Bilateral ovarian cysts are independent sacs of fluid that form on both ovaries at the same time. Considered a rare medical condition that can necessitate surgery, these ovarian cysts can cause a variety of signs and symptoms prior to their detection. Serious complications can occur if the cysts rupture, including ovarian torsion.
The formation of cysts on both ovaries can occur when there is a disruption in the release of luteinizing hormone (LH) during a woman’s menstrual cycle or if fluid collects in a vacated follicle following egg release. During menstruation, it is the job of the pituitary gland to signal the release of LH so that an egg may be released in anticipation of fertilization. Sometimes, a miscommunication can result in the absence of LH that causes the egg to remain within the follicle where it forms a cyst. In other cases, once an egg has been released, a premature closure of the follicle may occur leading to fluid accumulation and cyst formation.
Most unilateral ovarian cysts, and even those that form bilaterally, will dissolve on their own within one or two subsequent menstrual cycles. Those that remain in place are generally detected during a pelvic examination. Once found, additional diagnostic testing may be performed to evaluate the composition, form and size of the cyst. Various imaging tests, including an ultrasound, may be utilized to assess the precise location of the cyst and whether or not it is solid or contains fluid. In some cases, a blood test may be conducted to rule out cancer or identify other contributory conditions, such as pelvic inflammatory disease (PID) or endometriosis.
Individuals who develop bilateral ovarian cysts may experience a variety of signs and symptoms prior to receiving a diagnosis. The most common presentation of this condition is intense abdominal and lower back pain. Pelvic pain may be episodic and intensify during bowel movements, intercourse and menstruation. Additional signs of bilateral ovarian cysts can include irregular menstruation cycles, nausea, and a persistent feeling of abdominal heaviness. If symptoms are ignored and either one or both cysts rupture, a woman is at risk for serious complication development, including a twisting of the affected ovary which can jeopardize proper blood flow and organ health.
Cysts that are small in size may be monitored for pronounced changes with regular physician visits and imaging tests. Women experiencing mild to moderate discomfort may be advised to use heat therapy, such as a heat wrap or heating pad, and over-the-counter (OTC) analgesic medications to manage and alleviate any pain. When bilateral ovarian cysts are large in size, malignant or causing secondary conditions to develop, including placing undue pressure on surrounding organs, surgery to remove the cysts and one or both ovaries may be recommended.
The removal of ovarian cysts may be performed with a procedure called a cystectomy. If both the cyst and affected ovary are removed, the procedure is known as an oophorectomy. The ideal situation for women of childbearing age would be successful cyst removal allowing one of the ovaries to remain in place to ensure fertility. When bilateral cysts compromise a woman’s health, a bilateral oophorectomy may be performed to remove the cysts and both ovaries.