Ovarian Cysts - The normal and the painful
Hello all! I am sitting here writing this after coming back from the Emergency Room. Don’t freak out, I walked in completely fine and walked out completely fine. However, this little trip prompted me to write about this topic— ovarian cysts.
Last night at like 2 am, I was up watching Big Bang Theory re-runs when all of a sudden it hit…
Intense pain suddenly hit me. It was so sharp that I could pinpoint exactly where it was coming from— the middle, left side of my uterus/ovary area. The pain is different than menstrual cramps, it’s one that you can’t get rid of no matter what position you are laying in.
I began puking like crazy, got cold sweats, contemplated my pain tolerance level, and activated the fetal position... I was not sure what I wanted to do or if it would go away. The last time this happened to me I went to the ER and out of commission the next day (while on vacation).
Wanna hear the best part about this particular experience? It was all over within 30 minutes.
I have experienced this before, so I knew exactly what was going on— possible ovarian cyst rupture. Once I acknowledged what was happening, I couldn’t decide if I needed to go to the ER or not. Again this is 2 am, there’s snow on the ground, and my partner was sleeping. I also didn’t want to get hit with a big medical bill. So once the pain was gone after thirty minutes, I just went back to bed.
When I woke up I made an appointment at the urgent care and noted that it might be a possible ruptured cyst. I knew that things needed to get checked out just in case anything went wrong. They called me soon after— to let me know that they don’t have an ultrasound and that I should go to the ER.
I am fine and nothing major happened, but it prompted me to write about why it’s important to acknowledge this type of pelvic pain and when to go to the ER.
What are ovarian cysts?
An ovarian cyst is a fluid-filled sac that can form in the ovaries. There are different types of ovarian cysts that are normal and functional for the body’s natural cycles, and there are some that are more painful and may require treatment. Most cysts can go away on their own without needing treatment and are non-cancerous.
Keep reading on to learn about 3 different types of ovarian cysts and what to do if you feel one rupture.
Functional (Follicular) Cysts
These cysts occur during the menstrual cycle. The cyst grows on the surface of the ovary and contains a mature egg. If the body does not get pregnant, these cysts will go away by the next menstrual cycle. The sac closes up after the egg is released and can sometimes fill with fluid. Functional cysts occur when a sac on the ovary does not release an egg, and the sac swells up with fluid OR a luteal cyst occurs when the sac releases an egg and then reseals and fills with fluid.
These types of cysts do not usually cause symptoms and can be harmless as they are normal to menstrual cycle functioning, however, if it becomes larger then there is more risk for torsion (twisting), rupturing, bleeding, and pain.
symptoms
Aching or sudden lower abdominal (belly) pain
Bloating in the lower abdominal area
Nausea, vomiting or loss of appetite
Dizziness when standing up from a sitting position
Changes in the timing of menstruation
Very heavy vaginal bleeding
Change in bowel movements
More frequent urination
Weight gain
Pain during or after sex
Endometriomas aka Chocolate Cysts
Endometriomas cysts form from the endometrium—or the tissue that lines the uterus. These types of cysts can be painful and are sometimes called “chocolate cysts” because of the brown color from the blood they are filled with. Observation with your medical provider may be necessary for treatment. According to the Endometriosis Foundation of America, chocolate cysts occur in 20 to 40 percent of AFAB bodies who have endometriosis.
Endometriosis is a condition where the inner lining of the uterus—the endometrium, grows on the outside of the uterus and onto other areas of the reproductive tract (ovaries, fallopian tubes, etc).
symptoms
painful, crampy periods
pelvic pain not related to your menstrual cycle
infertility for some AFAB bodies
Dermoid Cysts
Dermoid cysts are also known as teratomas. These cysts are an enclosed sac near the surface of the skin that can form during a baby’s development in the uterus. These types of cysts can contain tissue, such as hair, skin or teeth, because they form from embryonic cells. While these types of cysts can form just about anywhere, our focus here is on the ones that grow on the ovaries.
Just like other kinds of dermoid cysts, an ovarian dermoid cyst first forms before birth or could be present on an ovary for many years until it’s discovered during a pelvic exam.
Ovarian dermoid cysts are rarely cancerous.
symptoms
Depending on how large the cyst has grown, there may be pelvic pain on the side where the cyst lives, and the pain may increase during your menstrual cycle.
What happens when they rupture?
A ruptured cyst may cause severe abdominal pain like in the story I described above. This can definitely be a medical emergency. Seek medical attention if you suspect that you are experiencing a ruptured cyst. Depending on the cyst, pain can occur during the menstrual cycle, after sex or exercising, etc. A ruptured cyst can cause pain at any time.
Symptoms
intense pain
tenderness in the pelvic/abdominal area
feeling faint
fever
increased pain while sitting
full or heavy feeling in your pelvis
shoulder pain (if you have a lot of bleeding)
Why go to the ER?
A ruptured cyst can be a serious medical emergency. On top of the pain and symptoms listed above, complications from the ruptured cyst could include:
Release of fluid from the cyst or bleeding into the abdomen.
Torsion or twisting— by cutting off the blood supply to the ovary, ovarian torsion can cause inflammation and death of the ovary.
Diagnosis
There are a number of different methods used for diagnosing ovarian cysts. The most common methods are pelvic exams, where the doctor would check for the presence of a mass, and through ultrasounds— a clinician uses this tool to capture images of the size and location of the cyst through sound waves. Other diagnostic tools that are used (but aren’t as common) include CT scans, MRI, laparoscopy, and blood tests.
Treatment
Treatment of ovarian cysts is provided primarily by Gynecologists… and ER doctors for when you feel a rupture. Check-in with your medical provider if you think this is something that you experience or have any questions about. Treatment looks different depending on the type of cysts you are having and a medical provider is the best resource for figuring it out.
Till next time!
Jenn
Photos from shutterstock.com