What causes ovarian cysts?

Ovarian cysts are one of the most commonly seen problems which cause a female to go to the doctor, emergency room or hospital. Thankfully, the majority of ovarian cysts are not worrisome (benign). In fact, often these cysts may even go away on their own!

If ovarian cysts are so common, then what causes them? While most of the time an exact cause is not known, the causes may range from ovulation (follicular cysts) to abnormal bleeding during ovulation (hemorrhagic cyst) to endometriosis (endometrioma) to an abnormal growth within the ovary itself.

The most common type of cyst in premenopausal women is called a follicular or functional cyst. Thankfully, these cysts almost always resolve on their own without treatment. Some patients are prescribed oral contraceptives to help prevent new cysts from forming.

The most common type of benign solid growth within an ovary in a young woman is called a dermoid cyst. Dermoid cysts require surgery. Malignancy is also a possibility but is quite uncommon in women prior to menopause age.

Another type of ovarian cyst is a benign cystadenoma. This is a commonly seen benign ovarian tumor often seen after menopause. Abnormal cysts in postmenopausal women usually require surgical evaluation.

Another common type of ovarian "cyst" is a condition called polycystic ovarian syndrome. This is not actually a true "cyst" but rather a hormonal condition associated with insulin resistance. This condition causes the ovaries to appear filled with multiple tiny cysts. Females with this condition will have abnormal menstrual cycles which are irregular and sometimes very unpredictable. Many of these patients will have problems with acne, abnormal facial and body hair and even scalp hair thinning at time.

A pelvic ultrasound is often used to determine if a woman has an ovarian cyst. The ultrasound is usually performed through the vagina with a vaginal probe. This test is very reliable and is minimally uncomfortable. It usually only lasts about 10 minutes. Most gynecologists may perform this test in the office.