Causes of ovarian cysts

Written by Hou Jie
Obstetrics and Gynecology
Updated on September 11, 2024
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The cause of ovarian cysts is unclear, with many factors that can lead to ovarian cysts. The most common type of physiological ovarian cyst is the follicular cyst. The most common pathological causes are chronic inflammation or abnormalities in hormone secretion and endocrine factors, but most causes are unclear. If an ovarian cyst is discovered, it is recommended to regularly check with a color Doppler ultrasound, which is a common gynecological test for tumor markers. If the results are abnormal, timely surgical treatment is recommended to more directly understand the nature of the ovarian cyst. If the cyst is smaller than five centimeters in diameter and has good internal sound transmission, it can be observed regularly; otherwise, aggressive surgical treatment is advised.

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malignant symptoms of ovarian cysts

Malignant ovarian cysts, commonly known as ovarian cancer, often present with no symptoms in most people. Patients generally do not exhibit any specific symptoms. In advanced stages, however, symptoms such as ascites and abdominal swelling or pain may occur due to the cyst pressing on other organs in the abdomen. Initially, these symptoms might be mistaken for gastrointestinal issues, hence the importance of undergoing a gynecological ultrasound examination. In early stages, ovarian tumors may not show any symptoms, so it is recommended that women undergo tumor marker tests, such as CA125 and HE4, as well as routine ultrasound examinations.

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Are ovarian cysts easy to treat?

Most ovarian cysts are physiological. If it's the first time an ovarian cyst is detected, it can be observed, and a re-examination can be conducted after two months. If the cyst disappears or reduces in size, it is physiological and there is no need for concern or treatment. However, if the ovarian cyst has not reduced but has increased in size after two months, this is pathological, indicating an ovarian tumor. In this case, surgical treatment is necessary. This is because if an ovarian tumor persists for a long period, it may become malignant or lead to ovarian torsion, both of which can affect the body adversely.

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Symptoms of benign ovarian cysts

When women develop benign ovarian cysts, the clinical symptoms are somewhat related to the number and size of the cysts. For example, when the cysts are relatively small in diameter, they usually exhibit no clinical manifestations and are often only discovered during routine gynecological exams or ultrasound screenings. As the cysts grow in size, some women may experience heaviness and pain on one side of the lower abdomen, along with a sore back. These abdominal symptoms can worsen with excessive fatigue, staying up late, or during intercourse. Some women may also experience abnormalities in their menstrual cycle, such as changes in the amount of menstrual bleeding, duration of menstruation, or irregular vaginal bleeding.

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Is an adnexal cyst the same as an ovarian cyst?

Adnexa clinically refers to the fallopian tubes and ovaries combined, thus, adnexal cysts are not necessarily ovarian cysts. During gynecological ultrasound, these are often reported as cysts in the adnexal area because the proximity of the ovaries and fallopian tubes makes it difficult to conclusively determine if an adnexal cyst is an ovarian cyst. Clinically, cysts in the fallopian tubes are also referred to as cysts in the adnexal area. Distinguishing them often requires surgery to see the exact location of the cyst for identification.

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Do ovarian cysts require the removal of the ovary?

Generally, ovarian cysts do not require the removal of the ovary; the common practice is to perform a cystectomy, which involves peeling off the cyst from the ovary. After that, the situation of bleeding is assessed. If there is no significant bleeding on the surgical surface, suturing can be done, which preserves both the morphology and function of the ovary. Ovaries are crucial for females as they produce estrogen, progesterone, and also have the function of ovulation. Therefore, removing ovaries would reduce the levels of estrogen and progesterone in the body and decrease ovulation functions, which is why ovary removal is generally not recommended. Typically, the impact of the cystectomy on these ovarian functions is minimal. Thus, recovery tends to be good, with minimal impact on daily life in terms of prognosis.