Advanced Endometriosis Center NJ

Advanced Endometriosis Center NJ is one of the leading endometriosis treatment place in NJ areas.

No other organ in the female body—or even the human body—can has as many different types of cysts as your ovary. The most common type is the follicle in which you mature an egg every month in preparation for its release, called ovulation. After an egg is released from the follicle, this tissue is either resorbed or is hormonally stimulated to function in making progesterone to support a pregnancy, depending on whether that released egg is fertilized or not.

Calling a follicle a “cyst” is a stretch, because the definition of a cyst—being a collection of fluid more than 2 cm in diameter—does not really qualify the less-than-two-centimeter follicle as one. Thus, it’s just arithmetic. Any follicle bigger than 2 cm is called a cyst, but most of them aren’t. And even if a normally functioning follicle were to be slightly larger than 2 cm, its fate is the same as any follicle less than that. It’ll be history with the next cycle.

So, does calling something an ovarian cyst have any meaning?

The real relevance is when a cyst is other than a normally functioning follicle:

• Precancerous cyst (“cystadenoma,” benign cyst)
• Cancerous cyst (“cystadenocarcinoma,” malignant)
• Polycystic ovaries (runaway cyst formation)
• Genetic cyst (“teratoma,” when embryonic tissue types grow in the ovary; sometimes they can be malignant, or even function like the tissue of which it is made—e.g., thyorid)
• Hemorrhagic cyst (when bleeding from a normal ovulation can collect within your ovary)
• Chocolate cyst (collection of endometriosis within your ovary)
• Other rare types of malignancies

What kind of cysts can cause pain?

Your ovary can generate pain in one of two ways:

1. A cyst can make your ovary heavier.

Your ovary hangs on a stalk that is rich in sensitive nerve endings that can create pain for you if that stalk is tugged upon. This can happen if your ovary becomes heavier than normal because of a cyst. (Follicles aren’t usually heavy enough to tug that hard.)

2. The lining over your ovary is very sensitive: this lining is the same as the lining surrounding your abdominal cavity, called “peritoneum.” Peritoneum can generate pain if stretched, as it is if the size of your ovary expands with increased size of a cyst within it; peritoneum can also provoke pain if inflamed, which can happen over your ovary due to endometriosis or infection.

Thus, any cyst which makes your ovary bigger or heavier or which is involved in an inflammatory process can give you pain.

What kind of pain does an ovarian cyst cause?

Pain can present in different ways from your ovaries. Since they are bilateral organs, they can cause you pin-point right-lower-quadrant abdominal pain or left-lower-quadrant abdominal pain. This pain can extend into your inguinal areas. If rupture of a cyst causes blood to leak into your pelvis, that pin-point pain will be replaced by a vague, burning sensation corresponding to where the blood settles—usually all over.

Bleeding from normal ovarian function can happen like this, but it is usually self-limited and harmless—just inconvenient for a day or so. It is not dangerous.

But this brings up an important point:

Normal function that causes pain should see that pain go away within a couple of days.

Lingering longer than that is a red flag that a cyst is being caused by something other than normal functioning. An ovarian cyst specialist like Dr. Ulas Bozdogan at NJEndometriosis can easily make that determination.

What if an ovarian cyst is other than normal-functioning?

It would probably need to be seen to, with close observation or—if indicated—a surgery to assess/address it. An ultrasound can usually help distinguish those that only need watching from those that need to be dealt with. Fortunately, today’s minimally invasive (and robotic) laparoscopic surgery like the kind Dr. Bozdogan performs can get you an answer from a cosmetically-sensitive same-day “band-aid” surgery. This allows a definitive diagnosis, but in the hands of an experienced expert like Dr. Bozdogan, it also allows treatment—either by draining or removing a cyst for study under a microscope.

What kind of cyst can cause infertility?

Remembering the purpose of your ovary for producing eggs in preparation for fertilization and pregnancy, anything that gets in the way of that normal functioning will change the monthly cycle and with it, ovulation, even to the dysfunctional point of infertility.

• Follicular cyst: when, for some reason, you don’t ovulate, and your ovary gets “stuck” in the first half of your cycle (the “pre-ovulation” half). If that happens, of course, you don’t ovulate, so there’s no chance of pregnancy. Such a cyst can linger for a month or two, but will usually jump-start itself over time back into a normal ovulation cycle. In the meantime, you may experience irregular bleeding.
• Corpus luteal cyst: this is a variation within your cycle in which you get “stuck” in the second half of your cycle, effectively preventing ovulation for the next cycle, with the same self-limits and resumption of function seen with follicular cysts [ABOVE].
• Choclate cyst: An endometriosis cyst (“chocolate cyst”) is more of a case of having endometriosis instead of just a cyst. Endometriosis tissue is bloody, which causes inflammation that can alter ovarian function. This is likely to continue indefinitely until the endometriosis is treated with minimally invasive laparoscopic/robotic surgery. But a chocolate cyst is really a “co-conspirator” in your infertility—because the endometriosis anywhere in your pelvis interferes with fertilization from inflammatory chemicals it releases and by causing mechanical blockage and kinks in your tubes from scarring, preventing fertilization.

When should you call your gynecologist?

When your period is late due to a cyst, the first thing you need to do is have a pregnancy test to make sure it isn’t that. When that comes back negative, you should call your gynecologist for any sever pain that puts you in bed, causes painful intercourse, or makes you nauseated. Irregular bleeding with pelvic pain usually means the pain is part of a process that involves your ovary or ovaries, so irregular bleeding + pain usually requires an evaluation from your gynecologist.

Can something other than an ovarian cyst cause infertility?

• Anything that causes scarring, such as a gonorrhea, chlamydial, or other infection can block your tubes.
• Hormonal interference with your cycle, such as thyroid disorders, changes due to obesity, or even abnormalities in your brain (hypothalamus and pituitary gland problems).
• Medications can disrupt the fertility properties of your cycle.

What type of gynecologist should you see?

You should see a pelvic surgeon who has vast experience with minimally invasive and robotic surgery, like Dr. Bozdogan at NJEndometriosis. Seeing an expert in endometriosis, as well as in dealing with ovarian cysts, means you will get the minimum of medical (or surgical) intervention as is needed and nothing more. This is important when dealing with ovarian cysts, in which you want to leave a surgery with as much reproductive tissue as you went in with…or, rule out the need for surgery altogether.

Dr. Bozdogan has done thousands of these types of surgery for women for whom fertility and/or their quality of life depends.