{"paper_id":"fa562b3f-3f03-4134-a9f8-72621ab6a909","body_text":"~ 109 ~ \nInternational Journal of Clinical Obstetrics and Gynaecology 2025; 9(5): 109-112 \n \nISSN (P): 2522-6614 \nISSN (E): 2522-6622 \nIndexing: Embase \nImpact Factor (RJIF): 6.71 \n© Gynaecology Journal \nwww.gynaecologyjournal.com \n2025; 9(5): 109-112 \nReceived: 28-09-2025 \nAccepted: 15-10-2025 \n \nDr. Nazia Fathima \nPost Graduate, Department of \nObstetrics & Gynecology, VRK \nWomen’s Medical College and \nTeaching Hospital, Aziz Nagar, \nHyderabad, Telangana, India \n \nDr. VG Vanamala  \nProfessor (Emiratus), Department \nof Obstetrics & Gynecology, VRK \nWomen’s Medical College and \nTeaching Hospital, Aziz Nagar, \nHyderabad, Telangana, India \n \nDr. Rajinipriya \nHOD, Department of Obstetrics & \nGynecology, VRK Women’s \nMedical College and Teaching \nHospital, Aziz Nagar, Hyderabad, \nTelangana, India \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \nCorresponding Author: \nDr. Nazia Fathima \nPost Graduate, Department of \nObstetrics & Gynecology, VRK \nWomen’s Medical College and \nTeaching Hospital, Aziz Nagar, \nHyderabad, Telangana, India \n \nA review of ovarian cyst in Gynaec practice \n \nNazia Fathima, VG Vanamala and Rajinipriya \n \nDOI: https://doi.org/10.33545/gynae.2025.v9.i5b.1697  \n \nAbstract \nIntroduction: Physiologic & functional Ovarian Cysts are most commonly seen in reproductive age group \nbut also to be seen in any age group from infancy to postmenopausal period. Incidence of Ovarian Cyst in \ngynaec OPD at attending OPD in Dr.V.R.K Hospital is 0.6%. The study was conducted to evaluate the \npercentage of regression of ovarian cyst with 3 months OCPs (Category II 3 menstrual cycles — either \nunderwent ultrasound follow-up for 3 months or administration of OCP (oral combined pills for 3 months). \nMethodology: A prospective study was conducted in which women presenting with complaints such as \nabdominal pain, bloating, menstrual irregularities, or those found to be asymptomatic but diagnosed wit h \novarian cysts were evaluated. Diagnosis was established using pelvic ultrasonography (USG) and serum \nCA-125 levels. Women with ovarian cysts identified on USG were further assessed with CA -125 to \nexclude pathological conditions. Patients diagnosed with f unctional ovarian cysts were administered oral \ncontraceptive pills (OCPs) for a period of three months, after which follow -up pelvic USG was performed \nto assess regression. \nResults: Out of about 32 women studied for 3 months:  CA125 levels were normal in fu nctional cysts.  \nOvarian cyst in all 32 cases were of functional type.  CA125 levels were raised in Endometriotic cysts. The \nabnormal cases were ruled out.  Regression of functional ovarian cysts was seen with OCP administration.  \nThere’s also a small hand -drawn pie chart at the bottom of the page, likely showing data distribution \nvisually. \nConclusion: Combined oral contraceptives significantly promote regression of functional ovarian cysts by \nsuppressing ovulation. CA -125 evaluation is essential to differentia te benign from malignant or complex \ncysts. Conservative management with OCPs remains an effective first -line option in reproductive -age \nwomen. \n \nKeywords: Ovarian cyst, Functional cyst, Follicular cyst, Pelvic ultrasonography, CA-125, Reproductive \nage women, Conservative management, Gynecology practice \n \nIntroduction  \nAmong the most common gynecological disorders seen in women of all ages, from childhood to \npostmenopause, ovarian cysts rank high. They can be physiological, functional, or pathological, \nand the y depict sacs filled with fluid either inside or outside the ovary. Cysts in women of \nchildbearing age often develop normally during the ovulatory cycle and serve a useful purpose [1, \n2].  \nFollicle cysts and corpus luteal cysts are the two main types of fu nctional ovarian cysts. If the \nfollicle doesn't burst or the sac doesn't disintegrate after ovulation, a follicular cyst will form. \nCommon characteristics of these cysts include thin walls, lack of eyes, and a diameter of 3 -5 cm. \nCorpus luteal cysts, on th e other hand, are often bigger, have thicker walls, and can often be \nassociated with bleeding. While the majority of functional cysts do not cause any symptoms and \ndisappear on their own, a small percentage of women may have dysmenorrhea, bloating, \nabdominal pain, or irregular periods. Women who visited the gynecology outpatient department \n(OPD) at Dr. V.R.K. Hospital had a 0.6% incidence of ovarian cysts [3-5]. \nAlthough most cysts are harmless, it is important to distinguish them from endometriotic, \nhemorrhagic, or malignant cysts. To this day, ultrasonography and serum CA -125 estimate are \nthe diagnostic evaluation's lynchpins, helping to differentiate between functional and abnormal \ncysts. Medications or close observation are typically the first lines of d efense against functioning \novarian cysts [6-8]. Because they reduce gonadotropin secretion, which in turn suppresses \novulation, combined oral contraceptive pills (OCPs) are quite popular because they help existing \ncysts to recede and prevent new cysts from  forming. Despite mixed results from earlier research, \nthe use of OCPs to resolve cysts remains a topic of active clinical interest [9-11].  \n\n\nInternational Journal of Clinical Obstetrics and Gynaecology https://www.gynaecologyjournal.com \n~ 110 ~ \nThis study aimed to examine the correlation between clinical \npresentation, sonographic findings, and CA -125 level s in order \nto assess the regression of functional ovarian cysts after OCP \ntreatment in reproductive-aged women. \n \nMaterials and Methods \nA prospective, randomized study was conducted in the \nDepartment of Gynecology, Dr. V.R.K. Hospital, from January \n2023 to December 2023. The study population included women \npresenting to the gynecology outpatient department (OPD) with \nsymptoms suggestive of ovarian cysts or those diagnosed \nincidentally on ultrasonography (USG). A total of 6,527 women \nattended the gynecology  OPD during the study period. Out of \nthese, 110 patients were diagnosed with ovarian cysts based on \npelvic USG. \n \nInclusion Criteria \n Women of reproductive age (adolescent to premenopausal). \n Functional ovarian cysts measuring <7 cm in diameter. \n Cysts with thin walls, unilocular structure, and clear fluid \ncontent. \n Serum CA-125 levels <300 IU/ml. \n \nExclusion Criteria  \n Ovarian torsion. \n Complex or hemorrhagic cysts. \n Large cysts (>7 cm). \n Postmenopausal ovarian cysts. \n Suspected malignant ovarian masses. \n \nDiagnostic Evaluation  \nAll patients underwent pelvic USG to assess cyst size, wall \nthickness, septations, and internal echoes. Measured in all \npatients to differentiate functional cysts from endometriotic or \nneoplastic cysts. Patients with elevated CA -125 (>300 I U/ml) \nwere excluded from the functional cyst group. \n \nIntervention \nPatients with functional ovarian cysts (n = 96) were divided into \ntwo groups: \n1. OCP group (n = 48): Received combined oral contraceptive \npills for three consecutive menstrual cycles. \n2. Control group (n = 48): Kept under conservative \nobservation without medical therapy. \n \nFollow-up USG was performed after three months to evaluate \ncyst regression. \n \nOutcome Measures \n Regression or persistence of ovarian cysts on follow -up \nUSG. \n Correlation of CA-125 levels with different types of ovarian \ncysts. \n Age-wise distribution of ovarian cysts. \n \nResults \nDuring the study period (January -December 2023), 110 patients \nwere assessed for ovarian cysts. Outpatient gynecology patients \nhad a 0.6% overall incidence of ova rian cysts. Although fewer \noccurrences were found in adolescents and postmenopausal \nwomen, the reproductive age group (21 -40 years) accounted for \nthe bulk of ovarian cyst diagnoses. \n \nAge Distribution  \nThe age group of 31 -40 years old women had the highest  \nfrequency of ovarian cysts, followed by the 21 -30 year old \nwomen. In women under the age of 20 and above the age of 50, \nonly a small number of cases were identified. \n \nTable 1: Age distribution of patients with ovarian cysts (January-\nFebruary 2023) \n \nAge group (years) No. of patients \n10-20 3 \n21-30 25 \n31-40 45 \n41-50 15 \n51-60 3 \n>60 3 \n \nOvarian cysts are more prevalent in women of childbearing age, \nas the age group between 31 and 40 years old had the highest \nnumber of cases (45 patients). \n \nDistribution of Ovarian Cysts by Age \nWomen between the ages of 21 and 30 had the greatest \nfrequency of ovarian cysts (54 cases), followed by those \nbetween the ages of 31 and 40 (51 cases). Women who had gone \nthrough menopause had the lowest incidence. \n \nTable 2: Age-wise distribution of ovarian cysts (January-February \n2023) \n \nAge group (years) No. of ovarian cyst cases \n10-20 9 \n21-30 54 \n31-40 51 \n41-50 17 \n51-60 1 \n>60 0 \n \nOvarian cysts are most common in women between the ages of \n21 and 40, which is close to the reproduct ive age, according to \nthe study's authors. \n \nMonthly Distribution of Cases  \nThe majority of cases concentrated in the 21 -40 year old age \ncategory, as also shown in the monthly analysis. \n \nTable 3: Age distribution of patients with ovarian cysts (April 2023) \n \nAge group (years) No. of patients \n10-20 3 \n21-30 14 \n31-40 32 \n41-50 9 \n51-60 3 \n>60 3 \n \nThe age range of 31 -40 years old continued to have the highest \nnumber of reported cases, demonstrating that this is the \ndemographic most impacted by the disease. \n \nTable 5: Age distribution of patients with ovarian cysts (June 2023) \n \nAge group (years) No. of patients \n10-20 5 \n21-30 33 \n31-40 31 \n41-50 15 \n51-60 6 \n>60 - \n\nInternational Journal of Clinical Obstetrics and Gynaecology https://www.gynaecologyjournal.com \n~ 111 ~ \nAdditionally, the pattern that was present in June showed that \nthe 21 -40-year age group had the gr eatest number of cases, \nwhile women who were above the age of 50 had very few \noccurrences. \n \nCorrelation with CA-125 Levels \nCA-125 estimation was performed for all patients to differentiate \nfunctional from pathological cysts. The findings were as \nfollows: \n \n \nFig 1: Distribution of ovarian cysts among study participants \n \n Functional ovarian cysts:  Normal or slightly reduced CA -\n125 levels. \n Adolescent age group: Predominantly normal CA-125. \n Perimenopausal age group:  Normal to mildly raised CA -\n125. \n Endometriotic cysts: Significantly raised CA-125. \n Hemorrhagic cysts: Mild elevation of CA-125. \n Malignant cysts: Markedly elevated CA-125 (>300 IU/ml). \n \nFunctional cysts were consistently associated with normal CA -\n125 levels, while raised CA-125 was indicative of endometriotic, \nhemorrhagic, or malignant cysts. \n \nDiscussion \nGynecological conditions including ovarian cysts are common in \nreproductive-age women. The gynecology OPD had 0.6% \novarian cysts, which is similar to other hospital -based research. \nMost of the 110 c ases (87%) were functioning ovarian cysts, \nwhile complicated, torsion, and postmenopausal cysts were rare. \nOne case of ovarian cystadenocarcinoma was also found, \nreinforcing the significance of rigorous evaluation and \ndiscrimination between benign and mali gnant ovarian tumors [12-\n14].  \nFunctional ovarian cysts result from follicular rupture failure or \ncorpus luteum persistence following ovulation. Though thin -\nwalled, unilocular, and self -limiting, these cysts can cause pain, \nbloating, and menstrual abnormal ities. Our study found that \nfunctional cysts were more common in women aged 21 -40, \nwhen ovulatory activity is highest. The lower number of \ninstances in teens and postmenopausal women supports the \nhormonal theory of functional cysts [15-17].  \nIn this trial,  48 women with functioning ovarian cysts got \ncombination OCPs for three menstrual cycles and 48 were \nconservatively handled. OCP patients had higher cyst regression. \nThis supports the well -established mechanism of OCPs, which \nrestrict ovulation by blocking  GnRH secretion and lowering \nFSH and LH. The absence of the LH surge precludes ovulation \nand subsequent cyst production, therefore aiding regression of \nexisting functional cysts. In our study, the 21 -30-year age group \nhad the most cysts, which correlates w ith peak reproductive \nactivity. Unmarried women (30%) also had ovarian cysts, \ndemonstrating that marital status does not protect against them. \nWomen with parity 3 had the highest incidence (35%). Parity \ndid not directly affect functional ovarian cysts [18-20].  \nThe serum CA -125 test helped identify functional cysts from \nunhealthy ones. Our investigation found normal CA -125 levels \nin functioning ovarian cysts but increased levels in 8 individuals. \nCystadenocarcinoma (3 instances) had markedly elevated CA -\n125 values, while endometriotic and hemorrhagic cysts had \nmodest elevations. This suggests that CA -125 should be \nincluded in ovarian cyst diagnostics to rule out malignancy and \nother complex disorders [21-23].  \nMost reproductive -age ovarian cysts are function al and \ndisappear naturally or with OCP, according to previous studies. \nThese data support OCPs as an effective and conservative \ntreatment method, as do our results. We found that complicated \ncysts, endometriotic cysts, and malignancies can appear as \n\nInternational Journal of Clinical Obstetrics and Gynaecology https://www.gynaecologyjournal.com \n~ 112 ~ \nfunctional cysts on imaging, highlighting the necessity for USG \nand CA-125 screening [24-26]. \n \nConclusion  \nThis study shows that ovarian cysts, both functional and \nphysiological, can be regressed after three menstrual cycles of \ntaking combined oral contraceptiv e pills. The effectiveness of \nOCPs as a non -invasive, conservative treatment choice was \ndemonstrated by the large number of patients who had full or \npartial remission. Suppressing the hypothalamic -pituitary-\novarian (HPO) axis, which stops ovulation and low ers the \nchance of cyst development and persistence, is the mechanism \nby which it helps. In addition, the study highlights the \nsignificance of serum CA -125 estimation in distinguishing \nbenign functional cysts from pathological or cancerous versions, \nwhich s hould be done in all women who report with ovarian \ncysts. Better patient outcomes and fewer needless surgical \nprocedures are possible results of early detection and proper \ncare. As long as the possibility of malignancy is ruled out \nthrough proper diagnostic examination, functional ovarian cysts, \nwhich are prevalent in reproductive -age women, can be \nconservatively treated with OCPs. \n \nConflicts of Interest \nNone. \n \nFunding \nNone.  \n \nReferences \n1. El-Beree SA, Salama KM, Mostafa ST, Mohamed AS. Are \nthe combined ora l contraceptive pills needed for \nmanagement of the simple ovarian cysts in reproductive \nwomen? A randomized controlled study. Benha J Appl Sci. \n2021;6(4):219-224. \n2. Grimes DA, Jones LB, Lopez LM, Schulz KF; Cochrane \nGynaecology and Fertility Group. 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J Mazandaran Univ Med Sci. 2014;24(2):102-\n107. \n \nHow to Cite This Article \nFathima N, Vanamala VG, Rajinipriya. A review of ovarian cyst in Gynaec \npractice. International Journal of Clinical Obstetrics and Gynaecology . \n2025; 9(5): 109-112.  \n \n \nCreative Commons (CC) License \nThis is an open access journal, and articles are distributed under the terms \nof the Creative Commons Attribution -NonCommercial-ShareAlike 4.0 \nInternational (CC BY -NC-SA 4.0) License, which allows others to remix, \ntweak, and build upon the work non -commercially, as long as appropriate \ncredit is given and the new creations are licensed under the identical terms.","source_license":"CC0","license_restricted":false}