So, you have been having some pain in your abdomen, and you go to the emergency department to get checked. After everything is said and done, the doctor tells you they have found some ovarian cysts. What does this mean? Should you be worried? Is it really what is causing your pain? Good questions, let’s explore these a little further.
If they are ‘normal’ then why do I hurt? If one of the cysts does not shrink like usual, then with the next menstrual cycle it may get bigger. When this happens, it may stretch the covering of the ovary causing pain, and it can sometimes cause the significant pain if the fallopian tubes get twisted or the cyst suddenly ruptures. Putting pressure on these cysts can also make them hurt.
So how do we know if these cysts are changing? In order to follow up on these cysts, often a transvaginal ultrasound will be performed. This type of ultrasound allows a very close look at the ovaries. Often this will be done by an obstetrician every 6-8 weeks. The key things they are watching is to see if the cysts get larger than 5 cm or if they change the composition of the cyst itself (British Medical Journal 1996).
Ok, so how do we treat them? Well, since these cysts are a part of normal ovulation, then any steps we take to stop ovulation will decrease the cysts. In most cases this means the use of oral contraceptive or depo-provera injections. Also, it is worth noting, that in women who have undergone menopause should not have any of these cysts. If a post-menopausal women has these type of cysts then they need further evaluation. In pre-menopausal women if these cysts are not going away over the course of a few menstrual cycles then they need a closer examination (Cochrane Database 2009).
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