Ovarian cysts and masses can be a danger to a woman’s health and should never be ignored. An ovarian cyst is a fluid-filled sac that develops on the ovaries. Cysts are fairly common in menstruating women and become less common after menopause.
Ovarian masses are growths on or in the ovaries. At times, it may be referred to as a pelvic mass. “Pelvic mass” is a general term for any growth or tumor in the pelvis. They can be cystic (cystadenoma), solid (fibroma), or both. A pelvic mass can be cancerous (malignant) or noncancerous (benign).
Ovarian cysts are generally full of fluid or tissue, while ovarian tumors are generally solid masses.
What are the ovaries?
The ovaries are an essential component of a woman’s reproductive system and an important part of a woman’s health. They’re located on each side of the uterus and produce the hormones involved in menstruation and pregnancy. During ovulation, ovarian follicles release a mature egg. This egg travels down the fallopian tube, where it may or may not be fertilized by a sperm.
What are the different types of ovarian cysts and masses?
Fortunately, most cysts and masses are benign, but some can become cancerous. Some of the more common types of issues include:
Functional cysts
This is the most common type of cyst. A functional cyst — also called a follicular cyst — can form either when the follicle fails to release the egg or fails to dissolve after releasing the egg. Functional ovarian cysts are not the same as ovarian tumors or cysts due to hormone-related conditions such as polycystic ovary syndrome.
Cystadenomas
Typically, fluid-filled cysts form from cells on the outside surface of the ovary.
Dermoid cysts
Cysts that contain mature tissue (such as hair, skin, and muscle tissue).
Endometriomas
Endometriosis is a condition in which the endometrial tissue, which lines the inside of the uterus, grows abnormally on other organs and tissues. Endometriomas are cysts formed when endometriosis affects the ovaries.
Corpus luteum cyst
After the follicle releases its egg, a small organ called the corpus luteum forms, the corpus luteum is responsible for producing progesterone during pregnancy and breaks down if an egg is not fertilized and implanted. Sometimes they develop into fluid-filled corpus luteum cysts.
What are the symptoms of ovarian cysts and masses?
Many times, ovarian cysts and pelvic masses have no symptoms at all. You may not know you have a cyst or tumor until your next pelvic exam.
If you are experiencing any symptoms, however, it’s very important to make an appointment with our gynecologist to have an examination. If cysts get larger, twist (ovarian torsion), or burst and cause internal bleeding, they can cause serious problems.
Symptoms that indicate a possible cyst include:
Dull aching in the lower back or thighs
Abdominal pain and bloating
Difficult or frequent urination
Pelvic pain shortly before or after the beginning of your menstrual cycle
Pressure on your bowel or pain during bowel movements
Pelvic pain can be a sign of many medical conditions, problems, and abnormalities. If you’re experiencing pelvic or abdominal pain, irregular bleeding, or a change in vaginal discharge, schedule a consultation with our OB/GYN.
How are ovarian cysts and masses diagnosed?
While cysts and masses are not uncommon, it’s important to have them examined. Most of the time, our OB/GYN will evaluate the mass during a pelvic exam and then turn to more advanced technology for further examination.
Diagnostic testing may include:
Ultrasound
A transvaginal ultrasound can help the doctor determine the size and precise location of the mass.
Magnetic resonance imaging (MRI)
This imaging test can provide a highly detailed image of your body to show the extent to which the tumor has spread. With the increased use of imaging and the recognition by healthcare professionals that ovarian cancers present with subtle symptoms, more ovarian masses are being detected in postmenopausal women using MRI.
Laparoscopy
During this procedure, a thin, flexible, lighted tube is inserted through an incision in your abdomen. It can give the surgeon a better look at the mass and can also be used to take a biopsy or remove the mass altogether.
Blood tests
Dr. Aliabadi may order a blood test to check for various hormones that indicate the presence of cancer. The blood can also be tested for a protein called CA-125, which is a tumor marker. A gynecologic oncologist may be consulted for worrisome findings such as thick septations, solid areas with the flow, ascites, or evidence of metastasis.
What causes ovarian cysts?
Common causes of ovarian cysts include:
Functional cysts may be caused by hormonal problems or drugs used to help you ovulate.
Endometriosis tissue can attach to the ovary and form a growth.
An ovarian cyst can develop early in pregnancy to help support the pregnancy until the placenta forms.
Pelvic infections can spread to the fallopian tubes and ovaries and cause cysts to form.
What are the treatment options for ovarian cysts and pelvic masses?
Most ovarian cysts tend to resolve on their own and don’t cause any long-term harm. Many patients with simple cysts found through ultrasounds do not require treatment.
If your symptoms aren’t bothering you, and if you are a premenopausal woman, Dr. Aliabadi may recommend a plan of “watchful waiting.” A follow-up exam may be recommended so that we can check on the progress of the cyst or pelvic mass.
If the cyst does need to be treated because it’s causing unpleasant symptoms or interfering with your ability to conceive, we have a handful of treatment options to choose from.
Birth control pills
Hormonal birth control pills prevent ovulation, which decreases the chances that new cysts will develop. Birth control pills have also been shown to relieve pain associated with cysts.
Laparoscopy cystectomy
The vast majority of ovarian cysts and masses in premenopausal patients are benign, so a laparoscopy is a great option for many patients. This is a surgical procedure that uses a laparoscope to remove ovarian cysts through a small abdominal incision.
Laparotomy and debulking
Also known as “open surgery,” laparotomy is a more invasive surgical removal procedure in which the surgeon makes a larger incision in the abdomen to remove larger cysts, tumors, and any other tissue onto which the masses have spread. The surgeon takes out as much of the tumor as possible, which may mean the removal of the ovaries, fallopian tubes, uterus, or other tissues.
If the ovarian mass is cancerous, surgery may be performed in conjunction with chemotherapy. Chemotherapy medicines may be used to shrink the tumor and destroy cancer cells.
Have questions about your health? Talk to Dr. Aliabadi
Dr. Aliabadi and her compassionate team are experts in women’s health care. When you’re treated by Dr. Aliabadi, you’re guaranteed to feel safe, heard, and well cared for.
We invite you to establish care with Dr. Aliabadi. Please make an appointment online or call us at (844) 863-6700.
The practice of Dr. Thais Aliabadi and the Outpatient Hysterectomy Center is conveniently located for patients throughout Southern California and the Los Angeles area. We are near Beverly Hills, West Hollywood, Santa Monica, West Los Angeles, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.
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Ovarian cysts and masses FAQs
Can ovarian cysts cause infertility?
Some conditions that cause ovarian cysts are linked to infertility. Endometriosis or polycystic ovary syndrome (PCOS) can interfere with ovulation and impact fertility.
What are the different types of ovarian tumors?
Ovarian tumors can be classified into several different types based on the cells from which they originate. The primary ovarian tumors include: germ cell tumors, stromal tumors, and epithelial cell tumors. All of these ovarian tumors can be cancerous or noncancerous.
Can a Pap smear test detect ovarian cancer?
There is no reliable routine screening test for ovarian cancer, so women with a family history of the disease or other risk factors should talk to their doctor about genetic testing and other steps to monitor or help reduce their risk of ovarian cancer.
What are adnexal masses?
An adnexal mass is a growth that forms near the uterus (in the ovaries, fallopian tubes, or connective tissues). In premenopausal women, adnexal masses include ovarian cysts, ectopic pregnancies, benign or malignant ovarian tumors, endometriomas, polycystic ovaries, and tubo-ovarian abscess, and the risk of malignancy is low.
Adnexal masses can be physiologic or complex. Common causes for adnexal masses are follicular cysts and corpus luteum cysts. Abscesses can form as a complication of pelvic inflammatory disease.
Sources
Bidus MA, Zahn CM, Rose GS. Germ cell, stromal and other ovarian tumors.In : DiSaia PJ, Creasman WT, eds. Clinical Gynecologic Oncology, 7th ed. Philadelphia, PA: MosbyElsevier; 2007:381.
Ma, G., Li, G., Xiao, Z., Gou, A., Xu, Y., Song, S., Guo, K., & Liu, Z. (2021). Narrative review of intraductal papillary mucinous neoplasms: pathogenesis, diagnosis, and treatment of a true precancerous lesion. Gland surgery, 10(7), 2313–2324. https://doi.org/10.21037/gs-21-450
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