Differences between uterine fibroids and ovarian cysts

Uterine fibroids and ovarian cysts are two common conditions that affect people with ovaries, especially before menopause. While they can both affect reproductive organs, understanding the differences in symptoms, causes, and treatments is essential. It’s even more important to consult a healthcare 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
• Heavy periods that may lead to anemia
• Pelvic pain
• Pressure on the rectum
• Urinating often (due to an enlarged fibroid)

During pregnancy, fibroids may grow faster or larger due to the increased blood supply to the pregnant uterus.

What are ovarian cysts?

These common cysts are pouches about half an inch to four inches or larger in size. They’re filled with fluid and develop in or on the ovaries. The cysts are usually benign, often linked to the ovulatory cycle, and typically develop before the onset of menopause. Most resolve on their own without treatment. However, complications like rupture or ovarian torsion (twisting of the ovary) can occur. Symptoms may include:

• Abnormal uterine bleeding
• Protruding abdomen
• Bowel issues
• Painful periods or sexual intercourse
• Lower back or thigh pain
• Sharp or dull abdominal pain, often on one side

If a cyst bursts or twists the ovary around its supporting tissues, it can cause symptoms like:

• Fainting or dizziness
• Fever or vomiting
• Heavy bleeding
• Rapid breathing
• Sudden and severe abdominal pain

“Ovulation happens when a follicle on the ovary ruptures to release an egg,” says 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 may 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 may grow in clusters. They’re most common in women in their 40s and early 50s.

Although the exact cause of fibroids isn’t known, genetics and female sex hormone levels may play a part. They become more common after age 30 through menopause.

Lifestyle factors may also contribute. Research shows that certain habits and dietary patterns can create an environment where fibroids are more likely to grow. You may be able to mitigation the risk of fibroid formation by:

• Avoiding red meat
• Avoiding fried foods and sugary foods
• Obesity

Causes of ovarian cysts

Ovarian cysts are considered functional cysts. This means they’re normal, temporary cysts that are 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. The causes of ovarian cysts may include:

• Endometriosis (an ongoing condition where tissue similar to the lining of the uterus — the endometrium — grows outside the uterus)
• Polycystic ovary syndrome (a hormonal disorder that affects the ovaries)
• Pregnancy
• Severe pelvic infections

Diagnosing uterine fibroids

Once you describe your symptoms, your doctor may want to confirm that you have fibroids and will give you a pelvic exam. The doctor may 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,” says Dr. Reed. “Fluid-filled cysts are almost always benign, while solid areas may need a closer look.”

Your doctor may recommend additional testing if:

• The mass is solid or partially solid
• You’re considered at higher risk for ovarian cancer
• You’ve already gone through menopause

In these cases, your doctor may 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 depends on the size of the fibroids and the severity of symptoms. Options include:

• Uterine fibroid embolization (cuts off blood supply to fibroids)
• Surgical removal of fibroids (myomectomy)
• Hysterectomy (removal of the uterus), especially if future pregnancy isn’t planned
• Hormonal contraceptives to manage heavy bleeding
• Watchful waiting with regular monitoring

Treating ovarian cysts

Just like fibroids, sometimes ovarian cysts don’t need treatment. But if they cause intense symptoms or affect fertility, you and your doctor may choose to treat them by:

• Performing minimally invasive surgery to remove a smaller cyst
• Performing surgery to remove the ovary completely
• Taking a “wait and see” approach with follow-up exams and imaging
• Using medicines such as 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 healthcare provider is the best next step. Our network of gynecology specialists across the state is standing by to help you restore or maintain your gynecologic health. Uterine fibroids and ovarian cysts are two common conditions that affect people with ovaries, especially before menopause. While they can both affect reproductive organs, understanding the differences in symptoms, causes, and treatments is essential. It’s even more important to consult a healthcare provider for an accurate diagnosis.