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Masses on the Ovaries: Complex vs Simple Cysts

written by: Roohi Khan • edited by: Emma Lloyd • updated: 5/22/2011

This article provides an overview of a type of growth called a complex ovarian cyst or mass and discusses the causes, risk factors, symptoms, diagnosis, and treatment.

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    Ovarian cysts are small fluid-filled sacs that develop in a woman's ovaries and are quite common during a woman's childbearing years, that is, from puberty to menopause. They rarely occur after menopause. They are mostly harmless although they may cause rupturing, bleeding, or pain. However, in some cases these may develop complications and often these are the complex ovarian cysts or mass. This article will have a look at the causes, risk factors, symptoms, and treatment of complex ovarian cysts or mass.

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    Types of Complex Cysts

    The ovaries are two small organs located on both sides of the pelvis that produce the eggs released during the regular menstrual cycles in women. Sometimes, small sacs tend to form on the ovaries and these are called ovarian cysts. Most of them do not cause any problems and may also disappear on their own. These are simple ovarian cysts, and include types such as Graafian follicular cysts and corpus luteum cysts.

    However, there can be times when cysts keep on growing and cause excessive bleeding and twisting of the ovaries. This leads to excessive pain in the abdominal and pelvic areas. These are called complex ovarian cysts and unlike the simple ones, consist of both fluid and solid contents. There are three types of complex ovarian cysts or mass and these are:

    • Dermoid cysts (teratomas) - These complex ovarian cysts or mass are formed from the eggs produced and are often filled with pieces of bone, teeth, hair, and cartilage. They are usually benign and may grow to six inches in diameter. They may not be malignant, however, they can cause excessive pain due to twisting of the ovaries as a result of its large size.

    • Endometrial cysts - These cysts are part of the endometriosis and are formed when endometrial tissues begin growing on the ovaries. These cause chronic pelvic pain related to menstruation and are often filled with dark, reddish-brown blood. They can be as small as 0.75 inches or as large as eight inches.

    • Cystadenoma cysts - These complex ovarian cysts or mass grow on the exterior of the ovaries, often attached to their stems. They are sometimes filled with a mucus-type fluid material and can become as large as twelve inches. Due to their large size, they can rupture anytime, which is extremely painful and often requires emergency surgery.
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    Causes and Risk Factors of Complex Ovarian Cyst Masses

    Ovarian cysts occur during the process of ovulation. Before ovulation, a follicle grows and when the ovulation is supposed to happen, it breaks open and releases an egg. However, sometimes, it fails to do so and instead the fluid stays in the follicle forming a cyst. However, not much known is why some women develop simple cysts and others form a complex ovarian cyst or mass.

    Although not much is known about the risk factors behind either simple or complex ovarian cysts or mass, there are certain factors that may increase the risk of getting these tumors. These include irregular menstrual cycles, excessive upper body fat, menstruation before the age of eleven, infertility, hormonal imbalance, or treatment for breast cancer.

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    Symptoms of Complex Ovarian Cyst Mass

    The signs and symptoms of these cysts are quite similar to endometriosis. These include:

    • Pain in the pelvic and abdominal area
    • Irregularity in periods along with pain before and after the periods
    • Vaginal bleeding between periods
    • Pain during sexual intercourse
    • Nausea
    • Breast tenderness
    • Vomiting
    • Heaviness in the abdomen

    If you notice any of the symptoms mentioned above, you should make sure to consult a physician immediately. A complex ovarian cyst or mass is painful and its symptoms should never be ignored since they can prove to be fatal.

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    Complex Ovarian Cyst Mass Diagnosis and Treatment

    The diagnosis of complex ovarian cyst or mass is usually done with the help of a pelvic examination and medical history. If a routine pelvic exam shows an ovarian cyst, an ultrasound of the abdominal area can reveal whether it is a simple or complex cyst. Although these masses are not always cancerous, a physician may carry out a laparoscopic test or a cancer antigen test, especially if you have a family history of ovarian cancer.

    If your complex ovarian cyst or mass does not go away even after two to three menstrual cycles, has an unusual appearance on the ultrasound, or causes symptoms, your physician may recommend birth control pills to prevent more cysts from forming. Heat and pain-relieving medication are often prescribed for bothering symptoms. If the cyst persists even after medical treatment or the pain keeps getting worse, a surgical removal of the cyst or cystectomy may be done through laparoscopy.