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Functional Ovarian Cysts: Etiology, Clinical Symptoms and Treatment


Ovarian cysts are defined as fluid-filled sac-like swellings which occur as a result of ovulation and blood circulation to the ovaries. Essentially, they involve adnexal masses, which may also be considered pelvic growth. There are numerous sub-clusters of functional ovarian cysts among women of reproductive age, including follicular, corpus luteum, hemorrhagic, and theca lutein cysts. These inflammations have the potential of being malignant among those who showcase them in a lifetime. Nonetheless, functional ovarian cysts have unique attributes such as pelvic pain, rupturing cysts, ovarian turning, and blood loss, all of which require prompt intervention.

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Although the cysts involve a broad series of growths that may be temporary or long-lasting, the etiology may range from normal physiology for follicular or luteal cysts to the ovarian section’s malignancy. The lumps are potentially dominant during the reproductive age, but the prevalence elevates during menstruation periods. A functional ovarian cyst may form as a result of a small alteration in the release of an egg from the ovary or hormonal imbalance. The follicular type emanates from the ovary’s failure to release an egg, filling the sac with fluid. Ideally, the follicles fail to rupture and block the ovum’s physiological release because there is an over-stimulation of FSH or no LH. The luteal category originates from the regular release of an egg, but the sac reseals to block the fluid that causes it to bulge. The corpus luteum has a life span of 14 days and continues to release progesterone hormone in the case of fertilization (Ayub, Ruzic, & Taylor, 2017). Likewise, the Theca Lutein Cysts occur because there are elevated human chorionic gonadotropin (hCG) levels in the body that promote overstimulation and alter the hormonal balance and cause luteinized follicle cysts.

Risk Factors

The key risk factors involve hormonal concerns and lifestyle decisions. The treatment of infertility is one of the leading predisposing circumstances that include the use of gonadotropin or ovulation-inducers. The management procedure may promote hyper-stimulation of FSH or LH, which heightens the chances of cyst development. Likewise, the gestation period, pregnancy may also be a risk concern in itself because the body tends to produce more hCG during the second trimesters and stands a chance of peak productivity of such hormones (Khandheria & Pandya, 2019). At the same time, women with hypothyroidism may also encounter elevated gonadotropin levels, which cause severe cysts with the potential of resulting in death. Some lifestyle choices such as smoking cigarettes may cause the body to release unnecessary chemical hormones associated with malignant growths.

Clinical Symptoms

In many instances, most of these functional ovarian cysts do not cause any notable symptom within the woman’s body. However, as the cysts grow, it tends to send significant signals to the body system’s functionality, which may include: lower belly pains amidst the menstrual cycle; delayed ovulation cycles; vaginal bleeds even when one is not menstruating. Nonetheless, it is possible to experience ruptured cysts, in which case; the symptoms may range from rapid change in everyday sexual experience; instead, the woman will have sharp pain experienced during sexual intercourse. Other implications may involve heavy bleeding, severe pain, and general sicknesses.

Relevant Laboratory Values

The management of functional ovarian cysts requires critical understanding and interpretations of the laboratory set values for hormonal functionality. According to Ayub et al. (2017), some of the relevant include the range of FSH and LH in the body during examination. Essentially, a normal woman’s body should possess 0.1–7.1 mIU/mL of FSH and 0.1–3.3 mIU/mL of LH under regular ovulation cycles (Ayub et al., 2017). Likewise, the thyroid-stimulating hormone (TSH) values should range between 0.27–4.20 mIU/mL during the examination. Together with other essential hormones, any patients showcasing values outside the laboratory-established figures may have the symptoms of any of the cysts because of altered hormonal balance or stimulation (Ayub et al., 2017). Therefore, females need to visit their gynecologists at any age frequently to avoid complications.

Sonographic Appearance

The transvaginal evaluation of the Sonographic appearance of cysts indicates that they keep changing over time, depending on the stage and predisposing factors portrayed by the patient. Sometimes the cysts may appear to have distributed single loci to indicate dominant growth. Likewise, others may appear to have daughter cell cysts to showcase the spontaneous existence of numerous lumps. The ultrasound may help to identify the capacity of the growth to become malignant in the end. Different studies indicate varying trends in the physical appearances of cysts. Ultrasonography helps to establish both the status and location of these fluid-filled sacs. A survey by Tyraskis, Bakalis, David, Eaton and De Coppi (2017) highlights that the standard measurement of functional cysts may vary from 3 to 12 cm depending on growth level. Likewise, many of the tumors are thin-walled, predominantly unilocular to allow sufficient enlargement with the potential of solid components (Tyraskis et al., 2017). Therefore, understanding the cyst’s sonographic appearances is fundamental in helping the doctors make the right decision during treatment and management.


Different treatment and management options exist to help the patient handle these conditions. Depending on the age and the health status, as well as the characteristics of the cyst, doctors can recommend various remedies to help the patient. However, most of these cysts, unless malignant, tend to heal on their own. One of the most effective techniques of handling patients with sizeable unilocular cysts involves clinical observation and monitoring using vaginal ultrasound equipment. Such a method requires critical care and expertise to help monitor and evaluate the progress of the condition. Likewise, the procedure allows distinguishing between functional and other types of cysts.

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Pregnancy-associated cyst tends to resolve during the third trimester as the hormonal production reduces. Simultaneously, the follicular type and corpus luteal will resolve between 14 and 16 weeks of the prenatal period unless they have grown more than 5 cm (Khandheria & Pandya, 2019). Predominantly, the primary medication should include sonograms and endometriomas. Nonetheless, the endocrine etiology is crucial in establishing these cysts’ nature and may help doctors prescribe the most effective management alternative to help the clients manage the conditions even at home. Gynecologists have the obligation of engaging women of all ages to ensure that any growth is identified at the onset to avoid malignancy.


To conclude, most functional cysts can resolve themselves with good care from the patient because they involve hormonal adjustments. Although many of the functional cysts tend to resolve by themselves during ovulation and pregnancy, critical care and nutritional adjustments are needed to ensure proper recovery among the patients. All females can be vulnerable to these conditions once in a lifetime. Hence, there is a need to provide an appropriate lifestyle and hormonal distress management strategies to prevent any change in reproductive health.


Ayub, S. S., Ruzic, A., & Taylor, J. A. (2017). Ovarian cysts, vaginal bleeding, and hypothyroidism in a 4-year-old female with down syndrome: A case of Van Wyk-Grumbach syndrome. Journal of Pediatric Surgery Case Reports, 25, 5-9. Web.

Khandheria, K., & Pandya, M. (2019). Study of injection placentrex on ovarian cyst. Indian Journal of Obstetrics and Gynecology Research. Web.

Tyraskis, A., Bakalis, S., David, A. L., Eaton, S., & De Coppi, P. (2017). A systematic review and meta‐analysis on fetal ovarian cysts: Impact of size, appearance, and prenatal aspiration. Prenatal Diagnosis, 37(10), 951-958. Web.

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