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Ovarian Cysts vs Polycystic Ovarian Syndrome

Although both polycystic ovarian syndrome (PCOS) and ovarian cysts have ‘cysts’ in their name, these two conditions are very different. Read on below to learn about the key differences between these conditions and symptoms you may experience. 

Ovarian cysts

Ovarian cysts are fluid-filled sacs that can develop inside or on your ovaries. Ovarian cysts are common and usually do not cause any symptoms. Most ovarian cysts resolve on their own and do not need any treatment. If an ovarian cyst is large, causing symptoms, or there is a risk it may be cancerous, then they may need to be removed surgically.

Symptoms of ovarian cysts

Ovarian cysts usually do not cause any symptoms, but you may experience some symptoms which can be vague or similar to other conditions, which may include:

    • Pain in your abdomen
    • Pain during sex
    • Painful periods or change in the pattern of your periods
    • Feeling bloated
    • Difficulty urinating or opening your bowels
    • Indigestion or heartburn

If you have any symptoms you are worried about, you should contact your healthcare provider for advice. 

Types of ovarian cyst

There are two main types of ovarian cysts; functional or pathological cysts.  

Functional ovarian cysts

Functional ovarian cysts are the most common, and these develop as part of the menstrual cycle. During your menstrual cycle, your ovaries produce several follicles (fluid-filled sacs) that will develop and grow bigger. One of these follicles will be selected to mature and release an egg. The follicle which released the egg will then turn into a structure called the corpus luteum, which releases hormones to prepare your uterus for pregnancy. If the egg is not fertilised, the corpus luteum will break down and your menstrual period will begin. 

Functional ovarian cysts can occur:

    • If the follicle is not able to release an egg but it continues growing bigger
    • Or the corpus luteum does not break down and turns into a cyst and fills with blood 

Pathological ovarian cysts are much less common and develop due to an overgrowth of cells. Ovarian cysts can be non-cancerous (benign) or cancerous (malignant), but most are not cancerous.

Polycystic Ovarian Syndrome (PCOS)

Polycystic ovarian syndrome (PCOS) is a condition that affects how your ovaries work. PCOS is common, with one in 10 women being affected. (1) PCOS has no cure, however there are treatments to help ease symptoms and improve your fertility if required. 

Symptoms of PCOS

    • Irregular or no ovulation (which causes irregular or no periods)
    • Heavy periods and longer bleeding
    • Facial hair, such as on the upper lip, chin, around nipples or below your belly button
    • Acne
    • Hair thinning
    • Being overweight or finding it hard to lose weight
    • Darker skin around neck or groin

If you have any symptoms you are worried about, you should contact your healthcare provider for advice.  

How does PCOS occur

During your menstrual cycle, your ovaries produce several follicles (fluid-filled sacs) that will develop and grow bigger. One of these follicles will be selected to mature and release an egg. In women with PCOS, multiple follicles develop and grow bigger, but none are selected to mature and release an egg. These follicles remain and can vary in size from 2mm up to 9mm (see Figure 1). Despite the name, women with PCOS have enlarged follicles instead of true cysts. The body can try to mature the selected egg a few days later, or the cycle may terminate and you begin your menstrual period.

Both ovarian cysts and PCOS share a similar name, but these two conditions are different in terms of symptoms they may cause and the science behind them.

Figure 1: Diagram comparing Ovarian cyst and PCOS

References:

  1. Rosenfield RL, Ehrmann DA. The Pathogenesis of Polycystic Ovary Syndrome (PCOS): The Hypothesis of PCOS as Functional Ovarian Hyperandrogenism Revisited. Endocr Rev. 2016 Oct 1;37(5):467–520.

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