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Expert Q&A

What are the potential problems with ovarian cysts?

Asked by Jane Coles, Virginia

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I was recently diagnosed with polyps on my ovaries. Is this a serious condition? What are the risks and how concerned should I be about potential problems?

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Living Well Expert Dr. Jennifer Shu Pediatrician,
Children's Medical Group

Expert answer

Thanks for your question. In general, masses on the ovary are called cysts while growths on the cervix or uterus tend to be called polyps. Ovarian cysts are fairly common in women and often do not cause any symptoms at all, however, they sometimes can cause pain or pressure in the pelvic area. These cysts typically do not affect menstrual bleeding.

For more information about your specific condition and whether you can expect any serious problems, I encourage you to talk more with your doctor. To describe pelvic masses in general, I consulted with Dr. Jennifer Gunter, an OB-gyn at Kaiser Permanente in San Francisco, California, and author of the forthcoming book "The Preemie Primer: A Complete Guide for Parents of Premature Babies -- from Birth through the Toddler Years and Beyond." She shared the following information:

The expected course of ovarian cysts varies with a woman's age, the size of the cyst, whether there is a family history of ovarian cysts, and whether the cyst is fluid-filled, appears to be a solid mass of tissue, or has both fluid and solid components. Small fluid-filled cysts are part of the normal functioning of the ovary. A developing egg looks like a small cyst and after ovulation the corpus luteum that is left behind can also look like a cyst. Women who have polycystic ovarian syndrome may have many small cysts at one time.

On the other hand, cervical or uterine polyps are overgrowths of tissue. Cervical polyps can usually be seen during a pelvic exam (they typically have no symptoms, but can sometimes cause spotting between periods). Cervical polyps are almost always harmless, with the risk of cancer being less than 1 percent. Cervical polyps are typically removed only if they are large, causing irregular bleeding, or if there is an abnormal Pap smear or a persistently positive HPV (human papillomavirus) test. Removing a cervical polyp is a relatively simple procedure that can be performed in the office.

A uterine polyp is an overgrowth of the lining of the uterine cavity (called the endometrium). They can cause irregular spotting between periods or they may be asymptomatic. Endometrial polyps are typically identified during the evaluation of abnormal bleeding and may be found either on ultrasound or by endometrial biopsy, an office procedure that samples the lining of the uterus. Endometrial polyps are removed to treat the abnormal bleeding but also because of the potential risk of cancer. For women between the age of 25 and 45 this risk is less than 5 percent; between the ages of 45 and 65 the risk that an endometrial polyp will contain a cancer is about 9 percent and over the age of 65, 32 percent of endometrial polyps will be cancerous.

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