Uterine fibroids and ovarian cysts are two common conditions that affect people with ovaries, especially before menopause.
While both conditions can affect reproductive organs, doctors with HCA Florida Healthcare say it’s essential to understand the differences in symptoms, causes and treatments. It’s even more important to consult a health care provider for an accurate diagnosis.
What are uterine fibroids?
Fibroids are typically noncancerous smooth muscle tumors that form in the uterus. They can range in size from a small apple seed to as large as a grapefruit. Common symptoms include:
- Enlarged abdomen
- Frequent urination (caused by an enlarged fibroid)
- Heavy periods that can cause anemia
- Pelvic discomfort
- Pressure on the rectum
During pregnancy, fibroids can grow faster or larger due to the increased blood supply to the pregnant uterus.
What are ovarian cysts?
Ovarian cysts are pouches about half an inch to 4 inches or larger in size. They’re filled with fluid and develop in or on the ovaries. The cysts, which are common but typically benign, are often linked to the ovulatory cycle, and typically develop before the onset of menopause.
While most cysts resolve on their own without treatment, complications like rupture or ovarian torsion (twisting of the ovary) can occur. Symptoms can include:
- Abnormal uterine bleeding
- Bowel issues
- Dull or sharp abdominal pain, often on one side
- Lower back or thigh pain
- Painful during sexual intercourse or periods
- Protruding abdomen
Furthermore, if a cyst bursts or twists the ovary around the supporting tissues, it can cause symptoms that include:
- Abdominal pain that’s sudden and severe
- Fainting or dizziness
- Fever or vomiting
- Heavy bleeding
- Rapid breathing
“Ovulation happens when a follicle on the ovary ruptures to release an egg,” said Dr. Tony Reed, an OB-GYN with HCA Florida Healthcare. “Some people feel mild discomfort during this process, known as Mittelschmerz pain. It’s not a medical emergency, but it’s something you can mention at your next gynecology visit. However, if you experience sudden severe pain, that could be a sign of ovarian torsion, which is a medical emergency.”
Two clues that can help differentiate:
- Uterine fibroids may be the cause if you have heavy menstrual bleeding.
- Ovarian cysts may be the cause if you experience abdominal pain on only one side.
Causes of uterine fibroids
Uterine fibroids can develop at any point and sometimes grow in clusters. They’re most common in women in their 40s and early 50s.
Although the exact cause of fibroids isn’t known, research shows genetics and female sex hormone levels might play a part. Fibroids become more common after age 30 through menopause.
Lifestyle factors can also contribute. Research shows particular habits and dietary patterns can create an environment where fibroids are more likely to grow. You may be able to mitigate the risk of fibroid formation by avoiding:
- Fried and sugary foods
- Red meat
- Obesity
Causes of ovarian cysts
Ovarian cysts are considered functional cysts. This means they’re normal temporary cysts related to the ovulatory cycle. They show that the ovary is functioning the way it should. These cysts usually occur in women who haven’t reached menopause.
Causes of ovarian cysts can include:
- Endometriosis (an ongoing condition where tissue that’s similar to the lining of the uterus -- the endometrium -- grows outside the uterus)
- Polycystic ovary syndrome (PCOS -- a hormonal disorder that affects the ovaries)
- Pregnancy
- Severe pelvic infections
Diagnosing uterine fibroids
If you believe you’re experiencing symptoms of uterine fibroids, your doctor will want to confirm through a pelvic exam. The doctor might also recommend pelvic ultrasound imaging tests to provide more information about unusual growths and their location in your abdomen. Occasionally, the results of the pelvic exam or ultrasound are inconclusive, and an MRI of the pelvis might be ordered.
Diagnosing ovarian cysts
Ultrasound imaging is the most common way to evaluate the ovaries and identify whether a mass is present.
“Ultrasound gives us a clear picture of whether a mass is solid or fluid-filled,” Dr. Reed said. “Fluid-filled cysts are almost always benign, while solid areas may need a closer look.”
Your doctor might recommend additional testing if:
- The mass is solid or partially solid
- You’re considered high risk for ovarian cancer
- You’ve already gone through menopause
In these cases, your doctor might order a blood test called cancer antigen 125 (CA‑125). This test measures a protein that can be elevated in several conditions, including ovarian cancer. If your CA‑125 level is high, your doctor will investigate further to determine the cause.
Treating uterine fibroids
Treatment for fibroids depends on the size and the severity of symptoms. Options include:
- Hormonal contraceptives to manage heavy bleeding
- Hysterectomy (removal of the uterus), especially if future pregnancy isn’t planned
- Surgical removal (myomectomy)
- Uterine fibroid embolization (cuts off blood supply to fibroids)
- Watchful waiting with regular monitoring
Treating ovarian cysts
Just like fibroids, sometimes ovarian cysts don’t need treatment. However, if they cause intense symptoms or affect fertility, you and your doctor may choose to treat them by:
- Performing minimally invasive surgery to remove smaller cysts
- Performing surgery to remove the ovary completely
- Taking a wait-and-see approach, with follow-up exams and imaging
- Using medicines like hormonal contraceptives to help lower the chance of cysts forming
Understand the differences between fibroids and cysts
Whether you’re experiencing symptoms or simply want to learn more, speaking with a health care provider is the best next step.
HCA Healthcare’s network of gynecology specialists across Florida is standing by to help patients restore or maintain their gynecologic health.
Click or tap here to learn more, find a location near you or schedule your appointment.