Ovarian Cysts in Singapore

What are ovarian cysts? 

Ovarian cysts are fluid filled sacs within the ovary. Most women will have ovarian cysts at some point in their life. Ovarian cysts are usually picked up on pelvic ultrasounds. Not all of them require treatment.

The common types of ovarian cysts include:

Follicular cyst

Follicles burst open and release an egg around the middle of your cycle during your childbearing years. If the egg is not released, the follicular cyst may grow and be seen on a scan. This usually resolves without needing treatment, but may occasionally require hormonal medication. Taking birth control pills may reduce the risk of having this.

Corpus luteum cyst

After the egg is released, the burst follicle becomes a corpus luteum which begins secreting hormones to prepare for a possible pregnancy. Sometimes, fluid may accumulate within and form a corpus luteal cyst. This usually resolves without needing treatment, except in rare cases where a corpus luteal cyst can cause pain or bleed from its raw edges. Taking birth control pills may reduce the risk of having this.

Dermoid cyst

These form from embryonic cells, are rarely cancerous and typically contain hair, teeth, sebum etc.

Endometriotic cyst

These are otherwise known as “chocolate” or “blood” cysts. Endometriosis is a condition where tissue from the womb lining is found outside the womb, which can cause painful periods and infertility.

Cystadenomas

These contain watery or mucous material and are usually benign.

Polycystic ovary syndrome (PCOS)

This is a condition where there are many small cysts (which do not require surgery) in both ovaries, and is usually associated with irregular periods and infertility.

Ovarian cancer

These are usually thick-walled and appear on scan as having many locules, solid areas, with strong blood flow to the area. Some ovarian cancers cause ascites (abnormal fluid accumulation in the abdomen). Symptoms may include feelings of bloatedness, discomfort, loss of weight or appetite.

Hand of surgeon with scalpel near female genitals

What are the symptoms of an ovarian cyst?

Some women with ovarian cysts may not have symptoms, until the cysts become large in size. Large ovarian cysts can sometimes burst, bleed or cause the ovary to twist – called an ovarian cyst accident, this can result in severe pain, nausea, vomiting and fainting. If you experience these symptoms, and especially if you have a history of ovarian cysts, seek the advice of a gynaecologist immediately. Without treatment, ovarian torsion can cut off the blood supply to your ovary causing permanent damage. 

Other symptoms of ovarian cysts may include: 

  • Painful periods 
  • Painful urination or bowel movements (especially during periods)
  • Painful intercourse
  • Abdominal swelling or bloating
  • Loss of appetite or weight
  • Nausea and/or vomiting
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Who is at risk for developing ovarian cysts? 

Every woman can potentially develop ovarian cysts at any point of their lives. However, you may be at increased risk of ovarian cysts if:

  • You have a history of ovarian cysts, PCOS or endometriosis
  • You have a family history of ovarian cancer 
  • You are on fertility medications e.g. drugs for ovarian stimulation

Although there is no way to prevent most ovarian cysts, being alert to your menstrual cycles and bodily symptoms as well as regular checks with your gynaecologist can ensure early diagnosis and treatment if needed. 

Can ovarian cysts be cured? What are the treatment options?

Treatment options and possibility of cure depend on the type of ovarian cyst. If your ovarian cyst is small, not causing you symptoms and does not appear suspicious for cancer, we may recommend watchful waiting with an interval scan for monitoring, as some cysts may disappear or resolve on their own without the need for treatment. 

If your ovarian cyst is physiological and recurrent (e.g. follicular cyst/ corpus luteum cyst), hormonal medications like birth control pills can help to reduce its incidence. 

Surgery is usually recommended if the ovarian cyst is large or suspicious for cancer. Most of the time, this involves a laparoscopic “keyhole” ovarian cystectomy (removal of cyst from the ovary), but may involve an oophorectomy (removal of ovary), laparotomy (open surgery) or other procedures depending on one’s age and risk factors for cancer.