What you should know about ovarian cysts

An ovarian cyst is definitely not pleasant – and we hope you never encounter one! We're here with all the information you need to help you understand what an ovarian cyst is and how it might impact your fertility and health.

What is an ovarian cyst? (And how do I know if I have one?)

An ovarian cyst is a fluid-filled sac that grows on your ovary. In speaking with a wide variety of Modern Fertility readers, we heard about painful cysts that were treated successfully, but you should know that cysts can also be painless and causes no symptoms; in this case, they usually heal themselves without any outside treatment. Sometimes, however, they can cause you quite a bit of discomfort and even throw a wrench in how your body functions.

Remember: we’re here to guide and offer advice, but not diagnose. It can be difficult to determine if you have a cyst on your own. That being said, severe abdominal pain, especially accompanied by fever, vomiting, or any indications of shock (such as cold, clammy skin, rapid breathing, and lightheadedness), could be symptoms of ovarian cysts.

Wait - so there's more than one kind of ovarian cyst?

There are actually quite a few different types. “Functional ovarian cysts” are the most common. You probably won’t even realize it if you’ve had one of these cysts. It’s a normal part of your cycle to grow what doctors call “cyst-like structures,” which are actually follicles generated during your menstruation cycle. These follicles produce your estrogen and progesterone hormones. They also release an egg during ovulation. It’s when the monthly follicle keeps growing (this is the “functional cyst" part) that an issue can develop.

There are two types of these functional cysts. The first is a follicular cyst. During a typical menstrual cycle, you’ll release an egg from a follicle, and that egg will venture down your fallopian tube. Problems arise if the follicle doesn’t release its egg, but instead holds onto it and it continues to grow. The second type of functional cyst is one known as a corpus luteum cyst. The corpus luteum is formed in your ovary, at the site of a follicle, once an egg has been released at the time of ovulation. The follicle seals itself off after the release of the egg and forms the corpus luteum, a temporary mass of cells that generates progesterone, the hormone that sustains a pregnancy. If there isn't a pregnancy, the corpus luteum stops secreting progesterone, decays (after about 10 days) and then becomes a mass of scar tissue. When the corpus luteum fills up with fluid, a cyst can form.

The good news is both of these functional cysts are usually harmless. They rarely cause pain and disappear on their own within two or three menstrual cycles, Cysts that aren’t functional may be a bit more painful - and a tad more complicated. These are cysts that don’t correlate with a menstrual cycle. Dermoid cysts, which are also called teratomas, can contain tissue, such as hair, skin, or teeth. They form from embryonic cells and are rarely cancerous. Cystadenomas cysts develop on the surface of an ovary. They are often filled with a watery or a mucous material.

Another type of cyst are endometriomas. These cysts are connected to endometriosis, a condition during which uterine endometrial cells grow outside your uterus. These tissues attach to your ovary and cause extreme discomfort. Endometriomas range in size from less than an inch to over 6 inches. (Yikes!)

Can ovarian cysts interfere with my fertility?

Dr. Iris Orbuch, an OB/GYN and endometriosis specialist, estimates that “40% of unexplained infertility is due to endometriosis,” which both “decreases a woman’s ovarian reserve [and] decreases fertility by either an anatomical distortion or via inflammation.”

Ovarian cysts resulting from polycystic ovary syndrome (PCOS) may also impact your fertility. PCOS is a condition marked by many small follicles on your ovaries. These follicles house eggs which should mature and get released by the follicles, but if you have PCOS, these eggs don't mature and therefore can't be ovulated. PCOS is associated with irregular ovulation, which may also contribute to problems with fertility for some.

Remember, not all ovarian cysts are linked to infertility. Functional cysts should not impact your fertility. Some cysts can result in complications – although these are infrequent. Cysts that grow to large sizes can actually cause the ovary to move. This movement increases the chance of something known as ovarian torsion, which is a very painful twisting of the ovary. Keep an eye out for an abrupt onset of severe pelvic pain, nausea, and vomiting. Ovarian torsion can also decrease or stop blood flow to the ovaries, which, besides being painful, can lead to future complications, like losing an ovary, so if you experience these symptoms, don't hesitate to get to a doctor ASAP. Another complication that can occur is if your cyst were to rupture. The larger the cyst, the greater the risk of rupture – which is accompanied by extreme pain.

There’s no way to prevent ovarian cysts, and most likely you will have at least one in your lifetime (and you might not even know it!). If you are diagnosed with a cyst, your doctor may recommend birth control pills to prevent new cysts from showing up. Birth control won't shrink an existing cyst, though, so if you have a large cyst, your doctor may want to remove it with surgery. If you have a cyst that's particularly solid, or you have a familial history of ovarian cancer, she may also order a ca-125 (ca stands for cancer antigen) blood test to check for ovarian cancer.

Having regular pelvic examinations (go to your yearly well woman visit!) can help diagnose cysts before they become a problem. If you’re worried about ovarian cysts, keep an eye on your menstrual schedule and track any changes in terms of length, flow, and pain. Be sure to talk to your doctor about changes that concern you.

As you learn more about cysts - and your fertility - we’re here to help! Modern Fertility's test can offer more important insight into your hormones and fertility.

Jordyn Rozensky

Jordyn Rozensky is a writer and photographer living in El Paso, Texas. Their work has been featured on a variety of publications including CNN and NPR. Follow their photography on Instagram @jordynrr.

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