not be benign physiologic cysts.
Pathologic Ovarian Cysts
Pathologic cysts of the ovary result from growth and development of various types of cellular tissues within the ovary and these include dermoids, serous cystadenomas, mucinous cystadenomas, endometriomas and Brenner’s tumors. When these cysts enlarge significantly they may create a variety of symptoms including pelvic pain, bloating, frequent urination, pain during intercourse nausea and vomiting. They are usually diagnosed with ultrasound and can sometimes be felt during the pelvic exam. These cysts do not resolve on their own and require surgery for removal. Fortunately, the cysts can typically be excised with minimally invasive surgical techniques so that patients recover quickly.
If you have any questions about ovarian cysts please discuss this with me or our group of medical professionals.