Can you feel an ovarian cyst from the outside?

 Key takeaways

• Ovarian cysts are fluid-filled sacs that develop within or at the edge of the ovaries. They can be functional or pathological.
• You often cannot feel an ovarian cyst from the outside (on the abdomen) except in cases of large-sized cysts. The diagnosis of this condition is mostly made after a positive imaging result, like that of an ultrasound.
• Ovarian cysts can lead to some complications, such as ovarian torsion, cyst rupture, and ovarian hemorrhage. 

An ovarian cyst is a fluid-filled sac that develops within or at the periphery of an ovary (an almond-shaped female reproductive organ positioned on both sides of the uterus). The ovaries are responsible for releasing an egg (also called an ovum) every menstrual cycle (during ovulation) and also produce reproductive hormones like estrogen and progesterone necessary for regulating the menstrual cycle. 

Ovarian cysts can develop at any stage in a woman's life, but they are more common among those in their reproductive age. An estimated 10 out of 100 women have ovarian cysts, and about 20% of women are presumed to have a pelvic mass in their lifetime—which could be a cyst or a solid mass.

Ovarian cysts often do not cause any symptoms except in cases where the cyst is infected, large, or complicated, e.g., in cases of ovarian torsion or rupture.  

 Can you feel an ovarian cyst from the outside?

"Ovarian cysts cannot be felt from outside, i.e., by touching or feeling the abdominal area," says Oluwatobi Oni, (MBBS), a gynecologist at the Federal Teaching Hospital in Lokoja, Kogi State, Nigeria. "However, in cases of a large-sized cyst (about 10 cm and above), you might feel a lump-like mass on the affected side, but this finding is not definitive of an ovarian cyst".

Since you typically can't tell whether you have an ovarian cyst or not by feeling your abdominal or pelvic area, it is important to speak to a doctor and run appropriate tests, e.g., ultrasound, for a proper diagnosis and treatment

 Types of ovarian cyst

Ovarian cysts are of different types. They can be functional or pathological.

 1. Functional ovarian cyst

This is also called a physiological ovarian cyst. It results from the normal activities of the ovary. It is of two types:

• Follicular cyst

In every menstrual cycle, the ovary produces immature eggs encapsulated in a follicle. In response to the follicle-stimulating hormone (FSH) and luteinizing hormone (LH), a follicle matures and releases its egg into the uterus (ovulation). In a follicular ovarian cyst, the follicle does not release its egg. It keeps growing and forms a cyst. This usually resolves after 3–4 menstrual cycles. Therefore, it's harmless and poses the individual no risk.

• Corpus luteum cyst

When a follicle releases an egg, it becomes the “corpus luteum,” which produces progesterone to support pregnancy until the placenta takes over this function. When this happens, the corpus luteum gradually shrinks and dissolves. This shrinkage also occurs when fertilization does not occur.

In the corpus luteum cyst, the corpus luteum does not dissolve. It closes up, continues growing, and eventually forms a cyst. This type of cyst is common among pregnant women and usually resolves by the end of the first trimester.

 2. Pathological ovarian cyst

This type of cyst results from the abnormal functioning of the body. It can cause pain and other symptoms. If not properly managed, it may lead to a more severe condition. The types include:

• Dermoid cyst

Dermoid cysts, also called teratomas, develop from the reproductive cells of the ovary. This cyst comprises different types of tissues in the human body, e.g., skin, hair, and teeth.

• Endometriomas

Endometriomas, also called chocolate cysts, are commonly seen in people with severe endometriosis, a condition where the tissues lining the inner layer of the uterus are found outside the uterus. These tissues can embed in the ovary to form cysts called endometriomas.

• Cystadenomas

This cyst usually grows on the surface of the ovary and may be filled with thin, watery, or thick, mucus-like fluid.

• Polycystic Ovarian Syndrome (PCOS)

PCOS is a disorder of hormones that mostly affects women in their reproductive years. It usually presents with multiple cysts at the edge of the ovary. However, the cyst isn't the only diagnostic criterion.

 How can you tell you have cysts? Can you feel cysts on your ovaries?

Ovarian cysts don't always cause any symptoms. However, in people who do experience symptoms, they may feel pain on the affected side or the lower abdomen. "The pain most likely results from infected cysts. In this case, the pain may be accompanied by some gastrointestinal discomforts like nausea and vomiting", says Dr. Oni.

"One can hardly tell if there's a cyst in the ovary without proper investigation," he adds.

Because of the asymptomatic nature of most cysts, ovarian cysts are usually found during routine medical check-ups, especially during imaging investigations like ultrasound and laparoscopy.

When a cyst does not cause any harm to an individual, the treatment is mostly conservative, usually called "watch and wait." During watch and wait, your doctor subjects you to regular investigations to monitor the cyst. In most cases of functional cysts, they typically resolve after 3–4 menstrual cycles.

However, if the cyst isn't physiological, there's a high chance it won't resolve and will probably increase in size. In this situation, your doctor may suggest commencing active treatment, which usually involves surgical removal of the cyst and other medications.

 What causes ovarian cysts?

Although ovarian cysts can result from physiological factors, other factors can contribute to their development. They include:

• Hormonal treatment: Some hormonal treatments that stimulate ovulation may lead to the development of follicular cysts, e.g., Clomiphene.
• Pregnancy: Corpus luteal ovarian cysts are more common in pregnancy because, in some cases, the corpus luteum does not dissolve.
• Severe pelvic infection: Infection can spread to the ovary, causing the development of ovarian cysts.
• Endometriosis: The tissues of the inner lining of the uterus may embed in the ovary, causing endometrioma.

 Can you feel an ovarian cyst rupture?

You cannot feel when an ovarian cyst ruptures. However, some symptoms are suggestive of a ruptured ovarian cyst. They include:

• Sudden sharp pain in the pelvic area or abdomen
• Bloating
• Nausea
• Vomiting
• Fever
• Dizziness
• Bleeding may or may not be present

If you have an ovarian cyst and start experiencing the above symptoms, it's best to see your doctor.

 How often can ovarian cysts rupture?

For physiologic ovarian cysts, rupture is very common, and this usually does not cause any harm to the person. However, for pathologic cysts, the frequency of ovarian cyst rupture can hardly be ascertained.

Nevertheless, the size of the cyst and how fast it grows can determine how often a cyst ruptures, i.e., the bigger the cyst and the faster the development, the more likely it is to burst soon.

 Possible complications of ovarian cysts

Untreated or poorly managed ovarian cysts can lead to the following complications:

• Ovarian torsion: The weight of the cyst may cause the ovary to twist, thereby preventing blood flow to the ovary and leading to the death of the affected ovary if not attended to immediately. This is usually seen in large-sized cysts. Ovarian torsion can present with severe pelvic pain.
• Ovarian rupture: Ovarian cysts may grow so big that they burst and spill their contents. This may lead to infection, which can present with pain and fever.
• Hemorrhage: In certain cases, an ovarian cyst can lead to hemorrhage (bleeding from a ruptured blood vessel), in which case it is called a hemorrhagic ovarian cyst. The cause of this is unknown. However, it can be due to a rupture of the cyst.

These complications are usually treated as medical emergencies and mostly require surgical interventions.

 Seeking medical attention: When to see the doctor

Medicine always recommends routine medical check-ups. This is important because most disease conditions are found during check-ups, including asymptomatic ovarian cysts.

However, some symptoms that are suggestive of ovarian cysts or their complications may require immediate medical attention. Some of these include:

• Severe lower back pain, abdominal pain, or pelvic pain
• Pain while urinating or defecating
• Bloating or other gastrointestinal discomforts
• Pain during sexual intercourse
• Persistent fever
• Vaginal bleeding
• Dizziness
• Nausea and vomiting

Although these symptoms are not definitive of an ovarian cyst, having your body examined can help in the proper diagnosis and treatment.

 Conclusion

Ovarian cysts are common in women of childbearing age, and you can often not tell if you have them by self-diagnosis or by feeling the area in your abdomen.

The most common type of ovarian cyst is the physiological ovarian cyst, and it requires no treatment. However, some pathological cysts can cause discomfort and may lead to complications if left untreated.

The treatment of ovarian cysts depends on the type and size of the cyst, as well as the age of the person. Premenopausal and postmenopausal treatments of ovarian cysts differ. Therefore, it's important to visit the doctor and discuss the best treatment options for you.