General Practice 2022

Ovário cyst: what é, symptoms, causes, types and treatment

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Ovário cyst: what é, symptoms, causes, types and treatment
Ovário cyst: what é, symptoms, causes, types and treatment

Ovarian cyst is a fluid-filled sac that forms in or around the ovary, which can cause symptoms such as pain in the pelvic region, irregular menstruation, or bleeding outside the menstrual period.

Having an ovarian cyst, most of the time, is not serious because it is a common situation that happens in many women between 15 and 35 years of age, and can appear several times throughout life, as in case of follicular cyst or corpus luteum cyst, for example.

Usually, the ovarian cyst, also known as ovarian cyst, is benign and disappears after a few months without needing treatment, and it is important to follow up with the gynecologist regularly to check if the cyst has diminished.However, when the cyst is large or ruptures, treatment with surgery is necessary.

Ovarian cyst symptoms

Ovarian cyst symptoms are:

  • Ovarian pain during ovulation period;
  • Pelvic pain before or during menstruation;
  • Irregular menstruation;
  • Heavy menstrual flow;
  • Bleeding outside of menstrual period;
  • Feeling of a swollen or painful belly;
  • Painful bowel movements;
  • Pain or discomfort during intimate contact;
  • Nausea and vomiting.

In the presence of these symptoms, a gynecologist should be consulted for the diagnosis of the ovarian cyst and the most appropriate treatment to be initiated.

In addition, it is important to seek medical help immediately or the nearest emergency department if symptoms such as fever, vomiting, fainting, bleeding or increased respiratory rate appear, as they may indicate that the cyst has ruptured, twisted or is blocking blood flow to the ovary.

How to confirm the diagnosis

Ovarian cyst diagnosis is made by the gynecologist by evaluating the symptoms and performing a pelvic exam. If the doctor suspects an ovarian cyst, some tests may be ordered, such as pelvic or transvaginal ultrasound, CT scan or MRI.

In addition, the doctor should order a beta-HCG test, to rule out the possibility of pregnancy, in addition to blood tests such as complete blood count, hormone levels of estrogen and progesterone, and CA-125 levels, for rule out ovarian cancer.

Another exam that the gynecologist may request is laparoscopy, which allows visualizing the ovaries and all structures present in the abdominal and pelvic region, and if necessary, removing the ovary or cyst, or performing a biopsy. Learn how laparoscopy is performed.

Possible causes

The causes of ovarian cyst are most often related to hormonal changes, and some factors can increase the risk of its development, such as:

  • Hormonal problems;
  • Pregnancy;
  • Endometriosis;
  • Pelvic infection.

Furthermore, women with a history of ovarian cyst are at greater risk of developing a new cyst.

Types of ovarian cysts

The types of ovarian cyst vary according to their origin, the main ones being:

1. Follicular cyst

Follicular cyst is a small fluid-filled sac located on the surface or inside the ovary that can arise when follicles do not rupture during ovulation to release the egg, being the most common type of ovarian cyst in women of childbearing age.

This type of cyst is benign, its size can vary from 2.5 cm to 10 cm, and normally disappears on its own within 4 to 8 weeks, requiring no treatment. However, very large follicular cysts may rupture and require surgical treatment.Learn more about the follicular cyst.

2. Corpus luteum cyst

The corpus luteum cyst can appear after the egg is released, and its size can vary between 3 and 4 cm. The corpus luteum is a structure responsible for favoring fertilization and implantation of the fertilized embryo in the uterus, resulting in pregnancy. When fertilization does not occur and the corpus luteum does not dissolve, a cyst can result. Understand better what the corpus luteum is for.

The corpus luteum cyst is a benign cyst and usually does not require treatment. However, it can break during intimate contact, causing severe pain, a drop in blood pressure, and an accelerated heartbeat, which may need to be removed by laparoscopy surgery.

3. Theca-lutein cyst

Theca-lutein cyst is a rarer type of benign cyst, which usually arises from overstimulation of the ovaries due to high levels of beta-HCG.

This type of cyst is more common in women who are pregnant with twins, usually disappearing on their own after delivery, but they can also be associated with molar pregnancy, also called gestational trophoblastic disease, or ovarian hyperstimulation. Understand what gestational trophoblastic disease is and how to treat it.

4. Hemorrhagic cyst

The hemorrhagic cyst happens when there is bleeding from the cyst wall to its interior, and can be of several types, such as follicular cyst, corpus luteum or endometrioma, for example.

This type of cyst usually disappears on its own, however, in cases where the cyst is larger than 5 cm, or ruptures, surgical treatment may be necessary. See other hemorrhagic cyst treatment options.

5. Dermoid Cyst

The dermoid cyst, also called mature cystic teratoma, can be found in children and can be composed of hair, tooth or bone fragment.

This type of cyst is benign, but requires treatment, as there is a risk of about 1 to 2% of cases, of the cyst becoming malignant.

6. Ovarian fibroma

Ovarian fibroma is a rare benign tumor, but it is one of the most common types in menopause, and its size can vary from microcysts to weighing up to 23 kg, and must be removed by surgery.

7. Ovarian endometrioma

Ovarian endometrioma, also called chocolate cyst, can arise in cases of endometriosis in the ovaries, which can cause a pouch filled with blood to appear, requiring treatment with medication or surgery.

This type of cyst is more common during the childbearing years, before menopause.

8. Cystoadenoma

Cystoadenoma is a benign ovarian tumor that develops on the surface of the ovary, usually filled with an aqueous or serous fluid, and must be removed by laparoscopy.

Is ovarian cyst dangerous?

Having an ovarian cyst is not always dangerous, and is usually not cancer, it is just a benign lesion that can disappear on its own or be removed through surgery, when it is very large and there is a risk of rupture or causes pain and discomfort. Ovarian cancer is more common in women over 50, being very rare under 30.

However, some features of cysts can be dangerous and indicate cancer, such as large size, thick septum or solid tumor, for example, being more common in women over 50, and very rare under 30 See how to identify ovarian cancer.

In case of suspicion of ovarian cancer, the doctor should order the CA 125 blood test, because this high value may indicate a cancerous lesion, however women with ovarian endometrioma may have an elevated CA 125, and not be cancer. Understand what the CA 125 exam is for.

How the treatment is done

Ovarian cyst treatment is not always necessary, depending on its type. In most cases, the gynecologist may just recommend regular follow-up to make sure the cyst shrinks over time. However, in some cases, the doctor may indicate the use of contraceptives to regulate hormone levels, which may favor the reduction or disappearance of the cyst.

In cases where the cyst is very large and causes symptoms, surgery to remove the cyst or ovary may be indicated when there are signs indicative of cancer or ovarian torsion. See more details on ovarian cyst treatment.

Also, one way to relieve discomfort is to use a warm water compress on the painful area. Check out other ways to relieve ovarian cyst pain and discomfort by watching the video below:

Is it possible to get pregnant with an ovarian cyst?

Ovarian cyst does not cause infertility, but a woman may have difficulty getting pregnant due to hormonal changes that led to the cyst's appearance. However, with proper treatment, the ovarian cyst tends to decrease or disappear, causing the woman to return to her normal hormonal rhythm, facilitating fertilization.

When a woman with an ovarian cyst manages to get pregnant, she should make regular appointments with the obstetrician because there is a greater risk of complications, such as ectopic pregnancy, for example.

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