An ovarian cyst is a cyst that develops inside an ovary.

A cyst is a fluid-filled sac that can grow in any part of the body. Cysts can vary in size, and contain a watery liquid, or sometimes a thicker paste-like substance. Some cysts are solid and can be called tumours. This doesn't mean they're necessarily cancerous, tumour is just the medical name for the swelling.

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The ovaries are two small, round organs in the female reproductive system that release an egg each  month. The egg is formed in a tiny structure inside the ovary called a follicle. The follicle contains fluid to protect the egg as it grows, and bursts when the egg is released. The ovaries also make the hormones oestrogen and progestogen, which help to regulate the menstrual cycle (periods). Sometimes a follicle doesn't release an egg, or doesn't shrink (shed its fluid) after the egg is released. If this happens, the follicle can get bigger as it swells with fluid. This is an ovarian cyst.

Ovarian cysts can grow as big as five to six centimetres wide and can last four to six weeks. They're very common, normally painless and usually go away without treatment.

Many women experience no symptoms when they have an ovarian cyst, particularly if it's small. If cysts grow quite large they  may cause the abdomen to swell. Depending on where the cyst is and its size, it may put pressure on the bladder or bowels, making you need to go to the toilet more often. You may also notice abdominal discomfort and sex may be uncomfortable or painful. Your periods may be affected; they may become irregular or the bleeding may be heavier or lighter than usual.

Although a woman may live with a cyst for years and not even know she has it, occasionally cysts do cause problems. If a cyst is growing on a stem, the stem may become twisted. This causes intense pain, vomiting and a rapid heartbeat. This emergency condition is called torsion and you  will need to attend hospital for treatment.

Some cysts can rupture. If this happens, how you feel depends on what was in the cyst, whether it was infected or whether there was any bleeding. There is normally some pain when a cyst ruptures, but it is only as severe as the pain in torsion if there is bleeding or infection. Again you need to go to hospital for treatment.
As most cysts don't cause symptoms, they are usually discovered during routine examinations where an internal examination has been performed. They may also be picked with an ultrasound scan during pregnancy.
An internal examination is the first stage in diagnosis and if something is felt, you will be sent for an ultrasound scan and referred to a gynaecologist.

The gynaecologist will ask about your periods, age, previous pregnancies, and whether sex is painful. All of this information will help in determining the type of cyst and how much it is troubling you. A further internal examination will probably be called for because the gynaecologist will want to double check what your doctor has found.
An ultra sound scan will help build up a more complete picture. There are two ways of scanning, using either an external or internal probe.
The internal probe is shaped like a tube with a rounded end which is inserted into your vagina and moved around to get a clear picture on the screen.
The external probe is flat and moved around whilst pressing on your abdomen. For this type of scan you need a full bladder so that your organs can be seen more clearly – this means drinking around a litre of water shortly prior to the scan.
Some women find the vaginal probe somewhat embarrassing, intrusive and/or uncomfortable, but often it gives a clearer picture and allows blood flow to the ovary to be visualised, which helps with the diagnosis. Maintaining a full bladder for a long time then having someone pressing down on it can also be very uncomfortable.

The scan results will help define the type of cysts you are suffering from. Because the ovaries are hidden away and are located close to other organs, problems in the bowel, the uterus or other organs may be confused with ovarian cysts, and diagnosis is a complicated procedure.

You may get frustrated waiting between tests but there isn’t really a short cut, all the correct tests need to be done to be able to find the correct treatment.

If the scan shows only a small cyst and you haven't yet reached the menopause and you aren't taking the pill, you probably have a functional cyst. As long as it isn't causing pain or any other symptoms, most doctors will suggest waiting a month or two to see if it goes away without intervention. You may also be offered the pill while you are waiting, as some doctors believe it improves the chances of the cyst disappearing. Although the pill doesn't seem to help once you have a functional cyst, it may help to prevent them in the first place.
If you frequently get functional cysts, it might be worth taking the pill as a purely preventative measure.
Only functional cysts will disappear on their own; other cysts may need surgery. Your doctor will discuss this with you if it’s needed.

If your cyst is discovered in pregnancy and is causing symptoms or it is large, it will need to be removed. As with non-pregnant women, this will involve a general anaesthetic, but care will be taken to protect the baby and your other reproductive organs. You may be offered a laparoscopy at first to get a better view of the cyst. Depending on what's found, a technique called laparoscopic fenestration may follow. Using the same small cuts as an ordinary laparoscopy, the cyst is removed by draining its contents. These are sent to the laboratory for analysis. Recovery is much the same as for ordinary laparoscopy.

If there are any concerns that a cyst may rupture and spill during it’s removal you may be advised to have a laparotomy, a more serious operation which involves a much larger cut across the top of the pubic hairline. This gives the surgeon better access to the cyst. The entire cyst is then removed and sent away for analysis during the operation to check whether it’s cancerous.

Whether the surgeon removes anything else largely depends on your age and what they find on closer examination. These issues will be discussed with you prior to any surgical treatment. If you are under forty, they are likely to recommend leaving the ovary intact, particularly if you may want children / more children later. Even if the ovary is badly damaged by the cyst and only a small part remains, that part can still go on working normally. If you are over forty, the risk of developing cancer increases and, as a preventative measure, your doctor may recommend removing one ovary (oophorectomy) or both (bilateral oophorectomy) along with your fallopian tubes (salpingectomy) and your womb (hysterectomy).

It is important to remember that removing both ovaries will cause a premature menopause, if you haven't reached menopause. Even after menopause, the ovaries continue to produce small amounts of hormones that influence sexual health. A hysterectomy involves a long recovery period afterwards. You need to be quite clear about your own views and needs before any operation.

Reading some of the leaflets or books or contacting one of the organisations in the resources section might give you more information to help you make the decision. I cured my cysts naturally in under two months - click here to see how.

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