Ovarian cysts: When should you worry?

April 5, 2018 Swedish Blogger

woman holding stomach_350

  • Most ovarian cysts disappear naturally
  • In a small minority of cases, cysts can be cancerous. Here are the signs to watch for.

It can be frightening to hear the phrase “ovarian cyst,” but start with this knowledge: ovarian cysts are a naturally recurring part of the ovulation cycle and most of the time, they resolve themselves without intervention.

But in a small minority of cases, ovarian cysts signal the presence of cancer. That’s why many of the women who visit Swedish gynecologist Dr. Eleanor Friele are worried.

“We have to deal with that up front,” says Dr. Friele. Patients who come to her often have seen a worrying ultrasound and experienced some pain. “Many times they are terrified of dying of cancer. The good news, though, is that the majority of ovarian cysts “have nothing to do with cancer,” she says. “They are benign.” 

Where cysts come from and where they go

During a woman’s monthly cycle of ovulation, the ovaries form cysts which contain the eggs. These resolve with the monthly ovulation, in which the egg is released and the cyst fluid is also released and the cyst then resolves.  This is a very small amount of fluid that is absorbed by the body.  These cysts may be up to 4 cm, or 1.5 inches in size.

Occasionally, these cysts remain and grow up to two to three inches. But these too usually resolve naturally within a month or two

When a health care provider examines these benign cysts via ultrasound, they tend to be clear, with no particles, no dividing walls and no nodules. It’s only when the cysts look different, grow larger and don’t resolve naturally that they should be examined via surgery, says Dr. Friele, who practices minimally invasive procedures that don’t require an incision. 

In some cases, even when they are benign, the cysts should be surgically removed.  

The possibility of cancer

While most ovarian cysts are benign, women and their caregivers should be vigilant about them, responding to feelings of pain and other signals that may mark the presence of something abnormal. In addition to pain, symptoms of ovarian cancer may include bloating, feeling full, vaginal bleeding or a change in bathroom habits, such as a more frequent urge to go.

“The biggest thing we need to rule out is whether it’s cancer or not,” says Dr. Friele.

Ovarian cancer can grow undetected, with no obvious symptoms. And among women, ovarian cancer is the fifth leading cause of cancer deaths. That’s why it’s so important to keep watch on cysts.

When a health care provider finds a cancerous cyst, she or he often can remove it with minimally invasive surgery. Sometimes the cysts are removed along with the ovaries and the Fallopian tubes. The choices may depend on a woman’s age and desire to give birth later.

Risk factors for developing ovarian cancer, according to the U.S. Centers for Disease Control and Prevention, include:
• Being middle-aged and older
• A history of ovarian cancer among close family members
• Having had breast, uterine, or colorectal cancer
• Having an Eastern European (Ashkenazi) Jewish background
• Having never given birth or having had trouble getting pregnant
• Having endometriosis, a condition in which uterine tissue grows elsewhere in the body

The key thing for a woman facing surgery, is to see a provider who’s experienced in minimally invasive techniques. The vast majority of cysts can be treated without making an incision, says Dr. Friele.

Talk to your provider about your symptoms and risk factors. You can search our online directory to find a Swedish provider near you.

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.

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