Ovarian Cysts are sacs of fluid or semi solid material developed in or on the surface of an ovary. They generally appear and disappear during the menstrual periods and are not a major concern. However, they may become a medical problem if they remain in the ovaries and increase in size, causing pain and other symptoms.
Ovarian Cysts Description:
The most common types of ovarian cysts, called functional cysts, that have relation to menstrual cycle are:
- follicular luteum cysts
- corpus luteum cysts or luteal cysts
Other types of cysts not related to ovulation are:
- Dermoid cysts
- Neoplastic cysts
- Abnormal cysts
Follicular luteum cysts:
Ovary consists of tiny tube-like membranes called follicles. The function of follicles is to store immature eggs. During each menstrual cycle, an egg matures inside a follicle. To nourish the matured egg, a fluid called liquor folliculi fills the follicle sac. The swollen follicle sac is known as the follicular cyst. During ovulation, when the egg is released into the fallopian tube, the follicle sac breaks and drains the fluid.
Due to menstrual cycle problems, the fluid may not drain completely after the release of egg, thus increasing the size of follicle. These cysts are small and harmless, although painful, and may disappear after two or three menstrual cycles. They generally occur in menstruating women and are absent in women who reached menopause or have stopped ovulating.
Corpus luteum cysts
Another type of cyst forms, after ovulation, on the ovary where the egg was released. This type of cyst is known as the corpus luteum, a small yellow body that produces the hormone progesterone, which plays an important role during pregnancy. If pregnancy does not happen, then the cyst will dissolve and disappear as part of menstrual cycle.
However, in some cases, the cysts may not disappear and continue to grow. The cysts may grow to a diameter of 4 in (10cm) and sometimes even twist the ovary, causing pain in the abdomen.
Corpus luteum cysts occur during the early stage of pregnancy and occasionally occur during menstruation years. Quite often, these cysts are wrongly diagnosed as tubal (ectopic) pregnancies, especially if they are accompanied with pain and bleeding.
Dermoid cyst, contains hair, skin or teeth derived from the outer layer of cells of an embryo. These cysts, found occasionally in ovaries, are unrelated to menstruation cycle.
Neoplastic cysts develop when the cells of an ovary grow abnormally. However, they are benign
Abnormal cysts contain blood and fluid and may occur in the ovaries or under the ovaries. They may also contain cellular debris.
Polycystic ovary syndrome:
In some cases, eggs and follicles are not released from ovaries resulting in formation of multiple cysts. This condition is known as polycystic ovary syndrome (PCOS). The characteristic features of polycystic ovary syndrome are hirsutism (excessive growth of hair on body and face), infertility and irregular menstrual cycle.
Even though, most of the ovarian cysts are harmless and are quite common, they should be checked if present, because they have the same symptoms of ovarian tumors, which are malignant and cancerous. Ovarian cysts may occur at any stage of women’s life, from infancy to puberty to menopause or even during pregnancy.
Causes of Ovarian Cysts:
Ovarian cysts are formed due to various reasons such as stress, anxiety, suppressed anger or guilt, and unexpressed creativity. However, the causes of non-functional cysts are yet to be explored.
Unusual buildup of fluids around the maturing egg in the follicle sac causes the formation of follicular cysts. Excessive accumulation of blood during menstrual cycle and ovarian tumors may cause the formation of corpus luteum cysts.
Research revealed that the occurrence of ovarian cyst has relation to a genetic disorder known as McCune-Albright syndrome. Mutation of GNAS1 gene causes this syndrome. The characteristic features of McCune-Albright syndrome are skin discoloration, abnormal bone development, and premature puberty. Nevertheless, this syndrome is sporadic and not inherited.
Causes of Polycystic ovary syndrome:
The causes of polycystic ovary syndrome are:
- Obesity – almost 50% of PCOS patients are found to be obese.
- Hormonal imbalance – high levels of androgen and low levels of progesterone.
- High blood insulin levels – PCOS patients are ten times more prone to type-2 diabetes.
- Genetic factors
Symptoms of Ovarian cysts:
Most of the Ovarian cysts are asymptomatic, i.e., they do not show any symptoms. However, multiple cysts and enlarge cysts may show symptoms such as:
- Urination problems
- Heaviness or Fullness in the abdomen
- Missed or late menstrual periods
- Pelvic pain just before or after periods and during intercourse
When cysts are ruptured, severe symptoms similar to the symptoms of appendicitis or infection or ectopic pregnancy may show up.
Diagnosis of Ovarian cysts:
Diagnosis of Ovarian cysts is usually done by pelvic exam and ultrasound tests to identify the size, type and location of cysts. Ovarian cysts of size 1.6in (4cm) are normal in ovulating women. Doctors may watch the cysts for a month or so to allow them to shrink or disappear on their own.
Ovarian cysts may be carefully examined to make sure that they are not cancerous tumors or fibroids. In the female fetus the diagnosis of ovarian cysts is carried out by transabdominal ultrasound test during mother’s pregnancy.
Treatment for Ovarian cysts:
Treatment of follicular and corpus luteum cysts involves a watchful period of one to one-and-half month, during which the cysts are allowed to shrink or disappear on their own. However, if the cysts are interfering in the daily activities, then birth control pills may be use. Cysts more than 4 inches (10cm) in size and complex cysts can be surgically removed through a procedure called laparoscopic cystectomy.
Treatment for McCune-Albright syndrome involves the use of testolactone (Teslac), an anti-estrogen drug, to correct the hormonal imbalances.
Treatment for polycystic ovary syndrome involves the hormonal therapy and use of hormone-regulating drugs such as ganirelix (Antagon). Surgery is recommended for more severe cases.
Diabetic type-2 drugs such as Metformin ( Glucophage) are used to treat the symptoms of hyperandrogenism and insulin resistivity in patients of PCOS. Flutamide (Eulexin), a drug used in treatment of prostate cancer in men, is also used to treat PCOS. If drug treatments do not induce any response, then a method called ovarian wedge is used to improve the ovulation.
Alternative Treatment for Ovarian cysts:
Conventional treatments are supplemented by alternative treatments such as:
- Herbal tonics that can be added to tea or herbal tincture. Herbal tonics include false unicorn root (Chamaelirium luteum) and blue cohosh (Caulophylum thalictroides)
- Vegetarian diet, including carrots, beetroot, lemons and dark-green leafy vegetables.
- Avoiding usage of animal and dairy products.
- Antioxidant supplements such as evening primrose oil (Oenothera biennis), borage oil, black currant oil, Zinc, Selenium and vitamin A, C and E.
- Castor oil and essential oil (made from lavender, chamomile and rosemary) compress packs.
- Hydrotherapy of the abdomen.
Diet and Nutrition for Ovarian Cysts:
The following diet and nutrition guidelines to prevent and treat the ovarian cysts shall be used.
- Usage of Omega-3 essential fatty acids such as fish oil (trout and salmon), evening primrose oil and flaxseed oil.
- Consumption of whole-wheat grain rich in Vitamin B.
- Reducing the consumption of sugar, honey and white flour products.
- Increasing the intake of foods rich in Vitamin A and carotenoids (tomatoes, green leafy vegetables, carrot).
- Stopping the consumption of alcohol and caffeine products.
- Increasing the intake of Iodine (seaweeds).
Prognosis for Ovarian Cysts:
Prognosis is excellent for non-cancerous ovarian cysts. Most women do not have any problem with cysts. Some have lived with large cysts throughout their life without any complications.
Prevention of Ovarian Cysts:
As of now the prevention of ovarian cysts is not possible.