Physiologic ovarian cysts

Alternative names
Ovarian cysts; Functional ovarian cysts

Definition
Ovarian cysts are sacs filled with fluid or a semisolid material that develops on or within the ovary.

Causes, incidence, and risk factors

Typically, ovarian cysts are functional (not disease related) and disappear on their own. During the days preceding ovulation, a follicle grows. At the time of expected ovulation, the follicle fails to rupture and release an egg.

Instead of being reabsorbed, the fluid within the follicle persists and forms a cyst. Functional cysts usually disappear within 60 days without treatment and are relatively common. They occur most often during childbearing years (puberty to menopause), but may occur at any time. No known risk factors have been identified.

Functional ovarian cysts are not to be confused with other disease conditions involving ovarian cysts, specifically benign cysts of different types that must be treated to resolve, true ovarian tumors (including ovarian cancer), or hormonal conditions such as polycystic ovarian disease.

Symptoms

     
  • pelvic pain - constant, dull aching  
  • pain with intercourse or pelvic pain during movement  
  • pelvic pain shortly after beginning or ending a menstrual period  
  • abnormal uterine bleeding (change from normal menstrual pattern)       o lengthened menstrual cycle       o shortened menstrual cycle       o menstruation, absent       o irregular menstruation  
  • abdominal bloating or distention

Note: Often no symptoms are noted.

Signs and tests

     
  • A pelvic examination may reveal an ovarian enlargement or a mass/cyst.  
  • A serum HCG (pregnancy test) may be done to rule out pregnancy.  
  • An ultrasound or CT scan may be ordered to detect the cyst(s).

Blood tests may be ordered:

     

  • Ca-125 - an ovarian cancer marker that may help to identify cancerous cysts in older women.
         

  • Hormone levels (such as LH, FSH, estradiol, and testosterone) may be checked to evaluate for associated hormonal conditions.

    Treatment

    Functional ovarian cysts typically disappear within 60 days without any treatment. Oral contraceptive pills may be prescribed to help establish normal cycles and decrease the development of functional ovarian cysts.

    Ovarian cysts that do not appear to be functional may require surgical removal by laparoscopy or exploratory laparotomy. Surgical removal is often necessary if a cyst is revealed that is larger than 6 centimeters or that persists for longer than 6 weeks.

    Other medical treatment may be recommended if other disorders are found to be the cause of ovarian cysts, such as polycystic ovary disease.

    Expectations (prognosis)

    Functional ovarian cysts usually disappear without any residual problems.

    Complications

    Any ovarian cyst that enlarges or persists longer than 60 days is probably not a functional cyst. A laparoscopy or exploratory laparotomy may be done to rule out other conditions.

    Calling your health care provider

    Call for an appointment with your health care provider if you have symptoms of an ovarian cyst (to rule out other possible causes of the symptoms).

    Call for an appointment with your health care provider if an ovarian cyst persists longer than 60 days.

    Prevention

    If a woman is not seeking pregnancy and develops functional cysts frequently, they can be prevented by taking oral contraceptives, Depo-Provera, or Norplant, all of which prevent follicle formation.

    Johns Hopkins patient information

    Last revised: December 3, 2012
    by Gevorg A. Poghosian, Ph.D.

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