PCOS (Polycystic Ovary Syndrome) and endometriosis are often grouped together as they are common conditions affecting females. However, they are entirely separate issues, and notably, PCOS does not cause pelvic pain.
What is PCOS?
PCOS is a misnomer as it is associated with several small ovarian follicles rather than cysts. These follicles do not grow into a dominant follicle, meaning they are not large enough to rupture or cause pain. In contrast, true ovarian cysts can cause pain, especially if they rupture or become very large.
Types of Ovarian Cysts
There are different types of ovarian cysts, categorized as functional or pathological:
1️⃣ Functional Cysts:
- Follicular Cysts: Occur when the egg isn’t released, and the follicle continues to grow.
- Corpus Luteum Cysts: Form when the cells where the egg is released grow into a cyst.
- Functional cysts are generally around 3cm but can grow up to or beyond 10cm. They usually resolve within three months but can cause menstrual irregularities. They are typically asymptomatic unless they rupture, cause the ovary to twist (which is very painful), or grow very large, causing dull pelvic ache symptoms.
2️⃣ Pathological Cysts:
- Endometriomas: Form when endometriosis tissue grows on the outside of the ovary and fills with blood. These are non-cancerous but painful, especially if they rupture, and will not go away without surgery.
- Dermoid Cysts (Teratomas): Strange cysts made from different types of tissue, such as teeth, hair, and bone. They have a genetic predisposition and can grow quite large (e.g., >10-15cm) and occasionally be cancerous.
- Cystadenomas: Growths of the cells lining the ovary. They are usually benign but can be cancerous.
Key Takeaways
PCOS itself does not cause pelvic pain. If you have PCOS and experience severe pelvic pain, it is essential to investigate the underlying cause. Most ovarian cysts are functional and will disappear on their own, but any slightly abnormal cyst needs follow-up as some cysts can become cancerous. 🙅🏼♀️