What Causes Ovarian Cysts? Understanding the Mystery Within

Ovaries are complex organs, responsible for producing eggs and hormones that keep our bodies functioning smoothly. Sometimes, however, they present us with a challenge in the form of ovarian cysts. So, what causes ovarian cysts? 

These fluid-filled sacs can form on or inside the ovaries for various reasons, ranging from normal menstrual cycles to more complex health conditions. It’s important to note that cysts are different from tumors, as most cysts are benign (non-cancerous) and often resolve independently. Unlike tumors, which are solid tissue masses, cysts are typically fluid-filled and can come and go with your menstrual cycle.

Whether you’re dealing with a cyst or simply want to arm yourself with knowledge, you’ve come to the right place. We’re about to explore the world of ovarian cysts, uncovering their causes, symptoms, and everything in between.

What Causes Ovarian Cysts?

Let’s address the critical question: what causes an ovarian cyst? The answer isn’t always straightforward, but here are some of the common factors that cause ovarian cysts:

Your menstrual cycle: Many ovarian cysts are actually a normal part of your monthly cycle. Several follicles start growing in your ovary during your menstrual cycle’s follicular phase. A surge in FSH (Follicle Stimulating Hormone) helps these follicles develop until one becomes dominant. 

This dominant follicle produces estrogen, which triggers another hormone (LH) to cause ovulation. The remaining follicles typically rupture and transform into corpus luteum, which produces progesterone. 

Functional cysts can form in two ways: either when follicles don’t rupture during ovulation (possibly due to insufficient FSH or LH), or when the corpus luteum doesn’t dissolve properly. These cysts can sometimes fill with blood (become hemorrhagic).

Hormonal imbalances: Conditions like polycystic ovary syndrome (PCOS) can cause multiple small cysts to form on your ovaries. Very high levels of pregnancy hormone (hCG) can cause specific types of cysts called theca lutein cysts.

Cell growth: Sometimes cysts can form from ovarian tissue overgrowth (neoplastic cysts), similar to how tumors develop.

Endometriosis: This condition, where uterine tissue grows outside the uterus, can lead to cysts called endometriomas. They’re often filled with old blood and are sometimes referred to as “chocolate cysts.” (Learn more about the key differences between endometriosis and ovarian cancer.)

Pregnancy: The corpus luteum often forms cysts during pregnancy, which is normal. Very high pregnancy hormone levels can also lead to cyst formation.

Pelvic infections: Severe infections can spread to the ovaries and cause cysts to form.

While cysts can affect women of all ages, younger women are more likely to develop functional cysts due to their regular menstrual cycles. However, conditions like PCOS can also be a common cause in this age group.

Types of Ovarian Cysts

There are several types of ovarian cysts. Here’s an overview of the most common ones:

• Follicular cysts: These form when the follicle doesn’t release its egg and continues to grow. This is the kind of cyst that is often associated with PCOS.
• Corpus luteum cysts: After the egg is released, the empty follicle can seal itself off and fill with fluid.
• Dermoid cysts: These unusual cysts can contain tissue like hair, skin, or even teeth.
• Cystadenomas: These cysts develop from ovarian tissue and can be filled with a watery or mucous-like substance.
• Endometriomas: As mentioned earlier, these are associated with endometriosis and filled with old blood.

What are the First Symptoms of an Ovarian Cyst?

Do ovarian cysts cause pain? Sometimes, but not always. Many women with ovarian cysts don’t experience any symptoms. When pain does occur, it can vary significantly in nature, ranging from sharp to dull, and may either come and go or remain constant.

Common symptoms may include:

• Pelvic pain or pressure, especially on one side
• A feeling of fullness or heaviness in your abdomen
• Bloating or swelling
• Changes in your menstrual cycle
• Pain during sex
• Frequent urination

It’s important to note that these symptoms can be similar to other conditions, including ovarian cancer. While it’s natural to be concerned, the best action is to promptly consult with your healthcare provider. A proper medical evaluation is essential to rule out any severe conditions and ensure you receive appropriate care. Don’t hesitate to contact your doctor about any unusual or persistent symptoms. Remember: early detection can make a significant difference in treatment outcomes.

Emergency warning signs: If you experience severe pain accompanied by nausea or vomiting, seek immediate medical attention. This combination of symptoms could indicate ovarian torsion, where the cyst has caused the ovary to twist. This is a medical emergency requiring immediate treatment.

When to See a Doctor

While most ovarian cysts are harmless and resolve on their own, there are times when you should seek medical attention:

• If you experience sudden, severe abdominal pain
• If you have pain accompanied by fever or vomiting
• If you feel faint, dizzy, or weak
• If you have rapid breathing

These could be signs of a ruptured cyst or ovarian torsion (when the ovary twists on itself), both of which require immediate medical attention. It can happen spontaneously, but physical activity, sex, or pregnancy can sometimes trigger a rupture.

Are Ovarian Cysts Serious?

In most cases, ovarian cysts are not serious and often resolve without intervention. However, there are situations where they can cause complications. Large cysts can lead to ovarian torsion, where the ovary twists and cuts off its own blood supply. This is a painful condition that requires immediate medical attention. Additionally, a ruptured cyst can cause severe pain and internal bleeding, which can be dangerous if left untreated.

While rare, some cysts can be cancerous, especially in postmenopausal women. This brings us to an important question: what causes ovarian cysts after menopause? Although less common, postmenopausal women can develop cysts due to hormone therapy or, in some cases, ovarian cancer. 

That’s why women in this age group must have any ovarian cysts carefully evaluated by a healthcare provider. Early detection and proper assessment are key to ensuring the best possible outcomes.

How is An Ovarian Cyst Diagnosed?

If your doctor suspects you have an ovarian cyst, they’ll conduct a comprehensive evaluation to confirm the diagnosis and rule out other conditions. For pre-menopausal women, the diagnostic workup is particularly thorough due to several important differential diagnoses that need to be considered.

The standard diagnostic process typically includes:

Physical examination: Your doctor will perform a pelvic exam to check for any abnormal swelling or tenderness in your lower abdomen.

Pregnancy test: This is crucial, especially for pre-menopausal women, as ectopic pregnancy is an important differential diagnosis that needs to be ruled out immediately.

Complete Blood Count (CBC): This helps assess if there’s any internal bleeding and provides important information about your overall health status.

Cervical swabs: These tests check for pelvic inflammatory disease (PID), which can present with similar symptoms.

Urinalysis: This helps rule out other conditions like kidney stones or urinary tract infections that might mimic cyst symptoms.

Transvaginal ultrasound: This is the primary imaging tool for diagnosing ovarian cysts. It can confirm the presence of a cyst, determine its size and location, and provide crucial information about its characteristics. Cysts typically appear as round or oval structures with a clear, dark center and thin walls, while tumors tend to have a more complex appearance with solid components.

Blood tests: These include:

• CA-125 to screen for potential ovarian cancer biomarkers
• Hormone level tests
• Other relevant blood work as needed

Additional imaging: In some cases, CT scans or MRIs might be used for a more detailed look. These advanced imaging techniques can provide additional information about the cyst’s composition and help differentiate between benign cysts and potentially cancerous tumors. MRIs, in particular, can offer detailed images of soft tissues, helping doctors identify features that might suggest a tumor rather than a simple cyst.

It’s important to note that while imaging can provide valuable information, a definitive diagnosis sometimes requires further evaluation or even surgical exploration in certain cases. Your doctor will interpret the results of these tests together to determine the nature of the growth and the best course of action for your specific situation.

Risk Factors and Complications

While any woman can develop ovarian cysts, several factors can significantly increase your risk. Age plays an important role, with most ovarian cysts occurring during reproductive years. Key risk factors include:

• Fertility treatments, which can affect hormone levels and ovarian function
• Pregnancy, with its associated hormonal changes
• Hypothyroidism, which can impact overall hormonal balance
• Use of tamoxifen, particularly in breast cancer treatment
• Cigarette smoking, which can affect hormone levels and overall reproductive health
• History of tubal ligation
• Hormonal conditions, such as polycystic ovary syndrome (PCOS)
• Endometriosis, which is associated with a specific type of ovarian cyst
• Previous history of ovarian cysts

While most cysts are harmless, complications can occur. Ovarian torsion is a serious condition where the cyst causes the ovary to twist, cutting off its blood supply. A ruptured cyst can lead to severe pain and internal bleeding.

Some conditions that cause cysts, like PCOS, can make it harder to get pregnant, potentially leading to fertility issues. Although rare, some cysts can be or become cancerous, especially in older women. These potential complications underscore the importance of regular check-ups and prompt medical attention if you experience any concerning symptoms.

Ovarian Cyst Management and Treatment

The approach to managing ovarian cysts is highly individualized and depends on several key factors: the size of the cyst, your menstruation status, age, and any indicators of potential malignancy. Current medical recommendations provide clear guidelines for treatment approaches.

For cysts less than 10 centimeters in size, which are generally considered benign regardless of age, the primary approach is watchful waiting. These cysts often resolve on their own without intervention. Your healthcare provider will monitor the cyst through regular check-ups to ensure it doesn’t grow or cause complications.

Specific types of cysts require different management strategies. Endometriomas and dermoid cysts typically need ongoing monitoring through ultrasound until surgical removal becomes necessary. Birth control pills might be recommended in some cases to prevent new cyst formation, particularly for recurring functional cysts.

Surgical intervention becomes necessary under several circumstances:

• Severe or persistent pain
• Suspected ovarian torsion
• Cysts that persist or grow larger over time
• Any features suggesting potential malignancy

Your healthcare provider will work with you to develop an appropriate treatment plan based on these factors, and regular monitoring will help ensure the best possible outcomes. Over-the-counter pain medications can help manage any discomfort during the monitoring period.

Can You Prevent Ovarian Cysts from Happening?

While there is no surefire way to prevent ovarian cysts, there are some tips you can follow to reduce your risk. 

Hormonal birth control can be a powerful ally, putting the brakes on ovulation and making functional cysts less likely. Keeping your weight in check is another smart move, since higher body weights make cyst formation more likely.

Regular check-ups are key. Finally, get to know your body’s rhythms. Being tuned in to your menstrual cycle can help you spot when something’s off. After all, you’re the expert on you!

Lifestyle Adjustments That Can Help

Some lifestyle changes might help manage symptoms and reduce your risk:

• Diet considerations: Some women find that reducing inflammatory foods and increasing anti-inflammatory ones can help with cyst-related discomfort.
• Regular exercise: Physical activity can help regulate hormones and reduce inflammation. Just be mindful of high-impact activities if you’re experiencing pain.
• Stress management: Chronic stress can affect your hormones, potentially exacerbating cyst-related issues. Try incorporating stress-reduction techniques like meditation, yoga, or deep breathing exercises into your routine.
• Smoking cessation: If you smoke, quitting is important as smoking has been linked to increased inflammation and hormonal imbalances that may affect ovarian cyst development and healing.
• Prioritize sleep: Getting enough quality sleep is crucial for hormone balance. Aim for 7 to 9 hours of sleep per night.
• Alternative therapies: While scientific evidence is limited, some women find relief from cyst symptoms through alternative therapies like acupuncture, herbal remedies, or massage. Always consult with your healthcare provider before trying any new treatments, especially if you’re taking medications or have other health conditions.

Understanding what causes ovarian cysts, recognizing the symptoms, and knowing when to seek help can make all the difference. Remember, your body is unique, and what’s normal for someone else might not be normal for you. Trust your instincts, listen to your body, and don’t hesitate to reach out to a healthcare provider if something feels off.