Causes of ovarian cysts

Written by Xia Hu
Obstetrics and Gynecology
Updated on December 11, 2024
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There are several common causes of ovarian cysts. The first is during the ovulation process where the follicle fails to release an egg, resulting in the formation of follicular cysts. The ultrasound typically shows these as simple cysts containing follicular fluid. Another situation is the corpus luteum cyst, which occurs after ovulation when the ovary forms a wound surface and a corpus luteum. Cysts can also develop during the growth of the corpus luteum. These two types of cysts generally disappear after the next menstrual period and are considered physiological cysts that usually require no treatment. However, some cysts result from pathological changes in ovarian cells, or even from tumors. On an ultrasound, these appear differently, often as mixed composition masses, in which case surgical treatment is recommended.

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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.

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How to treat ovarian cysts?

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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Ovarian cysts have no symptoms

Most ovarian cysts are physiological, so few people experience symptoms. Common ovarian cysts include corpus luteum cysts and other ovarian cysts, which generally disappear naturally after two to three months. Therefore, if the ovarian cyst is not large, within five centimeters, and there are no symptoms, it is possible to temporarily observe it and perform an ultrasound after two to three months. If the cyst has not decreased in size or continues to grow, it may be an ovarian tumor, which would require surgical treatment. This is because if an ovarian tumor is left for a long time, it may become malignant or may lead to ovarian torsion.

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How to check for ovarian cysts?

There are two methods for examining ovarian cysts. Firstly, through a gynecological examination, especially in cases of sexual activity, a bimanual examination can be conducted. Under bimanual examination, a mass in one of the adnexal areas can be palpated, where the nature of the mass such as whether its boundaries are clear can be observed, as well as checking for tenderness. This allows for the examination of ovarian cysts. Another method involves an ultrasound. Generally, if performing an abdominal ultrasound, it is necessary to hold urine to view the ovaries clearly. If performing a vaginal ultrasound, especially in cases of sexual activity, this can be chosen; thus, the ultrasound can provide a clearer view. It is closer to the uterus and ovaries, and thus under ultrasound, the masses in the ovaries can be detected. Therefore, both of these methods are viable.

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Is an adnexal cyst an ovarian cyst?

In clinical terms, the adnexa include the fallopian tubes and ovaries, so an adnexal cyst is not solely an ovarian cyst; rather, ovarian cysts are just one type of adnexal cyst. Adnexal cysts can also include fallopian tube cysts, but in clinical practice, most adnexal cysts are manifestations of ovarian cysts. Therefore, when patients hear the term "adnexal cyst," they should further inquire whether it is an ovarian cyst, instead of simply assuming it to be one.