How to treat ovarian cysts?

Written by Li Shun Hua
Obstetrics and Gynecology
Updated on September 20, 2024
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The majority of ovarian cysts are physiological. If an ovarian cyst is detected for the first time during an ultrasound, it can be observed temporarily. Generally, such cysts will gradually shrink or disappear naturally after two to three months. If the cyst is relatively large, exceeding 5cm, and the ovary has not shrunk after two to three months of observation, but instead the cyst has grown, it is likely an ovarian tumor, which requires surgical treatment. If an ovarian tumor occurs, there is a potential for malignancy or torsion, so timely surgical intervention is necessary.

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Written by Xia Hu
Obstetrics and Gynecology
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Early Symptoms Judgment of Ovarian Cysts

The early symptoms of ovarian cysts include pain in the lower abdomen on one side, which is generally mild, persistent, and tolerable discomfort. However, this pain needs to be differentiated from other conditions. Since the pelvic area contains the uterus and ovaries, sometimes it is necessary to distinguish these symptoms from gastrointestinal diseases. For example, appendicitis often needs to be differentiated from cysts on the right side, as both can cause abdominal pain. However, appendicitis also includes gastrointestinal symptoms such as nausea and vomiting, and during examination, there is tenderness at McBurney's point, indicating appendicitis. On the other hand, the pain from an ovarian cyst is usually positioned slightly lower, and thus can often be differentiated through a gynecological examination.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Do ovarian cysts require the removal of the ovary?

When women discover ovarian cysts, it is not necessarily required to remove the entire ovary. For example, in women of childbearing age, the ovary can continue to ovulate, aiding in normal conception and secreting hormones to maintain normal endocrine function. In such cases, surgery to remove the ovarian cyst while preserving the healthy ovarian tissue can be performed. However, if a woman is nearing menopause or has already undergone menopause and discovers a large ovarian cyst, the function of the ovaries may have gradually declined or already ceased. If surgery is performed to remove the ovarian cyst, there is a possibility of recurrence, and the function of the ovary may already be lost. In this case, it might be appropriate to proceed with the removal of the ovary.

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Written by Xia Hu
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Do ovarian cysts require the removal of the ovary?

Generally, ovarian cysts do not require the removal of the ovary; the common practice is to perform a cystectomy, which involves peeling off the cyst from the ovary. After that, the situation of bleeding is assessed. If there is no significant bleeding on the surgical surface, suturing can be done, which preserves both the morphology and function of the ovary. Ovaries are crucial for females as they produce estrogen, progesterone, and also have the function of ovulation. Therefore, removing ovaries would reduce the levels of estrogen and progesterone in the body and decrease ovulation functions, which is why ovary removal is generally not recommended. Typically, the impact of the cystectomy on these ovarian functions is minimal. Thus, recovery tends to be good, with minimal impact on daily life in terms of prognosis.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Can ovarian cysts cause infertility?

Women with ovarian chocolate cysts may experience effects on their reproductive function. When the cysts are small, they typically do not significantly impact fertility. However, as the cysts grow in size, they can compress the normal ovarian tissue, causing ovulatory disorders and leading to infertility. Additionally, certain types of ovarian cysts, such as chocolate cysts, can cause adhesions in the female pelvic area. For instance, they may result in abnormal fallopian tube function, leading to infertility due to tubal factors. These cysts may also alter the pelvic environment, making conception difficult. If the ovarian cysts are malignant or capable of secreting hormones, they can also affect normal ovulation, leading to infertility.

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Are ovarian cysts serious?

Ovarian tissue is very complex in composition. It is the site with the most types of primary tumors among all body organs. Different types of ovarian tumors exhibit significant differences in histological structure and biological behavior. Benign ovarian tumors are typically small, often asymptomatic, and are usually discovered incidentally during gynecological examinations. As cysts grow, one may experience abdominal bloating or feel a mass in the abdomen. During examination, abdominal distention can be observed, the mass is usually mobile, percussion shows a dull sound, and there is no shifting dullness. If the tumor is malignant, there are often no symptoms in the early stages; later stages mainly present with symptoms of abdominal bloating, abdominal masses, and gastrointestinal symptoms. If adhesions occur with surrounding tissues, symptoms of compression, such as abdominal pain, back pain, and leg pain may also appear. Therefore, ovarian tumors should be treated promptly once detected.