The term ovarian cyst is known to most women in the reproductive age group. It denotes fluid-filled swellings within the ovary. Many women get anxious whenever a diagnosis of an ovarian cyst is made.
Luckily, most cysts are innocent (or benign in medical terms), and usually disappear on their own without any active interventions.
The occurrence of most ovarian cysts is related to the way the ovaries function.
Women with regular menstrual cycles, and in the absence of hormonal contraception, will release an egg every month. Eggs develop in fluid-filled sacs called follicles.
Why do they occur?
Once an egg is released (ovulation), the fluid-filled sacs linger on for a while and eventually disappear. Occasionally, they may enlarge further to become benign cysts. But cysts may also occur due to other disease conditions, in which case they may not be benign.
What are the symptoms?
An ovarian cyst may be suspected following pelvic symptoms that may include a vague discomfort, or painful cramps.
In such cases, pelvic imaging with ultrasound is usually required to identify the cause of the symptoms. An ovarian cyst will sometimes be identified, and linked to the symptoms.
Others will be diagnosed with a cyst coincidentally when having pelvic scans for other reasons. Once a cyst has been diagnosed, the immediate step is to determine if it’s benign in nature, or otherwise.
Do they require surgery?
Young women in the reproductive age group will mostly have benign cysts. Older women, especially in the menopause years, should be carefully assessed before a cyst is deemed to be benign.
Benign cysts only require active intervention if they cause symptoms. Most will disappear within three menstrual cycles. Simple painkillers may be used if necessary for pain and discomfort. But some cysts may enlarge and cause severe symptoms, sometimes necessitating surgical removal.
Can they end up being cancerous?
Non-benign cysts are sometimes labelled as complex in appearance. They require additional testing depending on the presenting symptoms, age and other variables.
The main thing to exclude, especially for older women, is the possibility of the cyst being cancerous. However, it is important to emphasise that most ovarian cysts will not end up being cancerous. Once a definite diagnosis is made, specific treatment options can be offered.
How do I get assessed for cysts?
Easy availability of ultrasound scans has unfortunately occasioned erroneous diagnoses of cysts in large numbers of women. This is especially the case when pelvic scans get done by unqualified practitioners, or the images are interpreted by non-specialists.
Some have ended up with unwarranted interventions following misdiagnosis, with attendant complications that may compromise reproductive capacity.
Women must tread with extreme caution when getting assessed for pelvic symptoms, and only seek help with appropriately competent healthcare providers.
Dr Alfred Murage is a Consultant Gynaecologist and Fertility Specialist. amurage@mygyno.co.ke