Earlier this year, Lena Dunham was hospitalized to treat a ruptured ovarian cyst, unintentionally shedding light on an often ignored area of women's health. Although most cysts don't require that kind of medical attention, they're far more common than you might realize.
Any person who ovulates will almost certainly get some kind of ovarian cyst at some point, but that's not always a problem. For instance, your eggs are normally released from your ovaries every month. But sometimes, instead of breaking open to release the egg, the follicle grows into a cyst that'll go away on its own in a few months.
"During the process of ovulating, people will have ovarian cysts develop, and they’re usually asymptomatic," says Wendy Chang, MD at the Southern California Reproductive Center. "But when they get larger and rupture, that’s when people will feel them."
In those cases, the pain can be mild or knife-in-your-side sharp. And there are a bunch of different things that cause cysts. Here's everything you need to know about the causes of ovarian cysts — and what they mean for your health.
What are the symptoms of an ovarian cyst?
"The first sign is usually pain on the side that the ovarian cyst is on," says Dr. Chang. That pain will usually be on just that one side, and it will be in your lower abdomen or pelvic region. "Most of the time people will say it feels 'sharp' and 'focused,'" she explains, "and the onset is usually pretty sudden, but it can be triggered by heavy exercise or intercourse."
In rare cases when there's a lot of fluid released in the rupture, you might even feel pain in your upper abdomen or shoulders because that fluid irritates the nerves of the diaphragm. "But it's perceived as shoulder pain," says Dr. Chang.
Photographed by Geordy Pearson.
How are ovarian cysts and endometriosis connected?
Endometriosis is a common cause of ovarian cysts, and actually causes its own kind of cyst called an "endometrioma." Sometimes these are called "chocolate cysts" because they're filled with fluid that makes them appear darker, Dr. Chang explains.
Photographed by Alexandra Gavillet.
What causes ovarian cysts? What causes them to rupture?
Again, most cysts are functional and totally normal parts of ovulation. "Less commonly you could have cysts that are growths on the ovary," says Dr. Chang. "Those generally will have different kinds of cells compared to ovulation cysts. Some can be benign, like dermoid cysts."
And when it comes to rupturing, Dr. Chang says heavy exercise and intercourse are the most common causes. But often the cause is just unknown, especially if the wall of the cyst becomes thin.
Photographed by Tayler Smith.
What are some of the effects of ovarian cysts?
How your cysts will affect you down the line depends on the type of cyst. If it's just an ovulation cyst, there won't be any long-term impact. "But if it's an endometrioma, that can increase the risk of tubal scarring and infertility later on." When dermoid cysts rupture, the fluid they release is very irritating and inflammatory, which can also cause infertility.
If you get one cyst, you're more likely to get even more. Some women are just especially vulnerable (thanks, partly, to genetics or taking blood thinners) to get recurring hemorrhagic cysts. "And certainly, women who've had endometriosis are prone to having cysts recur — even if you remove them, they can come back," says Dr. Chang.
Photographed by Tayler Smith.
How are ovarian cysts treated when they rupture?
"Some women recover quickly because they don't bleed heavily, but if they do bleed heavily or they have severe pain, they need to be monitored in the hospital," says Dr. Chang. "Sometimes women have to go to the emergency room — especially if they experience heavy bleeding symptoms, like lightheadedness or vomiting. And a small percentage of women will require surgery to drain out the fluid and stop the bleeding."
So the most important part of this is to get an accurate examination. Although Dr. Chang says laparoscopic surgery is the "gold standard" for diagnosing endometriosis, women who have those characteristic "chocolate cysts" may be diagnosed with an ultrasound. If you're concerned, definitely check in with your doctor.
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