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Ovarian Cysts

The obstetrician gynaecologist – Doctor Anna Janusz from the Medfemina Hospital in Wrocław talks about the symptoms and treatment of ovarian cysts.


Ovarian cysts are a common gynaecological disease. They concern women of all ages, but mainly in the procreative age.


The most common changes are as follows:

    • functional cysts:
    1. Simple, i.e. filled with a clear amber fluid, most often formed as a result of the functioning of the ovary (from ovulatory follicles)
    2. Haemorrhagic(an adnexal mass formed because of occurrence of bleeding into a follicular or corpus luteum cyst)
    • endometrial cystse. chocolate (the name comes from the colour of the ovary’s contents which closely resembles chocolate, but in fact it is haemolyzed blood)
    • dermoid cysts that is, the so-called teratoma, which are filled with sebum, hair, and sometimes we can find teeth in them. Contrary to what the name „teratoma” suggests, these changes are usually mild.


Ovarian cysts may cause aches and pains in the lower abdomen, abdominal fullness, flatulence, pressure on the bladder and pelvic floor, including the anal area, enlarged abdominal circumference. Often, cysts do not give any symptoms, so regular preventive gynaecological check-ups are important. Sometimes cysts give acute symptoms – severe pain, then it is necessary to undergo emergency surgery.


Cysts don’t always need treatment. If they do not show symptoms, do not have any disturbing features in ultrasound, are not large, they can be observed until they are absorbed. In such cases, we perform a control ultrasound and possibly a Ca125 marker from the blood approximately every 3 months. You do not need to fast for Ca125 testing, it can be done on any day of the cycle but not during menstruation.

When cysts show symptoms, have a suspicious appearance on ultrasound or other imaging tests (MRI, CT), or are over 5 cm in diameter, surgical removal is most often recommended.

As for endometrial cysts, the so-called chocolate cysts, their surgical removal is recommended in the case of symptoms of large size, i.e.> 3-5 cm; Cysts <3 cm in diameter that are asymptomatic (pain, infertility) can generally be observed. This is important for the maintenance of the ovarian reserve, as any operation on the ovary may lower the ovarian reserve.

With any type of cyst, but especially with a haemorrhagic cyst, it is important to be careful with intense sport, especially jumping, and with intercourse, while the cyst is still standing, because then the cyst may break or twist, which requires urgent surgery.


If the cysts recur, they are endometrial in nature, they give large symptoms, and their prophylaxis can be used with hormonal contraception, which will prevent the formation of new cysts.

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