What does an ovarian cyst feel like?
Pain from ovarian cysts differ in women depending on their size and type. Some people with ovarian cysts may feel pain in their pelvis or lower abdomen, while others do not.
An ovarian cyst is most common during the menstrual cycle and develops when the ovary fails to release an egg or when a follicle in the ovary continues to grow after an egg has been released. These cysts that develop during a woman’s normal menstrual cycle are called functional cysts. These functional cysts often cause no symptoms, are harmless and resolve themselves. Functional cysts occur if you ovulate, so if you are on the oral contraceptive pill or other hormonal treatments to prevent ovulation, functional cysts are unlikely to form.
Other types of ovarian cysts include neoplastic (non-functional) cysts, such as dermoid, cystadenomas and endometriomas.
- Dermoid cysts are sac-like benign growths on the ovaries that can grow into any type of tissue - even hair, teeth, or bone.
- Cystadenomas are benign growths that can develop on the outer surface of the ovaries. They can be filled with a transparent, watery fluid or can be filled with mucus.
- Endometriomas occur due to a condition called endometriosis. Endometriomas develop mostly in women below the age of 50 years and the symptoms can differ from mild to debilitating. If left untreated, endometriomas can worsen over time.
It is possible for large non-functional ovarian cysts to cause persisting pain and pressure.
This pain may come and go, be sharp or dull and is usually on one side. They can also cause symptoms including pain during periods, bloating, pain with sexual intercourse, feeling of fullness too quickly after eating, or changes in urinary or bowel habits. The larger the cyst, the more likely you will experience one or more of these symptoms.
Ovarian cysts and severe pain
Ovarian cysts, mostly dermoid cysts, can grow large and may cause ovarian torsion resulting in sudden, severe pain. Ovarian torsion is uncommon but occurs when a large cyst causes an ovary to twist around its own blood supply or that supports it in its original position. This can decrease or cut off the blood flow to the ovaries. This sudden, very severe pain may also cause symptoms including fever, nausea or vomiting.
Ruptured cysts, when the cysts break open, can cause very intense pain and internal bleeding. Both ovarian torsion and ruptured cysts require immediate medical care and severe cases may require surgery.
How do you diagnose an ovarian cyst?
Ovarian cysts are diagnosed during a gynaecological pelvic examination and with the help of a pelvic ultrasound. The ultrasound will show if the cyst contains fluid, or some solid elements. If it contains solid elements, it can be suspicious and may require further investigation including tumour marker blood tests.
Unless the cyst is large or causing severe pain, the cyst is normally monitored by a doctor through regular checks ups to ‘watch and wait’. Surgical removal is more likely for non-functional (neoplastic) cysts causing ongoing problems, or severe acute pain.
If your doctor believes your cyst is suspicious for ovarian cancer, you should be referred to a gynaecological oncologist. However, most new growths on or near the ovary are benign and not related to ovarian cancer.
When to visit your doctor
For intense pelvic pain that comes quickly, and may make you feel faint, dizzy, nauseas or feverish, you should seek medical advice immediately as it may be a sign of ovarian torsion or rupture. For general pelvic or lower abdominal pain that is ongoing and persistent there can be various causes, and you should visit your GP in the first instance.
If you wish to discuss assessment and treatment of ovarian cysts with Dr Obermair, please enquire about an appointment via the contact us page.