Ovarian Cysts
Ovarian cysts may be small and cause no symptoms, or very large and subject to complications such as torsion (where the cyst twists and interferes with its blood supply) causing severe pain or haemorrhage. There are a number of different types: follicular cysts are usually four to five centimetres in diameter and commonly occur during treatment for infertility; endometriotic cysts (see endometriosis in the uterus under the genitalia section) contain altered blood which looks like chocolate, and so are called chocolate cysts. Mucinous cystadenomas can be very large indeed, and contain fluid which is thick, called mucin; serous cystadenomas can be equally large, may affect both ovaries and may be difficult to differentiate from malignant ovarian tumours. Cysts arising from germ cells - called cystic teratomas or dermoid cysts, are more common in younger women and usually contain a mixture of tissue such as skin and bone, reflecting the potential of germ cells to make any tissue. While follicular cysts may regress, the treatment for other cysts is surgical removal. If the patient is over the age of 50 removal of the whole ovary may be the best approach; in younger women who wish to retain their fertility then, if possible, it might be better to remove only the cyst.
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