Fibroids and Ovarian Cysts
Uterine fibroids and ovarian cysts are both common women’s health issues that pertain to the reproductive organs. Many people are unsure of the difference between fibroids and cysts, and they share many common symptoms, but they are two different medical issues with unrelated causes, different complications, and different treatments. Fibroids and cysts can sometimes affect a woman’s fertility.
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How Are Fibroids and Ovarian Cysts Different?
Fibroids grow within or on the uterus, while cysts develop on the ovaries. They are different in composition as well. Cysts are sacs filled with fluid that form on the outside of the ovary, and fibroids are composed of the same smooth muscle cells that make up the uterus wall and fibrous connective tissue.
Ovarian Cysts
- Follicle cysts: normally, during the menstrual cycle, the ovary releases an egg every month. This egg is grown inside of a tiny sac called a follicle, and when it matures, the follicle breaks open and pushes the egg out. If the follicle does not force the egg out, the follicle fills with fluid and grows into a cyst. Most often, there are no symptoms associated with follicle cysts, and they go away without any treatment.
- Corpus luteum cysts: when the follicle pushes out the egg, the empty sac is supposed to shrink into a cell formation called a corpus luteum. This corpus luteum produces hormones in preparation for the next menstrual cycle and a new egg. If the empty sac does not shrink but seals itself up instead, fluid will build up inside and form a cyst. Most corpus luteum cysts will go away on their own in just a few weeks, but some can grow quite large, bleed or twist, and can cause pain.
Less common types of benign ovarian cysts include:
- Endometrioma cysts form when tissue from the endometrial grows into the ovaries. These cysts are normally filled with old menstrual tissue and blood and because they are dark brown in color they are also called chocolate cysts.
- Dermoid cysts are present from birth, are not cancerous, and do not usually cause symptoms.
- Cystadenoma cysts are filled with thick mucus-like gel or watery fluid and are usually attached by a stalk-like stem to the outside of the ovary.
Polycystic Ovary Syndrome can cause fertility issues and is a condition where the ovaries create several small cyst-like growths.
Even though cysts that are cancerous (malignant) are rare and seen more in older women, ovarian cysts should be examined by your OB-GYN to determine which type of cysts you have to determine the type of treatment necessary.
Uterine Fibroids
Uterine fibroids are tumors that grow in and on the uterus and affect between 70-80% of women before they reach the age of 50. They most often occur in women of childbearing age, and statistics show that they affect African American women 2-3 times more than Caucasian women. There is no exact known cause of fibroids, but research has linked excess estrogen, vitamin D deficiency, obesity, and genetics to the probability of developing them.
Fibroids can be as small as a tiny bead or as large as a huge melon, and a woman can have one fibroid or several. They can grow in different locations within the uterus, can change the shape of the uterus, and even protrude outward into the abdomen, causing the woman to look pregnant. Fibroids are classified by where they are located within the uterus and can grow directly attached to the uterus or grow from a stem or stalk.
Types of uterine fibroids include submucosal, subserosal, intramural, and cervical.
- Intramural fibroids are the most common type of fibroid and grow in the wall of the uterus and can cause mild to severe symptoms including stretching the uterus if they grow large enough.
- Subserosal fibroids grow toward the outside of the uterus on the outer lining and normally do not produce significant symptoms unless they are large.
- Submucosal fibroids are the rarest type of fibroids that grow in the inner layer of the uterus, but can protrude inside the uterine cavity and can affect fertility.
- Pedunculated fibroids are a variation of subserosal or submucosal fibroids that are not directly attached to the uterus but grow from a stalk or stem.
How Do I Know If I Have Fibroids or Cysts?
Uterine fibroids and cysts are different conditions but do share some common symptoms, so self-diagnosing the difference would most likely not be possible. A doctor can often determine the presence of cysts and fibroids through a pelvic exam or an ultrasound. An MRI is the best test to show more detail and would reflect the size and location as well.
Symptoms of Fibroids
- Abnormally heavy, which may also be prolonged, lasting longer than 8 days.
- Breakthrough bleeding between periods.
- Large fibroids can press on your bladder and urinary system, causing frequent urination and incontinence.
More serious fibroid symptoms:
- Twisted fibroids: In rare cases, a pedunculated fibroid (one that is growing from a stem) can suddenly become twisted, causing sharp stabbing pain in the area where it is growing. Similar to the torsion treatment for ovarian cysts, fibroids that are twisted require immediate medical attention.
- Kidney Issues: if fibroids push on the ureter (the tube linking your bladder and kidneys), you might develop a condition called hydronephrosis, which is a severe swelling of the kidneys. This can cause painful urination, back and side pain, having to make frequent trips to the bathroom, and sometimes kidney damage.
- Anemia: untreated fibroids can lead to anemia because they can cause heavy or prolonged periods and bleeding between periods. Losing too much blood depletes your body of the iron-rich red blood cells that your body critically needs.
Symptoms of Cysts
Most ovarian cysts are harmless (benign) and do not cause any pain. They might not cause any symptoms, so you may not even know you have a cyst unless it’s discovered during a routine pelvic exam or an imaging test.
Around 10% of the time, ovarian cysts cause problems, including:
- Pain in your pelvis or a constant dull ache in your lower back.
- A sense of fullness or bloating in your lower abdomen is often more noticeable on one side.
- Discomfort or pain during sex.
- Menstrual periods that are especially painful.
More serious symptoms:
- Ovarian torsion, caused by the displacement of the ovary due to twisting
- Ovarian rupture normally manifests as a sudden, intense pain on one side of the abdomen and often causes fever and/or vomiting. A ruptured cyst can create severe abdominal pain and swelling, and cysts that grow large have a higher chance of bursting.
Shared Symptoms of Cysts and Fibroids
- Pelvic or abdominal pain or pressure;
- Bloating or protruding abdomen;
- Lower back and leg pain;
- Constipation;
- Frequent urination or difficulty urinating;
- Pain during sex;
- Weight gain that is unexplained.
Which Condition Is More Dangerous: Cysts or Fibroids?
Because neither uterine fibroids nor cysts is usually cancerous, neither condition is particularly dangerous. However, they each can produce painful symptoms that initiate a medical emergency.
Ovarian Cysts Can Cause Complications
Functional cysts often burst without any harmful side effects, but sometimes a ruptured cyst can create severe abdominal pain and swelling. Cysts that grow large have a higher chance of bursting.
Sometimes cysts can grow so large that they twist the ovary, cutting off its blood supply. This can cause the ovary to die, leading to extreme pain, nausea, and vomiting.
If you begin having severe pain and symptoms that could be related to a ruptured cyst or a twisted ovary, seek medical attention immediately.
Can Fibroids or Ovarian Cysts Keep Me from Getting Pregnant?
Yes, large fibroids can exert pressure on the fallopian tubes and cause trouble with conception by blocking the egg from reaching its destination and preventing fertilization. Large or numerous uterine fibroids can take up space inside the womb and distort the shape of the uterus, affecting the ability of the fertilized egg to properly implant.
For women who do become pregnant, untreated fibroids can cause issues with the pregnancy by hijacking part of the blood flow meant for the fetus or take up valuable space and inhibit the proper growth and development of the fetus, or lead to miscarriage.
Fibroids can also cause childbirth complications such as preterm labor, the placenta separating from the uterus (placental abruption), low birth weight, the baby being in a breech position, and a higher chance of needing a cesarean delivery.
Ovarian cysts do not normally cause infertility issues unless they are related to an underlying condition such as endometriosis.
There is a condition called Polycystic Ovary Syndrome (PCOS) which is often misunderstood because of the word “cyst” in the title and the fact that these growths look a bit like tiny cysts. However, these are not cysts and this condition is related to a hormone deficiency and is one of the leading causes of infertility.
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Freedom From Fibroids Without Surgery
At Atlanta Fibroid Center®, we specialize in fibroid treatment and provide a non-surgical, minimally invasive procedure called uterine fibroid embolization (UFE). After this 45-minute procedure, all fibroids shrink and stop causing debilitating symptoms.
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How Can I Get Rid of Cysts or Fibroids?
If you have been experiencing any of the symptoms listed above and feel you may have uterine fibroids or ovarian cysts, the first thing you should do is consult your OB-GYN for a consultation. If you are diagnosed with either condition, the next step would be to determine the best treatment options for you. There are both surgical and non-surgical options available to treat fibroids and cysts. However, not all treatments will preserve fertility, so understanding all the options available to you will help you make an informed decision.
Fibroids are often treated through hormone therapies, surgeries to remove fibroids (myomectomy) or the entire uterus (hysterectomy), and non-invasive procedures such as Uterine Fibroid Embolization (UFE). Cysts are normally treated first with hormone therapy and then through surgery if necessary.
Treatment for Cysts
Not all cysts will require treatment, but things like your age, your symptoms, and the underlying cause of your cysts will all influence the type of treatment your doctor will use.
Most often, functional cysts disappear on their own without needing treatment, so doctors often recommend just waiting and watching and will perform a follow-up imaging test to make sure the cyst drains and goes away.
You may be prescribed hormone-containing medications such as birth control pills that will control your ovulation schedule and prevent new cysts from forming.
If a cyst is causing symptoms and continues to grow, surgery might be needed to remove it. The type of surgery and follow-up care will depend on the size and cause of the cyst.
The Safest Uterus-Sparing Treatment for Fibroids
Uterine fibroid embolization (UFE) is a significantly safer alternative to treating fibroids than surgical options. It is 90% effective in permanently getting rid of fibroids so they do not come back, and UFE does not cut up your uterus like a piece of Swiss cheese, like a myomectomy does, so it preserves the strength and integrity of the uterus. Women who undergo myomectomies often must have C-sections vs. a vaginal birth to avoid uterine rupture.
UFE allows you to keep your uterus and only eliminates the fibroids, their symptoms, and side effects. Surgical options are often unable to reach or remove all the fibroids present, so doctors often recommend a hysterectomy (taking out your entire uterus) as a fibroid treatment. In fact, most of the hysterectomies performed today are done to eliminate fibroids. This is unnecessary, and women can suffer a wide range of long-term side effects from undergoing a hysterectomy, especially before the age of 45.
UFE is performed by an interventional radiologist and not an OB/GYN, which is one reason that most women are not given this option as a form of treatment when they are diagnosed with fibroids. The doctor uses a tiny catheter that is inserted into the groin area and used to distribute tiny particles into the small blood vessels that the fibroids have used to siphon blood from the uterine artery. Without that blood, they shrink and die, which alleviates their symptoms.
UFE only takes between 45 minutes to an hour to perform and is done as an outpatient procedure, so you don’t have to stay in the hospital. There is no surgery, so your recovery time is a week or less, depending on how many fibroids you have to treat. Most women are symptom-free by their third cycle after their UFE procedure, but many report significantly fewer symptoms as early as one month after UFE.
If you are experiencing pain or other symptoms caused by uterine fibroids , contact Atlanta Fibroid Center® for a consultation. Dr. John C. Lipman, an Interventional Radiologist, has over 25 years of experience performing UFE procedures and has helped over 10,000 patients break free from fibroid symptoms.
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- Board-Certified Interventional Radiologist
- Pioneer and Most Experienced Doctor in UFE
- Founder of the Atlanta Fibroid Center®
Choose a UFE-Qualified
Interventional Radiologist
UFE is a procedure that is done by an interventional radiologist and is not performed by an OB/GYN. This procedure requires a specialist with extensive training, like Dr. John Lipman at the Atlanta Fibroid Center. Together, they have over forty years of experience in treating uterine fibroids and performing the UFE procedure.
Dr. Lipman was one of the original pioneers of the UFE procedure and was the first in the state to perform it. After over 25 years and more than 10,000 completed procedures, he is known as one of the world’s leading specialists in UFE treatment for fibroids. He has treated women from all around the world, including many celebrities.
He is an advocate for women and has a mission to educate the public and legislative entities about these non-cancerous tumors through public speaking engagements and lectures. He has been instrumental in getting legislation passed in Rhode Island that provides health care coverage for non-surgical removal of fibroids through UFE fibroid treatment. He has also recently made a substantial donation to the SIR Foundation to fund research on fibroids and adenomyosis.
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