You may have seen Hailey Bieber posting about her ovarian cyst "the size of an apple". She shared the image of her stomach, explaining that she's suffered from the condition before and how "it's painful and achey and makes [her] feel nauseous and bloated and crampy".

If anyone has suffered from an ovarian cyst, they'll know this feeling well. But unfortunately, there's not much information out there and lots of people don't what to do if you have one or if you think you have one. Ovarian cysts can also be mistaken for other health conditions like IBS (Irritable Bowel Syndrome), bloating or discomfort. Sometimes they're associated with painful periods or painful sex.

Dr. Gidon Lieberman, our Medical Director, advises that "if an ovarian cyst doesn't go away or you have symptoms, then you need to take action." To help you out, we've put together an overview answering the most frequently asked questions:

• What is an ovarian cyst?
• What should you do if you think you have one?
• How do you treat ovarian cysts?
• How can an ovarian cyst impact your fertility?

What is an ovarian cyst

An ovarian cyst is a fluid-filled sac that develops in the ovary. Typically they don't cause any symptoms and aren't something to worry about - unless they don't go away. An ovarian cyst will only cause symptoms if it splits, is very large, or blocks the blood supply to the ovaries. Larger cysts pose higher risks, as they can rupture more easily, leading to potential blockages and abdominal discomfort.

Ovarian cyst symptoms can include abdominal pain, pelvic pain, a frequent need to urinate, heavy periods, light periods, irregular periods, bloating, and a swollen tummy. In some people it might cause a dull ache or in others it can be a sharp pain, some people might also experience pain during sex. Most ovarian cysts will go away by themselves in a few months, without needing any treatment.

There are some risk factors for ovarian cysts. Namely if you have medical conditions like endometriosis - especially if endometrial tissue is in or around the ovary -, pelvic infections which spread to the ovaries, abnormal hormone levels, or hormonal changes such as taking fertility drugs. 

Some people with ovarian cysts will also have a condition called Polycystic Ovarian Syndrome (POCS), however, and if you have an ovarian cyst it does not necessarily mean you also have PCOS. Polycystic Ovary Syndrome is a complex condition and people with it also often have hormone imbalances and irregular menstrual cycles. 

Read more about PCOS 

What should you do if you think you have one

Our clinical team suggests visiting your doctor or GP if you have any of these symptoms. In most cases, if it is an ovarian cyst, your doctor will advise what's known as “watchful waiting”. This means that you might not need treatment right away, but you'll probably have an ultrasound scan a few weeks or months later to check that the cyst has gone. If you have a simple ovarian cyst, your doctor might recommend going on the birth control pill for a few months to see what happens with it. There are lots of different types of cysts which all have different treatments.

If you've been through menopause, you'll be advised to have a pelvic ultrasound and blood tests approximately every 4 months. This is because postmenopausal women have a slightly higher risk of developing ovarian cancer, so these ultrasounds will monitor for abnormal cell growth. If the cyst has disappeared, you won't need further tests or treatment unless your doctor thinks it is necessary. If the cyst is still there, you might need surgery to treat it.

If the pain causes you to vomit, you have sudden pain that is severe, or you're experiencing pain that goes down the back of your leg, seek urgent medical attention as soon as possible as this could be a medical emergency.

How to treat ovarian cysts

If the cyst doesn't go away by itself or is causing symptoms, it might need to be surgically removed. There are two types of surgery used to remove ovarian cysts:

• A laparoscopy surgery: This is keyhole surgery and the most common way to remove an ovarian cyst. Small cuts are made in your tummy and the surgeon will remove the cyst through those small cuts in your skin.
• A laparotomy surgery: This is a single cut that's made into your tummy to give the surgeon better access to the cyst. It's usually used if your cyst is very large or there's a chance it's cancerous.

Everyone recovers from surgery in their own way and it may take some time to return to your normal activities. You'll probably feel pain in your tummy but this should improve after a few days. You should contact your GP as soon as possible if you have heavy vaginal bleeding, severe pain, a fever, or dark or smelly vaginal discharge because these signs can mean you have an infection.

How an ovarian cyst can impact your fertility

If you've not been through menopause, your surgeon will be careful to make sure your reproductive organs don't get damaged by the surgery. If one of your ovaries needs to be removed, your second ovary will release hormones and eggs as usual. Your fertility shouldn't be impacted, but it might be harder to get pregnant.

If you need to remove both ovaries, it will trigger early menopause as you will no longer produce any eggs. It might still be possible to get pregnant using a donor egg. Make sure you discuss your fertility concerns with your surgeon before your operation. If you're worried about your fertility being affected by ovarian cysts or ovarian surgery and you're a patient of Fertifa, message one of our clinical team members who will be happy to speak about your options. If you're not a patient of Fertifa, we'd recommend speaking to your GP or getting in touch with a fertility clinic that specialises in assisted reproduction techniques.

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