Cysts on the ovary

The diagnosis of ovarian cyst causes headaches for many women. If the word tumor is mentioned in the same sentence, many women are deprived of sleep. According to various sources, an ovarian cyst is diagnosed by the gynecologist in every 8th woman during her life.

It is important to know that in more than 90% of cases, the development of the ovaries is completely normal, but it should still be checked regularly until it regresses spontaneously. If you have regular check-ups, there is no reason to panic at first. An ovary that appears enlarged in ultrasound does not always have to be a cyst or a tumor; there may also be ovarian swelling.

Causes and development

A cyst is a space filled with fluid. This fluid can be any type of body fluid, from thin secretions to thick, viscous mucus. It is called in one breath with tumors because a cyst is a subtype of tumors.

Contrary to the common association with malignant cancers, a tumor is by definition first and foremost exclusively a swelling. This can be of any nature. Whether inflammations, water retention, cysts or even cancer, they all cause swelling, i.e. a tumor.

Therefore, there is not always a malignant disease behind the diagnosis of a tumor. A cyst is therefore nothing bad at first and only needs to be monitored in order to detect complications at an early stage, which in rare cases do require treatment. Cysts develop in many parts of the body and, in the case of an ovarian cyst, on the woman’s ovaries.

These are located to the right and left of the uterus and are loosely connected to it by the fallopian tubes. Due to their close proximity, they can be easily assessed with ultrasound through the vagina or abdominal wall. The cysts are often caused by hormonal factors.

Hormones are the signal transmitters of our body and are released, for example, in the brain and lead to various reactions in the body. In women, our sex hormones cause an egg to mature in the ovaries and cause menstruation from the lining of the uterus every month. The majority of ovarian cysts are formed in this hormonal structure.

These cysts are called functional cysts and they are usually harmless. They develop mainly during the hormonal changes in women, i.e. during puberty or the menopause. There are also different types, which can often grow up to 10 cm in size.

In young women, the ovarian cyst usually develops from the follicle, in which the egg in the ovary matures to a size of 2.5 cm. When it is mature, ovulation occurs and the egg jumps out of the ovary and then travels along the fallopian tubes towards the uterus. This happens once a month from puberty until menopause.

However, if ovulation cannot take place properly, the follicle with the egg continues to grow and produce fluid and an ovarian cyst, in this case called a follicular cyst, develops. If ovulation takes place normally, the follicle develops into the so-called corpus luteum, which is then broken down in the ovary. However, if this breakdown does not take place properly, the corpus luteum may bleed into the follicle and the corpus luteum cyst develops.

During infertility therapy, so-called lutein cysts can develop from the corpus luteum instead of luteal cysts as a side effect of the therapy. In addition to problems with female sex hormones, many women also have too many male sex hormones. Due to this excess, too many follicles grow in an ovary, but not all of them are able to reach the fallopian tubes and many ovarian cysts often develop here.

Because of the many cysts (Greek: poly = many), this clinical picture is also called polycystic ovaries (PCO). Other rarer causes are endometriosis, thyroid disease or a problem of the adrenal cortex, which also produces sex hormones. Endometriosis (endometrium= endometrium) leads to the proliferation of endometrium in other parts of the abdominal cavity, e.g. on the bladder wall or intestine.

Like the mucous membrane of the uterus, this mucous membrane also undergoes hormone-dependent changes and, like menstruation, begins to bleed once a month.If the blood accumulates in the tissue instead of draining off, an endometriosis cyst develops, which is also called a “chocolate cyst” due to the dark color of the blood. The second type, besides the functional cysts, is formed by cysts due to the malformation of germ cells in the ovarian tissue. They are not hormone dependent and develop mainly in girls and young women. These mostly benign tumors can degenerate into malignant tumors in 1-2% of cases around the age of 40. They should therefore be checked regularly after detection.