Gynaecology

Ovarian cysts and tumours

This page gives you more information about ovarian cysts and tumours, their symptoms and how they can be managed.

What is a cyst?

A cyst is just a sac of fluid which can develop in many areas of the body. Cysts may even occur in different places of the same person but often they are not related to each other and can have a different reason for occurring.

For women, one of the commonest places for cysts to arise is in one or both ovaries. Most of these are normal or sometimes called “physiological” or “functional”. This means that cysts grow as part of the process of releasing an egg (ovulation) or hormone production.

Such cysts usually disappear after the next menstrual bleed but can take several months to resolve. Most are small and certainly less than 5cm in size, but occasionally can be larger, especially in early pregnancy. Most of these cysts go un-noticed. Occasionally, there may be pain when a cyst ruptures or, rarely, when a cyst gets “twisted”. When looking at the ovary with an ultrasound scan machine, such cysts usually appear to be a simple sac of fluid (or at least have typical features of a physiological cyst).

Other cysts may be more persistent, lasting more than a few menstrual cycles. These are less likely to be physiological. Most are still benign (non-cancerous).

The flowing examples are the more commonly found “non-physiological” cysts:


1. Mature cystic teratoma (also called a dermoid)Show [+]Hide [-]

Teratoma cysts tend to occur in younger women. They can be small and first noticed on a scan for other reasons, or very large - up to 15 cm across. Often there are no symptoms but they can cause pain or “pressure” symptoms. They are unusual in that they can contain tissue such as hair, parts of teeth or bone, fatty tissue or skin-like structures.

In about 1 in 10 cases, an ovarian teratoma develops in both ovaries and teratomas may occasionally have a genetic link, running in a family. Smaller teratomas are often simply kept under observation, but larger or persistent ones may require surgery.

2. CystadenomaShow [+]Hide [-]

There are different types of cystadenomas, often filled with a watery fluid or thick, jelly like fluid. For example, serous cystadenomas fill with a thin fluid, and mucinous cystadenomas fill with a thick mucous-type fluid. Some grow very large. They are usually benign but some are cancerous.

Most are without symptoms until they become large. The commonest symptom is a general bloating feeing. Unfortunately this is common symptom and often has nothing to do with ovarian cysts. A simple ultrasound scan will determine if an ovarian cyst is present.

3. EndometriomaShow [+]Hide [-]

These cysts occur in women who have a condition called endometriosis. This problem occurs when tissue that looks and acts like the lining of the womb (uterus) grows outside the womb - the most common place is in or around an ovary. This is probably because tissue from the womb lining responds to the hormones made in the ovary.

When a woman has a period (menstruates) then this tissue also bleeds slightly. Blood may be trapped in a cyst forming an endometrioma, sometimes called a “chocolate cyst". They are benign but can cause pain during sex and during a period.

4. Polycystic ovariesShow [+]Hide [-]

Polycystic ovaries have very many, but very small cysts mainly around the outside of the ovary.

It’s thought that these cysts are caused when eggs mature within the ovary but are not released due to a problem with ovulation or hormone imbalance. With each cycle the number of cysts increases.

When associated with period problems, reduced fertility, hair growth, obesity, and acne, it is sometimes called Poly-Cystic Ovary Syndrome or PCOS. These changes are benign and rarely need surgery.

5. Other ovarian cysts and massesShow [+]Hide [-]

The cysts outlined above make up the vast majority of ovarian cysts found, but there are some rare types of ovarian cysts or even solid (non-cystic) ovarian tumours. Such types of occurrences can be discussed with your doctor.

Symptoms of ovarian cystsShow [+]Hide [-]

Many ovarian cysts don't cause symptoms. Others can cause pressure, swelling, or pain in the abdomen or pelvis. The pain may be constant or intermittent, and pain may only occur with sex.

Sometimes a cyst may bleed into itself, burst or become twisted (also called torsion) which can cause a sudden severe pain in the lower abdomen. Pain may also occur during periods, particularly if there is endometriosis..

There can be problems passing urine (incomplete or more frequent urination) and occasionally constipation. This may be due to a large cyst pressing on nearby structures such as the bladder or bowel. A large cyst can cause a distended abdomen, a feeling of bloating, sickness or vomiting.

Although most cysts are benign, some types have a risk of being cancerous. Women who notice abdominal bloating for the first time after the menopause should see their GP.

Management of ovarian cystsShow [+]Hide [-]

In Newcastle, there are dedicated facilities for diagnosing and if necessary observing ovarian cysts.

If surgery is required then we have a specialist team. Findings of scans are discussed with women who attend one of our clinics and any management plan will consider any concerns a woman may have.

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