Ovarian cyst breast pain

Ovarian cysts are sacs of fluid that can grow on the ovaries. They are very common; most women will get them at least once some time in their lives, according to the Mayo Clinic. For the most part, ovarian cysts are not life threatening or even bothersome. Some women do experience more advanced cases that require medical treatment.

Causes

According to the U.S. National Library of Medicine (NLM), women that are between puberty and menopause are most likely to develop ovarian cysts. There are several kinds of cysts that can form on the ovaries during this time in life.

The most common is a functional cyst. The ovaries grow structures called follicles, where immature eggs develop. If the follicle doesn’t open up and release the egg, it fills with fluid and causes a cyst. This is one type of functional cyst called a follicular cyst. If the cysts forms after the egg is released it is called a corpus luteum cyst.

Polycystic ovary syndrome (PCOS) is when the body doesn’t produce enough hormones for the follicle to release the egg, causing follicular cysts. PCOS disrupts the normal production of hormones, which can cause various problems.

Other cysts develop from tissue and cells. Some are created with ovarian tissue filled with a watery liquid or a mucous material. These types of cysts are called cystadenomas. Dermoid cysts are ovarian cysts that can contain hair, skin or teeth. These unusual additions are caused by cells that produce human eggs, according to the Mayo Clinic. Endometriomas are cysts caused by uterine endometrial cells growing outside the uterus and attaching to the ovary to form a growth.

Sometimes cysts can be caused by outside factors. For example, fertility drugs can cause multiple, large cysts on the ovaries. This condition is called ovarian hyperstimulation syndrome.

When a cyst becomes cancerous it is called ovarian cancer. One in 75 women will develop ovarian cancer, and about 14,240 women will die from ovarian cancer in 2016, according to the American Cancer Society.

Symptoms

Many women with ovarian cysts don’t experience any symptoms. This is particularly true with functional cysts. Symptoms usually occur when something goes wrong. For example, a cyst may grow larger, start bleeding, break open, twist the fallopian tube or interfere with the blood supply to the ovary, according to NLM. Some symptoms are also caused when a cyst is bumped during sexual intercourse.

Possible symptoms can include a sensation of pelvic fullness because a cyst is pressing on the bladder, pelvic tenderness or pain in the right or left side of the lower abdomen that can radiate to the back and down to the legs, pain while defecating, breast tenderness, changes in the menstrual cycle, such as spotting or bleeding at times other than when menses is expected and difficulty emptying the bladder.

Women experiencing ovarian cysts may also have problems eating. Getting full quickly when eating, loss of appetite and losing weight without trying most days for at least two weeks may be a sign of a cyst, according to NLM.

It is important to be aware of the symptoms of ovarian cysts because some symptoms are an indication that immediate medical attention is needed. “If you experience sudden, severe abdominal or pelvic pain, nausea or vomiting, or a fever, seek immediate medical attention, as this may be a sign of a more serious problem,” Dr. Leigh Matlaga, an OB/GYN at MedStar Franklin Square Medical Center.

Detection & treatment

Most cysts clear up on their own without the need for treatment in eight to 12 weeks, according to NLM. “However,” said Dr. Antonella Lavelanet, an obstetrician at Boston Medical Center, “cysts that grow larger than 5 centimeters are at greater risk for torsion (twisting around the Fallopian tube). Torsion is a gynecologic emergency. Women with ovarian torsion present with sudden onset of abdominal pain, often associated with nausea and possibly vomiting and low-grade fever.”

Early monitoring is key to finding ovarian cysts before they become a problem. “All women should visit their gynecologist regularly,” said Matlaga. “Routine pelvic exams can detect ovarian cysts, or any other changes in your ovaries, as early as possible. It is important to pay attention to your body and report any changes in your monthly cycle to your doctor.”

Doctors will often check for cysts using ultrasound, but other imaging devices, such as CT scans or MRI may also be used. Blood tests may also be performed to search for changes in hormone levels, signs of pregnancy and possible cancer. Once a cyst is confirmed, larger, cancerous or persistent cysts may be removed surgically. If the woman is near menopause the cysts may also be removed.

Some women are more prone to developing cysts. In these cases, a medical professional will often prescribe birth control that contains estrogen to help reduce the risk of developing certain types of functional cysts that occur after ovulation.

Women are often worried that cysts may affect their fertility. In general, fertility is not affected by functional cysts. “However, if cysts become too large and need to be removed surgically, there is always the risk that the ovarian tissue will be compromised or the ovary will be removed in its entirety,” said Lavelanet. As long as the other ovary is intact and functioning properly, a woman is usually able to go on to have children.

Additional resources

  • Office on Women’s Health: Ovarian cysts
  • American Cancer Society: Ovarian cancer
  • American College of Obstetricians and Gynecologists: Ovarian cysts

Ovarian Cysts

Ovarian cysts at a glance

  • Ovarian cysts (fluid-filled sacs) can form on the surface of or inside an ovary.
  • Most ovarian cysts cause no symptoms and will go away over time without any treatment.
  • If symptoms are present, they may include pelvic pain, pressure on the bladder or rectum, and/or a feeling of heaviness in the abdomen.
  • If necessary, treatment may include birth control pills or surgery.

Symptoms of ovarian cysts

For many women, ovarian cysts cause no symptoms. If symptoms are present, they may include:

  • Menstrual irregularities
  • Sensations of heaviness or fullness in the abdomen
  • Pelvic pain that may radiate to the lower back and thighs
  • Pelvic pain during intercourse
  • Pressure on the bowels or bladder
  • Pain during bowel movements
  • Difficulty emptying the bladder completely
  • Nausea, vomiting or breast tenderness similar to that experienced during pregnancy

Immediate medical attention is necessary if a woman experiences:

  • Sudden, severe pain in the abdomen or pelvis
  • Pain accompanied by vomiting and fever

These may be signs of a ruptured cyst or ovarian torsion (painful twisting of the ovary).

Causes

The most common types of ovarian cysts are known as functional cysts, and they grow during the normal menstrual cycle. Normal cyst-like growths, called follicles, develop throughout the month and rupture to release an egg. If a follicle keeps growing and accumulating fluid, it is considered a functional cyst.

There are two types of functional cysts, a follicular cyst and a corpus luteum cyst. Follicular cysts occur when the follicle does not release the egg, but instead continues to grow.

Corpus luteum cysts develop after the follicle has ruptured to release the egg, if the opening seals off and fills with fluid. In some cases, clomiphene (a fertility drug) can cause a corpus luteum cyst to develop after ovulation, but it poses no risk to a resulting pregnancy.

Other types of cysts can develop on the ovaries that are not related to the menstrual cycle, such as dermoid cysts or cystadenomas.

Dermoid cysts form from cells that create human eggs, so they may contain hair, skin, or teeth. Cystademomas form from ovarian tissue, and are filled with a watery, mucus-like liquid.

These less-common types of ovarian cysts may grow large and displace the ovary, which increases the chance of ovarian torsion, or the painful twisting of the ovary.

Endometriomas are ovarian cysts caused by endometriosis, a condition where the tissue that usually lines the uterus grows in other locations.

Treatment

Most functional cysts will disappear on their own within two or three menstrual cycles. A physician may recommend watching the cysts and waiting if there are no symptoms and an ultrasound indicates that the cyst is small and fluid-filled. Periodic follow-up ultrasounds may be necessary to monitor any cysts.

In other cases, depending on a woman’s age, symptoms, and type of cyst, the doctor may prescribe birth control pills or recommend surgery. Birth control pills will lower the chances of cysts developing during the menstrual cycle.

Surgery may be necessary to remove a cyst if it:

  • Does not appear to be a functional cyst
  • Is growing
  • Lasts more than two or three menstrual cycles
  • Causes pain or uncomfortable symptoms
  • Forms on a woman’s ovaries after menopause

In some cases, the cyst can be removed while keeping the ovary intact in a procedure called a cystectomy.

An oophorectomy is another surgical procedure in which one entire ovary is removed but the other is left intact.

A hysterectomy may be necessary if the cystic mass is cancerous.

What every woman should know about ovarian cysts

Ovarian cyst are a common, but often misunderstood, condition that can cause pain and concern for women.

Doctors, however, explain that although most of the time, they are painless and harmless.

Dr Iba Mayele, an obstetrician gynaecologist at Clinic Galien, Kimironko, says an ovarian cyst occurs when fluid accumulates within a thin membrane inside the ovary. The size can range from small to large—bigger than an orange.

He explains that women might get a cyst every month as part of their cycle but they might not even be aware since they usually go away on their own without treatment.

Dr Mohamed Okasha, a gynaecologist obstetrician at Legacy Clinics, says that ovarian cyst is a fluid filled sac that grows in the ovary. It is an abnormal pocket of fluid, akin to a blister. It contains liquid, gaseous, or semi-solid material.

He adds that there are two types of ovarian cysts, which include; functional ovarian cysts, (this is the most common type; they are harmless and form part of the female’s normal menstrual cycle and are short-lived.) While the second type is the pathological cysts, (these grow in the ovaries and they may be harmless or cancerous.)

SIGNS AND SYMPTOMS

Mayele notes that irregular and possibly painful menstruation may be one of the signs of ovarian cyst; it may be heavier or lighter than before.

Okasha explains that pain in the pelvis could contribute to ovarian cyst, the pain may be constant pain or irregular and it can stretch to the lower back and thighs. It may emerge just before menstruation begins or ends.

He says that if a cyst causes symptoms, one may have pressures, bloating, swelling, or pain in the lower abdomen on the side of the cyst, vaginal bleeding, and breast tenderness.

Mayele says if there are signs of dyspareunia (pelvic pain that occurs during sexual intercourse or pain and discomfort in the abdomen after sex), one should see a doctor as soon as possible.

He also says that painful bowel issues when passing stool, pressure on the bowels or a frequent need to pass stool could be a sign of the illness.

“There may be bloating, swelling, or heaviness in the abdomen, also, women may have problems emptying the bladder fully or feel the need to urinate often, so do not take this lightly,” Okasha urges.

He adds that some diseases like endometriosis are associated with painful menstruation and infertility.

Mayele also says that sometimes the body produces abnormal amounts of hormones, resultant to change in the way breasts and body hair grow.

COMPLICATIONS

He says that although an ovarian cyst often causes no problems, sometimes it can lead to difficulties, for instance; torsion, here the stem of an ovary can become twisted if the cyst is growing on it. The worrying bit is that it can block the blood supply to the cyst and lead to stern pain in the lower abdomen.

“If a cyst ruptures, you might experience severe pain in the lower abdomen. If the cyst is infected, the pain might even be worse. In unusual cases, a cyst may be an early form of ovarian cancer,” Mayele says.

TREATMENT

He says that there is no way to prevent ovarian cyst growth, however; regular pelvic examination will allow for early treatment if this is needed as it can prevent complications.

He says that treatment will depend on the person’s age, whether they have undergone menopause or not, the size and appearance of the cyst and whether there are any symptoms.

Okasha says most ovarian cysts have no signs or symptoms, so they often stay undiagnosed, but diagnostic test may include ultrasound and sound scan of a blood test.

Mayele explains that to reduce the risk of new cysts developing in future menstrual cycles, the doctor may recommend birth control pills. Oral contraceptives may also reduce the risk of developing ovarian cancer.

For Mayele, if the cyst shows cancerous risk, a biopsy can be taken for testing and if the result shows that cancer is present, some organs and tissue may need to be removed, for instance; the ovaries and uterus.

Okasha states that there is no way to prevent ovarian cyst growth. However, usual pelvic examinations will permit you to get early treatment where possible. This can help prevent complications.

He says that for neoplastic, surgery may be done. Surgery may also be proposed if there are symptoms; for example, if the cyst is large or appears to be growing, if the cyst does not look like a functional cyst or when the cyst keeps on growing through two to three menstrual cycles.

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If you’re having abdominal pain or discomfort that doesn’t seem quite normal, it’s possible that you have an ovarian cyst. These small fluid- or tissue-filled pouches on or in the ovary are actually very common. Here’s what Ob/Gyn Mark Dassel, MD, says you need to know.

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Not all ovarian cysts are the same

The good news is that the vast majority of ovarian cysts are harmless. Here’s a look at the most common types.

Functional cysts. This is the most common kind of cyst, occurring as part of the normal menstrual cycle due to ovulation, says Dr. Dassel. Every once in a while, a functional cyst may fill up with blood, making it swell and cause pain, but they’re normally painless and generally go away on their own over the course of a few months.

Dermoid cysts or teratomas. Women are often born with this type of cyst and “it can be full of all kinds of things that the body grows, like hair, teeth and even thyroid and brain tissue,” Dr. Dassel says. Very rarely, teratomas may become cancerous.

Cystadenomas. While a cystadenoma can get quite large, “it’s like a mole in that it’s usually a normal, benign growth,” explains Dr. Dassel. “And like a mole, sometimes we need to remove these to make sure they’re not cancerous.”

Endometriomas. “These cysts develop from endometriosis (a condition in which your uterine cells grow outside of your uterus) and they can be very tender and painful,” Dr. Dassel says.

Cancerous cysts. Fortunately, ovarian cancer is rare. “There’s a lifetime risk of about 1½ percent,” says Dr. Dassel. If you have a first-degree family member with ovarian cancer, this risk increases to 5 percent. “Women who have certain genetic conditions like BRCA1, BRCA2 or Lynch syndrome also need to be more concerned if they develop a cyst.”

Why do ovarian cysts develop anyways?

Beyond ovulation, endometriosis and the abnormal reproduction of cells, a pelvic infection like pelvic inflammatory disease (PID) can also cause ovarian cysts.

Do you always know if you have an ovarian cyst?

Ovarian cysts are usually small enough that most women don’t even realize they have one. In fact, Dr. Dassel says that many cysts are diagnosed during annual pelvic exams or imaging tests that are performed for another reason.

Even cysts that become enlarged often go unnoticed. However, “if a cyst gets big enough, it may create a feeling of pressure or even pain,” Dr. Dassel says.

Other possible symptoms of large cysts include:

  • Feeling bloated.
  • Pain with sexual intercourse.
  • Changes in bowel movements or urinary habits.
  • Unanticipated weight loss or gain.
  • Feeling full too quickly when you eat.
  • Pain on one side of your lower abdomen.
  • Painful periods.

These symptoms can be easy to ignore, and one by itself may not be concerning. But if you’re noticing many of these together, that’s a good reason to see your doctor for an evaluation.

A cyst that bleeds, bursts or causes your ovary to twist on itself (a condition called ovarian torsion) can cause sudden, severe pain.

What happens if you do have an ovarian cyst?

If your doctor finds an ovarian cyst, you’ll most likely have a pelvic ultrasound to see what’s going on and treatment will depend on your situation.

“Many times, if we have a slightly concerning cyst, we’ll wait six to eight weeks to see if it goes away on its own,” says Dr. Dassel. “A lot of cysts look just like a water balloon. There’s nothing inside them and they can be present even after menopause. It’s very reasonable just to watch these with an ultrasound every year to make sure they’re not growing.”

Occasionally, a cyst needs to be surgically removed. “There are a few things we look at in a cyst to evaluate whether or not it needs to be removed,” Dr. Dassel says. “If it’s causing painful symptoms, we may want to remove it for comfort reasons.”

You may also need surgery if the cyst is larger than 10 centimeters or if it looks abnormal on the ultrasound. “If, for instance, the cyst has extra solid tissue growing inside it, we’ll usually get tumor marker blood tests. The most common one is cancer antigen 125 (CA125),” says Dr. Dassel. “Elevated levels make us more concerned about cancer, especially after menopause.”

When you should see your doctor

If you experience intense pelvic pain, especially if it happens quickly, you need to get help immediately. Since a twisted ovary can reduce or stop blood flow, the sooner you get medical attention, the better chance there is for your ovary to be saved.

For general pelvic pain, “there can be a lot of causes, and sometimes they can be difficult to differentiate. In these cases, it’s best to go see someone who’s trained in pelvic exams to see if they can localize where that pain is because sometimes it’s very obvious,” advises Dr. Dassel.

Home remedies for ovarian cyst symptoms

Unless a cyst is very large or growing rapidly, a doctor will usually advise watchful waiting. This means waiting to see if the cyst goes away without treatment.

A doctor may perform several ultrasounds over a few months to monitor the cyst and ensure it disappears or does not grow larger.

Home treatment cannot make the cyst disappear. Instead, the goal is to treat any symptoms and manage pain. For example, many women with ovarian cysts experience more significant pain during their periods, so home ovarian cyst treatment often focuses on managing period pain.

Some of the most effective strategies include:

1. Over-the-counter medication

Share on PinterestOver-the-counter pain killers can provide relief from discomfort.

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can treat the pain caused by ovarian cysts, as well as period cramps.

Women who get no relief from NSAIDs should contact their doctor, since intense pain may point to a severe complication.

In some cases, a doctor may prescribe different pain medication, such as co-codamol, which contains codeine.

2. Massage

The pain of an ovarian cyst can cause the surrounding muscles to tense up. This can be particularly uncomfortable during a period. Massaging the lower back, thighs, buttocks, and stomach can help loosen tense muscles and reduce pain.

3. Exercise and stretching

Exercise and stretching can also help ease pain linked to ovarian cysts. It can also help with muscle tension. Some women get relief from intense exercise such as running, while others prefer gentle stretching and yoga.

Exercise can support healthy body weight in women with PCOS. Even without weight loss, exercise may reduce pain by strengthening the muscles. It may prevent the development of further cysts and help combat insulin resistance.

4. Heat

Heat increases blood flow, helping to reduce pain. Try applying a heating pad or hot water bottle wrapped in a towel to the stomach or lower back for about 20 minutes. It is safe to repeat this several times a day as long as the pad is not hot enough to burn skin. Do not sleep with a heating pad.

5. Relaxation techniques

Stress and anxiety can make pain worse. Relaxation techniques, such as meditation, yoga, and deep breathing, may help relieve anxiety and reduce the intensity of the pain. These techniques can also help a person manage pain long-term and improve general health.

6. TENS device

Transcutaneous electronic nerve stimulation (TENS) delivers a tiny, safe electrical signal to the nerves. This signal can change how the nerves respond to pain, helping with both period and ovarian cyst pain. TENS devices are available over-the-counter, but a doctor may also prescribe one.

7. Weight loss

If a woman is overweight, losing weight may help her body better regulate hormones, prevent the development of more cysts, and improve symptoms of pain and fatigue. It is difficult to lose weight with PCOS, so try not to become disheartened, as it may take time.

8. Dietary changes

Share on PinterestA low-carb diet may help reduce the symptoms of ovarian cysts.

Many women with PCOS are insulin resistant. This can lead to diabetes, make pregnancy more difficult, and cause weight gain.

A wide range of dietary changes may help, but as research does not point to a specific diet for PCOS, a woman may need to use trial and error to find what works best for her.

As women with PCOS may have insulin resistance, it might be helpful to reduce sugar intake. Sugar is in a wide variety of foods, including carbohydrates such as bread and pasta.

A doctor can check a person’s blood to see if they are at risk of developing diabetes. Choosing to eat healthful whole foods will help a person get their weight within a healthy range.

Management of Ruptured Ovarian Cyst

How do I get ready for management of a ruptured ovarian cyst?

A healthcare provider diagnoses a ruptured ovarian cyst. If you have sudden, sharp belly pain, see a provider right away. If you know that you have an ovarian cyst, be aware that it can rupture and need treatment.

Your healthcare provider or an ob-gyn (obstetrics/gynecology) doctor will diagnose the condition. Your provider will ask about your medical history and your symptoms. Be sure to tell the provider if you know that you have an ovarian cyst. You will also have a physical exam. This will likely include a pelvic exam.

If your provider thinks you may have a ruptured cyst, you may need tests. These tests can help rule out other possible causes of your symptoms, such as an ectopic pregnancy, appendicitis, or a kidney stone. Some of these tests may include:

  • Ultrasound. This test uses sound waves to view the cyst’s size, shape, and location.
  • Pregnancy test. This is done to check if pregnancy may be the cause of the cyst.
  • Blood tests. These check for low iron in your blood (anemia). They also check for infection and for signs of cancer.
  • Urine test. This looks for other possible causes of your pain.
  • Vaginal culture. This is done to check for a pelvic infection.
  • CT scan. This uses a series of X-rays and a computer to create a detailed picture of the area.

You may need more tests to rule out other possible causes of your symptoms.

If you need surgery for your cyst, your healthcare provider will tell you how to prepare. For example, you shouldn’t eat or drink after midnight before your surgery.

What happens during management of a ruptured ovarian cyst?

Management of a ruptured ovarian cyst depends on whether it is complex. A regular cyst is a simple fluid-filled sac. A complex cyst may have solid areas, bumps on the surface, or several areas filled with fluid.

Many women have functional ovarian cysts. Most of these are not complex. A ruptured cyst that is not complex can be treated with pain medicine. You may be told to watch your symptoms over time. In some cases, you may need to have follow-up ultrasound tests. You may not need any other treatment.

If the cyst is complex, you may need different care. This type of cyst may cause:

  • Blood loss that causes low blood pressure or fast heart rate
  • Fever
  • Signs of possible cancer

If you have a complex ruptured ovarian cyst, you may need care in the hospital. Your treatment may include:

  • IV (intravenous) fluids to replace lost fluid
  • Careful monitoring of your heart rate and other vital signs
  • Monitoring of your red blood cell level (hematocrit) to check the blood’s ability to carry oxygen
  • Repeated ultrasounds to check for bleeding into your belly
  • Surgery for a worsening medical condition or to check for cancer

If you need surgery, your provider may use a minimally invasive method. This is called a laparoscopy. The provider makes small cuts (incisions) in your belly while you are under anesthesia. A tiny lighted camera and other small tools are put through these incisions. The provider controls the bleeding and removes any blood clots or fluid. He or she may then remove the cyst or your entire ovary. The tools are then removed. The incisions are closed and bandaged.

If the provider does not use laparoscopy, the surgery will be done with larger incisions.

Talk with your provider about what type of treatment will work best for you.

What happens after management of a ruptured ovarian cyst?

You and your healthcare team will make a follow-up plan that makes the most sense for you.

If your ruptured ovarian cyst is not complex, you will likely continue your care at home. You can use pain medicines as needed. Your pain should go away in a few days. Let your provider know right away if you your pain gets worse, if you feel dizzy, or have new symptoms. Follow up with your provider if you need imaging or blood tests.

If you have a complex ruptured ovarian cyst, you may need to stay in the hospital for 1 or more days. If your cyst is no longer bleeding, you may be able to go home. You can use pain medicines as needed. You may need follow-up imaging tests to make sure that your bleeding has stopped and to see if the cyst needs surgery to rule out cancer.

If you had surgery, you will be told how to care for your wound and bandage. You may need to limit your physical activity for a while. Your healthcare team will give you more information.

In rare cases, a ruptured ovarian cyst is caused by cancer. This will need careful follow-up treatment from a doctor who specializes in cancer care. You may need surgery and other therapies.

Some women have more than one ovarian cyst. You can work with your healthcare provider to plan treatment for multiple cysts. A cyst that has not ruptured may need to be watched over time. In other cases, you may need surgical removal of the cyst. Your provider may prescribe medicines such as birth control pills. In some cases these can help shrink an ovarian cyst.

Next steps

Before you agree to the test or the procedure make sure you know:

  • The name of the test or procedure
  • The reason you are having the test or procedure
  • What results to expect and what they mean
  • The risks and benefits of the test or procedure
  • What the possible side effects or complications are
  • When and where you are to have the test or procedure
  • Who will do the test or procedure and what that person’s qualifications are
  • What would happen if you did not have the test or procedure
  • Any alternative tests or procedures to think about
  • When and how will you get the results
  • Who to call after the test or procedure if you have questions or problems
  • How much will you have to pay for the test or procedure

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