Ovarian cysts are delimited fluid-filled sacs in the ovaries. Residual egg cells in the ovaries or follicles which have not broken down are usually responsible for the formation of cysts after ovulation. Ovarian cysts occur more frequently after puberty or during menopause. They are benign changes; however ovarian cancer can sometimes also hide itself behind an ovarian cyst.
The most common cause of ovarian cysts are egg cells or follicles which remain in the ovary after ovulation. Sometimes a number of hormone producing cysts also develop in an ovary. This is known as a polycystic ovary. In even rarer cases endometriosis can also cause cysts to form in the ovaries. As such cysts contain clotted blood and are brown in colour, they are also known as chocolate cysts.
Smaller cysts do not usually cause symptoms and are often discovered by accident during a gynaecological check-up. Larger cysts can press on the bowel or on the bladder and cause digestive disorders, problems when passing urine or lower abdominal pain. Hormone-producing cysts can disturb the menstrual cycle and sometimes cause masculinisation with increased hair growth on the upper lip, the stomach or the legs. Ovaries, in particular polycystic ovary, can cause infertility.
An ultrasound examination is generally used to diagnose ovarian cysts. It usually makes it possible to differentiate between ovarian cysts and ovarian cancer. If the findings are unclear, computed tomography or an MRI is also carried out.
Ovarian cysts which are discovered by accident and do not cause any symptoms do not require treatment. It is sufficient to monitor these with regular check-ups. A hormone treatment can be used for ovarian cysts which cause symptoms. Polycystic ovary as well as ovarian cysts caused by endometriosis can also be treated with hormones. After menopause, it is recommended that the ovarian cysts be surgically removed. As women age, the risk of ovarian cancer spreading increases. You can find out more about the surgical treatment options in the ovarian surgery section.