Chapter 6.8 - Ovarian Cystic Disorders

Abstract

There are many benign and cancerous forms of ovarian cyst. We examine the biology of the common forms of ovarian cyst, follicular cyst, corpus luteum cyst, and polycystic ovary syndrome. Follicular cysts are small fluid-filled sacs that develop in a woman’s ovaries. A follicular cyst can range from being as small as a pea, to being larger than an orange. Ovarian cysts are generally functional in nature, and harmless. In the United States, follicular cysts are found in nearly all women having a normal menstrual cycle. They most commonly occur during a woman’s childbearing years. Corpus luteal cyst occurs when a corpus luteum is not properly formed from the follicle after the LH peak. If the corpus luteum forms a sealed structure rather than an open structure, and hemorrhages, a cyst is formed. Some corpus luteal cysts happen in cases with sufficient LH to promote ovulation, but insufficient to stimulate proper corpus luteum formation. A corpus luteal cyst produces progesterone just like a normal corpus luteum. This progesterone can feedback and block hypothalamic gonadotropin releasing hormone (GnRH) production, blocking LH and FSH production and in turn causing infertility. Corpus luteal cysts may grow as large as 4in. in diameter. Cysts normally exist for up to 3 months and normally disappear with time or can be removed by laparoscopic surgery. Another type of functional cyst is called a corpus luteum cyst. Corpus luteum cysts occur less frequently than follicular cysts, but can be more complicated. How to tell if the cyst is corpus luteal or follicular. All is dependent on what is seen by the ultrasound, symptoms and signs. Spotting following a missed period, pelvic pain and a tender ovarian mass indicate a corpus luteum cyst. If a corpus luteum cyst ruptures the bleeding and pain may necessitate urgent laparoscopic surgery.