Female anatomy comes with constant fluctuations. From the start of puberty to menopause, women may face reproductive health hurdles. One of them is the presence of ovarian cysts. The majority of the 20% of women who develop an ovarian cyst will not even know they have one. These primarily benign cyclical formations don't pose a huge concern but should still be acknowledged for the subset of women who experience discomfort or detrimental health implications.
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What Are Ovarian Cysts?
Female reproductive anatomy consists of two ovaries, one attached to each side of the upper part of the uterus. Ovarian cysts are fluid-filled sacs that develop either inside or on the surface of the ovaries. Most cysts are harmless and come and go as part of ovulation within the menstrual cycle. You typically won't treat these cysts because the body is able to dissolve them naturally. These occur in women of reproductive age in mostly benign presentations, but there are conditions where cysts can become chronic, pathological, or result in a medical emergency. In these cases, figuring out what type of cyst is present will be important.
Types Of Ovarian Cysts And Their Characteristics
There are five variations of ovarian cysts. The first and most common are called functional cysts. These present as either follicular or corpus luteum cysts. Both are normal occurrences during the ovulation phase of a menstrual cycle. Follicular cysts form when the follicle on the ovaries doesn't release an egg as it should. Instead, the follicle fills with fluid which can then become a cyst. A corpus luteum cyst happens after a follicle releases an egg. When the egg is released, it produces the corpus luteum, which can fill with fluid, causing a functional cyst. These two presentations occur monthly in some women without concern.
The other four types are not necessarily menstrual cycle regulated and can be a sign or symptom of an underlying health issue. These include cystadenomas, dermoid cysts, endometriomas, and ovarian cancer tumors. A cystadenoma is a benign growth that develops on the surface of an ovary, resulting in oversized water or mucous-filled tumor. A peculiar type of cyst is a dermoid cyst, which contains tissue material such as hair, teeth, and skin in a fluid-filled sac on the ovaries. These can develop anywhere in the body but are the most common ovarian tumor to occur in pregnancy. An ovarian endometrioma is also referred to as a "chocolate cyst" because of the color and consistency of the fluid-filled cysts. This type of cyst has fluid that mimics the endometrial lining fluid and is a key indicator of endometriosis. These last three mentioned cysts can be problematic and should be evaluated by a practitioner to determine if they need to be removed or treated.
Risk Factors Associated With Ovarian Cysts
There are some common causative risk factors associated with ovarian cysts. While functional cysts present as a normal process of menstruation, there are women who are at increased odds of having cysts become regular or problematic. This includes women with dysfunctional hormone processes such as Polycystic Ovarian Syndrome (PCOS) and hypothyroid disorder. Taking fertility medications like clomiphene, which is also commonly used with the PCOS population, can increase your risk as well. Having a history of ovarian cysts, being pregnant, having endometriosis, or contracting a pelvic infection can all increase your chances of cystic ovary formation. If you have any of these pre-existing conditions, it's especially important to know the symptoms of ovarian cysts, so you understand when to medical care.
Symptoms of Ovarian Cysts
Most women will not experience symptoms of cyclical cysts. There are cases of enlarged cysts becoming problematic, resulting in these symptoms:
- Pelvic pain
- Dull backache
- Bloating in the lower abdomen
- Unilateral abdominal pain
- Pain during intercourse
Some women develop debilitating cysts that require emergency care. These conditions will present with exacerbated symptoms in the form of:
- Pain with a fever
- Rapid breathing
- Vomiting
- Dizziness or faint feeling
- Weakness
Importance of Regular Monitoring for Patients With Ovarian Cysts
While functional cysts appear to be harmless, there are patients you'll want to routinely monitor due to their history of ruptured cysts, the size of the cyst, and their age. Ruptured cysts can cause debilitating pain and agony for the patient, but more importantly, there is a rare but real chance of having uncontrolled bleeding occur. This sometimes happens due to the size of the cysts, which becomes too big and ruptures.
Enlarged cysts that do not rupture can put women at risk for ovarian torsion, which occurs when a cyst becomes so large that it causes the ovary to shift and twist upon itself. Therefore monitoring cysts over the size of 10cm is warranted in case medical intervention is necessary.
As women age, regular cyst formation can put them at an increased risk of forming malignant cysts since malignancy odds, in general, increase with age. Complex or solid-forming cysts can be a precursor to malignant tumors, which, if going to happen, is more likely to occur in older populations. Utilizing transvaginal ultrasound, routine pelvic exams, hormone blood tests, and cancer screening can help detect complications of ovarian cysts. This can assist practitioners in determining preventative courses of action that will reduce those at risk for potentially harmful enlarged cysts that lead to rupture, torsions, and increased odds of malignancy.
Top Labs to Run Bi-Annually on Your Patients Who Suffer From Ovarian Cysts
Women at risk for ovarian cysts would benefit from laboratory testing every six months. This allows functional medicine practitioners to evaluate biomarkers that correlate to their clinical picture and provide evidence-based solutions for health optimization. Here are several helpful labs that your practitioner may order:
Comprehensive Metabolic Panel
Blood glucose and liver enzymes are key markers in a Comprehensive Metabolic Panel. When it comes to PCOS, there can be a correlation between fatty liver and insulin resistance which may play a role in the development of ovarian cysts. Getting a CMP will detect if your fasting blood glucose is in range and whether or not your liver is optimally functioning.
If your blood sugar tends to be high or you are known to have insulin resistance, getting an HbA1c is necessary. This marker is a representation of your blood sugar over the last three months. It gives a more accurate depiction of how your body is utilizing sugar which is important for insulin resistance and pre-diabetes screenings.
Female Sex Hormones
A hormone panel that includes comprehensive markers such as estradiol, progesterone, testosterone, LH, FSH, DHT, Sex-Hormone Binding Globulin, and cortisol gives a great representation of if your body is producing hormones within balance. Hormone imbalance is the leading cause of ovarian cyst formation, especially in at-risk populations.
Inflammatory Markers
Hormone imbalances, PCOS, ovarian cysts, and hypothyroidism can all have an inflammatory component to them. There are specific blood markers like C-Reacive Protein (CRP) and Sedimentation Rate (ESR) that represent the presence of systemic inflammation. The two labs can be done through Access Medical Laboratories as screening tools for inflammation in the body.
Additional Labs to Check
Transvaginal ultrasounds are commonly utilized to check for the presence of problematic cysts or repercussions of ruptured cysts. Creating a plan with your ob-gyn to monitor repetitive complications of cysts is a valid course of action to prevent harmful effects such as ovarian torsion or complex solid cysts.
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Summary
Preventative and proactive integrative care can be a means of supporting women who suffer from ovarian cysts. Painful and chronic ovarian cysts can impact a person's well-being and healing. Jumping in front of the situation by doing bi-annual testing can help manage patient care and provide an opportunity to improve treatment options and risk factors. Women who suffer from conditions that increase their risk for ovarian cysts can also address the root cause and hopefully decrease their susceptibility to cyst development.
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