What is an ovarian cyst?

If you’ve ever dealt with a particularly large and uncomfortable ovarian cyst, Hailey Bieber can relate. The founder of Rhode skincare revealed in her Instagram Story Monday that she has a cyst on her ovary that’s “the size of an apple,” sharing a photo of her stomach, which she also captioned, “not a baby,” shutting down pregnancy rumors.

An ovarian cyst is a fluid-filled sac that forms on the ovary. In many cases, they’re harmless and painless, and they’re incredibly common—most women will develop at least one in their lifetime. In some cases, however, cysts can grow quite large and become painful, and as they get bigger, there’s an increased risk a cyst could rupture.

While multiple small ovarian cysts can present with polycystic ovary syndrome (PCOS), not all people with PCOS have cysts. A specific type of ovarian cyst known as an endometrioma may also be connected to endometriosis. “I don’t have endometriosis or PCOS,” Hailey shared, “But I have gotten an ovarian cyst a few times and it’s never fun.” 

Hailey has spoken out about her health in the recent past: She was hospitalized earlier this year for a mini stroke, which doctors originally thought could have been related to a blood clot from birth control, but was eventually determined to be due to a small hole in her heart that required surgery to close. 

She was candid about how her current cyst is painful and achy and makes her feel “nauseous and bloated and crampy and emotional,” but didn’t discuss any treatment options. Large ovarian cysts may need to be surgically removed. “Anyways… I’m sure a lot of you can overly relate and understand. We got this,” she concluded. Here’s what to know about ovarian cyst symptoms, causes and treatment. 

Related: Pregnancy speculation hurts everyone—even celebrities

Symptoms of large ovarian cysts

Most ovarian cysts don’t cause any symptoms. When large, ovarian cysts can come with several unpleasant side effects as they grow in size. Symptoms may include: 

• Abdominal swelling or bloating
• Pelvic pain
• Painful sex
• Painful bowel movements
• Lower back pain
• Breast tenderness
• Nausea and vomiting

Related: A new gene identified for endometriosis may lead to more effective treatment

Causes

There are several types of ovarian cysts. Two types known as functional ovarian cysts may form each month as a normal part of the menstrual cycle. One type are follicles that produce estrogen and progesterone and release an egg during ovulation. If the follicle doesn’t break open to release the egg, the fluid inside can form a “cyst-like structure” on the ovary. 

Similarly, a corpus luteum cyst can form after ovulation. The corpus luteum is a small cluster of cells that produce progesterone to support a pregnancy. If the egg released isn’t fertilized, the corpus luteum will start to decay. If instead it fills up with fluid, it can form a cyst. 

Functional cysts are relatively harmless and can disappear on their own after two to three menstrual cycles. Other types of cysts, such as dermoid cysts, may contain embryonic cells or biological material such as teeth or hair. Cystadenomas are fluid-filled cysts unrelated to the menstrual cycle that can develop on the outside of the ovary, while endometriomas are cysts formed when uterine tissue that grows outside the uterus (as seen in endometriosis) attaches to the ovary.

Complications

In some cases, large cysts can pull on the ovary itself and cause ovarian torsion, cutting off blood supply to the ovary. Large cysts also can rupture, causing internal bleeding. Both scenarios are dangerous medical conditions requiring urgent treatment.

Symptoms of ovarian torsion or ovarian cyst rupture may include:

• Sharp or severe pelvic pain
• Fever 
• Dizziness and feeling faint
• Rapid breathing or shortness of breath

The majority of ovarian cysts are benign and don’t require treatment in that they’ll go away on their own in a few weeks or months, but in rare cases, a cyst could be cancerous. Your doctor may order a blood test to screen for ovarian cancer, while an ultrasound or other diagnostic scans can determine the type, size, composition and location of the cyst to best inform your treatment options. 

Treatment

Because functional cysts likely will vanish on their own and won’t impact your future fertility, in most cases no treatment is needed. However, if a cyst grows so large that it could cause your ovary to move or twist, or is at risk of rupturing (both of which could impact fertility), your doctor may recommend surgical removal of the cyst. 

Taking oral contraception to stop ovulation may also be recommended to prevent new cysts from forming, but hormonal birth control won’t shrink an existing cyst. 

Related: Amy Schumer says she ‘finally’ feels good months after endometriosis surgery

Prevention

While there’s no way to prevent a cyst from forming, tracking your cycle can be key to determining if any pelvic pain you’re experiencing is related to menstruation or if it’s something separate from your cycle. Noting how your cycle length and flow changes month to month can help pinpoint any issues with ovulation, too. It’s also important to keep up with your annual well-woman checkup, as regular pelvic exams can help to identify a potential cyst before it gets too big.