Cyst on the ovary

Dr. med. Julia Schwarz is a freelance writer in the medical department.

More about the experts All content is checked by medical journalists.

A cyst on the ovary (ovarian cyst) is a cavity on the ovary that is partially filled with fluid or tissue. An ovarian cyst is either congenital or develops under certain conditions. Most ovarian cysts are uncomfortable and resolve on their own. Read all about the causes and treatment of a cyst on the ovary here.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. D27N83E28

Cyst on the ovary: description

A cyst on the ovary is a type of bladder that can be filled with tissue or fluid. Usually it is only a few millimeters to centimeters in size and does not cause any discomfort. It is often discovered only by chance during a preventive ultrasound examination. Such cysts most often develop during puberty or during the menopause, as strong hormonal fluctuations can occur here, which favor the growth of a cyst.

Non-congenital ovarian cysts

Most ovarian cysts do not develop until adulthood. They are also called "functional" cysts. Since they are mainly formed under the influence of hormones, they usually occur as part of the female cycle. However, women are particularly often affected during puberty and menopause, as the hormonal balance undergoes changes during this time. In some cases, the cysts can also occur as a side effect of hormone therapy or in disease-related disorders of the hormonal balance. A distinction is made between various functional ovarian cysts: Follicular cysts, Yellow body cysts, chocolate cysts and the polycystic ovaries.

Congenital cysts

The gonad cells of the ovaries produce sex hormones (estrogens and progesterone). When a gland duct is blocked or blocked and the gland fluid backs up, a cyst develops. This process takes place during embryonic development. The cyst is then called "congenital". The congenital cysts include the dermoid cysts and the parovarial cysts (secondary ovarian cysts). They are much rarer than the functional cysts.

Cyst on the ovary: symptoms

Read everything you need to know about the symptoms of the disease in the article Ovarian Cyst Symptoms.

Cyst on the ovary: causes and risk factors

While the congenital ovarian cysts have arisen due to the obstruction of the gonad exit, the acquired cysts develop under hormonal influence. There are different types of cysts.

Corpus luteum cyst

After ovulation, the tissue of the ovary in which the egg cell grew - the follicle - changes into what is known as the corpus luteum. This produces the sex hormones estrogen and progesterone. If the egg cell is fertilized, the corpus luteum initially persists during pregnancy. If the egg cell fails to be fertilized, the corpus luteum is broken down and menstrual bleeding occurs as the hormone concentrations in the blood decrease.

However, if the corpus luteum has not broken down properly or continues to grow, one or more cysts will form. But they can also arise from bleeding into the corpus luteum. Yellow body cysts can grow up to eight centimeters. In most cases, they resolve on their own after a while.

Follicular cyst on the ovary

During the first half of the menstrual cycle, an egg matures in a follicle of the ovary. The follicle contains fluid to protect the egg. When ovulating, the follicle bursts and the egg cell enters the fallopian tube, where it can be fertilized. If ovulation does not occur, the follicle continues to produce fluid. A follicular cyst forms. These cysts particularly affect women of childbearing age. The follicular cyst lasts for about four to eight weeks and continues to produce hormones. In most cases, it eventually resolves on its own.

Chocolate cysts

In the disease "endometriosis", the lining of the uterus (endometrium) occurs outside the uterus. The endometriosis tissue reacts like the normal uterine lining to the cyclical hormonal fluctuations. It builds up, bleeds off, and builds up again. However, if the blood cannot drain properly due to a localization on the ovary, blood-filled cysts can form. These cysts are then called "chocolate cysts" because of their thick, dark-blooded content.

Polycystic ovaries

Polycystic ovaries have many small cysts in the ovaries. The numerous cysts arise due to a hormonal imbalance. The cause is suspected to be an excess of male sex hormones and insulin, which prevents the normal maturation of the follicles. The body produces too much insulin, for example in the case of obesity or (latent) type 2 diabetes, in order to compensate for the lower sensitivity of the cells to the metabolic hormone. This encourages the formation of numerous cysts in the ovaries. The so-called polycystic ovary syndrome can lead not only to infertility and miscarriages, but also to cardiovascular diseases, diabetes mellitus and mental illness.

Dermoid cysts

The so-called dermoid cysts are congenital cysts. They have formed from the embryonic gonad tissue and can contain hair, sebum, teeth, cartilage and / or bone tissue. The dermoid cysts grow very slowly and can reach a size of up to 25 centimeters. A malignant degeneration of the cyst in the form of a tumor is only found in about one to two percent of cases.

Parovarian cysts

The secondary ovarian cysts (parovarial cysts) arise from embryonic tissue and are located next to the actual ovaries. They represent residual tissue from the embryonic development period. The parovarial cysts can be of variable size and possibly grow on a stalk.

Cyst on the ovary: examinations and diagnosis

If an ovarian cyst is suspected, the doctor will first ask about the symptoms and previous illnesses. The following questions can be asked, among others:

• How old are you and at what age did you have your first menstrual period?
• When was the last menstrual period?
• Do you have a regular cycle?
• How many days does the bleeding last?
• Did you take or take hormonal preparations?
• How many pregnancies and births have you had so far?
• Are you known to have endometriosis?
• Are there any known diseases of the ovaries in your family?
• Do you want to have children?

The doctor will then examine the patient in order to feel for any (painful) enlargements of the ovaries. Depending on the cause of the cyst, it can be assessed with a laparoscopy and removed at the same time.

Especially in women over the age of 40, a precise diagnosis of a cyst on the ovary should always be carried out in order to rule out a malignant event.

Ultrasound examination

The ultrasound examination (sonography) enables the ovaries to be visualized. The doctor may use a transducer to assess the ovaries and surrounding structures through the abdominal wall or vagina. In many cases, it is already possible to determine the type of cyst with an ultrasound examination.

Laparoscopy

With many forms of cysts, it is sufficient for the doctor to check the course using ultrasound examinations. However, if a dermoid cyst or an endometriosis cyst is suspected by ultrasound, a laparoscopy is usually performed under general anesthesia. The camera and surgical instruments are guided into the abdomen through three small incisions in the abdominal wall. The surgeon can examine the ovaries up close, take tissue samples from the cyst or remove them completely.

Ovarian cyst: treatment

Treatment for the ovarian cyst depends on its type and size. As long as it does not cause discomfort and is not too big, its growth can first be observed. In more than 90 percent of cases, the cyst will resolve on its own. For this purpose, cysts should be observed by the doctor at regular intervals using ultrasound and palpation examinations. Sometimes drug therapy with hormones can cause the cysts to regress. In rare cases, however, surgical removal is necessary.

Medication

The ovarian function is suppressed by hormonal drugs such as birth control pills. In some cases, the hormones can also inhibit cyst growth or even cause them to regress. In the case of endometriosis cysts, a substance similar to the male sex hormone is used for treatment.

Surgical removal of ovarian cysts

Most ovarian cysts are acquired cysts that resolve spontaneously and do not require surgery. Surgical intervention to assess or remove the cyst is usually only performed if symptoms or complications arise. In the case of new cysts after the menopause or in the case of cysts that have existed for months, an operative investigation must also be carried out.

Various methods are available for surgical intervention. The choice of procedure depends on the size of the cyst and its cause. Usually a laparoscopy is performed, with which the cyst can be examined and possibly removed. Only in the case of large cysts does the abdomen have to be opened with an incision.

Polycystic Ovarian Therapy

The treatment of polycystic ovarian syndrome depends on whether or not you want to have children. The top priority is reducing body weight through increased physical activity and a balanced diet. If necessary, the insulin level must be lowered with medication. Furthermore, hormones can be given that regulate the ovarian function and counteract the increased production of male sex hormones.

Cyst on the ovary: the course of the disease and prognosis

In over 90 percent of cases, an ovarian cyst heals on its own and does not cause any discomfort or complications. In very rare cases, however, it can tear or twist (twisting of the stem). This can lead to complications.

Rupture of an ovarian cyst

Only in rare cases does an ovarian cyst rupture. Sometimes this can happen as part of a palpation exam, but most of the time the cyst ruptures without a particular trigger. The process is often painful, for example in the form of a sudden, stabbing pain, but is usually harmless. If, however, adjacent vessels also tear, it can lead to bleeding into the abdominal cavity, which usually has to be treated surgically.

Rotation of the stem of a cyst on the ovary

Large ovarian cysts, such as endometriosis cysts, are in some cases connected to the ovary by a movable vascular pedicle. If the body moves suddenly, the stem can rotate and the blood supply to the cyst or the surrounding tissue is cut off. Depending on where the cyst is located, a lack of blood supply leads to severe pain, nausea, vomiting, and sweating. The tissue around the cyst can die and lead to other complications such as peritonitis or blood poisoning.

In most cases, ovarian cysts do not pose a health risk. However, they can very rarely lead to malignant diseases such as ovarian cancer and should therefore be checked regularly. However, twisting the stalk is a dangerous and painful complication. It is possible that new cysts may form on the ovary after a cyst is removed.

Tags:  therapies vaccinations drugs