Ovarian Cysts

What it is

Ovarian cysts are sacs filled with fluid or other content that form within or on the ovary. Most are functional — that is, related to the menstrual cycle — benign, and disappear on their own within a few cycles. Other types, such as endometriomas and dermoid cysts, may require treatment. They often cause no symptoms and are found during routine exams; in other cases, they cause pelvic pain or pressure, menstrual changes and pain during intercourse. The assessment includes a gynecological examination, transvaginal ultrasound and, when indicated, blood tests, to determine the type of cyst and the approach: monitoring with periodic exams, medication to prevent the formation of new cysts, or ovary-preserving surgery, such as ovarian cystectomy.

Most common symptoms

• Pain or a feeling of heaviness in the lower abdomen
• Pain during intercourse
• Changes in the menstrual cycle
• Bloating or increased abdominal volume
• Sudden pain on one side of the pelvis
• No symptoms, found during a routine exam

Causes and risk factors

• Normal menstrual cycle changes (functional cysts)
• Endometriosis, which forms endometriomas
• Polyendocrine metabolic ovarian syndrome
• Dermoid cysts and other benign ovarian tumors
• Use of ovulation-induction medications
• History of cysts in previous cycles

How it is diagnosed

Many cysts are discovered by chance, during routine exams. At the consultation, your gynecologist discusses your menstrual cycle, pain and other symptoms, and performs a gynecological exam. Transvaginal ultrasound is the main test: it shows the size, content and characteristics of the cyst, which helps distinguish functional cysts from other types. When indicated, blood tests are ordered, such as tumor markers and hormone levels, and the exam may be repeated after a few cycles to monitor how it evolves.

How we treat it at Femi Saúde

Management depends on the type, size and symptoms of the cyst. Functional cysts usually go away on their own, and Femi Saúde's gynecology team monitors their evolution with periodic ultrasounds. When episodes recur, hormonal contraceptives may be recommended to reduce the formation of new cysts. Endometriomas, dermoid cysts, and persistent or larger cysts may require surgery, usually by laparoscopy, with ovarian cystectomy, which removes only the cyst and preserves the ovary whenever possible. Each plan is individualized, taking into account age, the desire to become pregnant and the characteristics of the cyst, and the patient is guided through every step.

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