Every month during her menstrual cycle, if a woman is not taking a hormonal contraceptive, a group of eggs starts to develop in the ovary.
Eventually, usually only one is released during ovulation. The egg is released from a follicle cyst which produces the hormone oestrogen that causes the lining of the uterus to grow in expectation of a fertilised egg.
After ovulation the cyst also produces progesterone to make the lining stable for 2 weeks.
Sometimes these cysts are painful, and can grow larger than usual.
The good news is that most will disappear with pain relief and observation, including a repeat scan.
Very occasionally cysts will be so painful they require surgery to remove them.
You've had pain, you've had bloating, maybe unexpected vaginal bleeding....so your GP orders a pelvic scan. And the radiologist finds an ovarian cyst. What does it mean? Here's some information while you're waiting for the specialist appointment.
Ovulation cysts are clearly benign and most resolve. But there are other cysts that will not resolve on repeat scanning.
They may be just stubborn follicles.
But some may require surgery because they can grow, and cause pain.
Some of these cysts need to be removed because they can twist (tort) and cut off the blood supply to the ovary, causing severe pain, and even loss of an ovary, not a good thing for those that want to maintain their fertility.
Learn about benign cysts that might need surgery..or not..
Thank you very much to the many patients over 15 + years, since I have been at The Wesley Hospital, who have allowed me to share the de-identified pictures of their surgeries with other women, and for participating in research projects I have been involved in. You have helped many other women understand their bodies by being so kind as to do this, you have reduced their anxieties, and helped them to make decisions about their own treatment ... you deserve to know how important this has been to them !
Fortunately these are the most uncommon of the ovarian cysts.
However the incidence of ovary cancer rises with age, and gynaecologists view all ovarian cysts diagnosed in post menopausal women seriously.
At present there are no national guidelines for screening for Ovary Cancer in Australia, although research is ongoing.
Any woman who has a complex cyst can expect to undergo a blood test called ROMA (risk of ovarian malignancy algorithm) which will help to determine if she should see a gynaecologic oncologist for her surgery. I work closely with these specialists at The Wesley Hospital.
Recent research on Ovary Cancer Prevention
Cigarette smoking increases the risk of mucinous ovary cancer.
Outcomes of The UK collaborative Ovary Cancer Screening RCT reported: trend to reduced mortality for patients screened with CA125 blood test and USS, cost effectiveness uncertain. Full article here
Large pooled analysis of case-control studies shows a small-to-moderate (20–30%) increased risk of ovarian cancer with genital-powder use. Full article here
Opportunistic salpingectomy (electively with hysterectomy, or instead of tubal ligation) appears to be safe and cost-effective, and should be considered for women requiring these gynecologic procedures.
Endometrial and Ovary Cancer prevention strategies for women with Lynch Syndrome. Full article here
Oral Contraceptive Use reduces risk of subsequent Ovary cancer Full article
Tubal sterilization reduces the risk of serous ovarian (EOC) and peritoneal cancer (PPC) by 41%.
Excisional tubal sterilization reduces the risk of serous EOC and PPC by 65%. Full article
Learn about the commonest cysts that women have very month
Information about how cancerous cysts are approached
Interested in things you can do to modify your risk of Ovary cancer?
Scroll down to read recent medical studies of interest.
Some ovarian cysts require surgery, but many will not.
You can learn about laparoscopy HERE
Dr Melissa Buttini