Infections and Ovarian Cysts: What Every Woman Should Know

  Ovarian cysts are fluid-filled sacs that commonly develop in the ovaries of women during their childbearing years. They are typically harmless, but some may cause pelvic pain, abdominal discomfort, and, in rare cases, infection. This guide from a trusted women’s health clinic in Singapore provides an overview of how bacterial infections can arise from ovarian cysts and other relevant information.

How Bacterial Infections Can Develop from Ovarian Cysts

Bacterial infections don’t occur with most ovarian cysts. However, certain types of cysts create an environment where infectious bacteria can flourish. Two ways ovarian cysts may become infected include:

Infected ovarian cysts/abscesses

Infection can set into an ovarian cyst if bacteria spread from another area of the body to the ovaries. This is more common in women with pelvic inflammatory disease (PID), often resulting from sexually transmitted diseases like chlamydia and gonorrhoea. The inflammation causes adhesions and scar tissue that can trap bacteria inside a cyst. As the infected cyst enlarges, it’s called an ovarian abscess. If the abscess ruptures, it releases pus and bacteria into the abdominal cavity. This can lead to a widespread abdominal infection called peritonitis. Prompt surgical drainage and intravenous antibiotics are required to treat a ruptured infected ovarian cyst.

Cysts related to endometriosis

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus. This errant endometrial tissue can attach to the ovaries or fallopian tubes, forming cysts called endometriomas. The old blood and tissue debris inside endometriomas create an environment where bacteria thrive. If an endometrioma ruptures, it can cause sudden, severe abdominal pain. Bleeding from the cyst increases the risk of infection. Laparoscopic surgery to excise endometriosis may be required to remove these cysts and lower infection risk.

Risk Factors and Susceptibility

There are certain conditions and factors that may increase the susceptibility to developing an infected ovarian cyst.

Endometriosis

As mentioned, endometriosis raises infection risk. The endometrial-like tissue forming cysts has a weakened wall. Old blood and debris in these cysts enable bacterial growth. About one in ten ovarian cysts in women with endometriosis become infected.

Pregnancy

Corpus luteum cysts that develop during early pregnancy are usually harmless. But, the high levels of hormones can cause the cyst to grow rapidly and potentially twist or rupture. An ectopic pregnancy attaching to the ovary also forms a cyst-like mass. Rupture of these pregnancy-related cysts mandates urgent surgery.

Previous ovarian cysts

Recurrence is common. More than 40 per cent of women have multiple ovarian cysts over their lifespan. The more cysts you have, the higher your odds of eventually developing an infected one.

Pelvic surgery

Any prior pelvic or reproductive surgery could introduce bacteria into the abdominal cavity. Post-surgical adhesions and scar tissue may also trap bacteria inside ovarian cysts after they form. Those with a history of pelvic surgery should be alert for any symptoms of cyst infection.

Other risk factors

Additional risk factors for infected cysts include STDs, PID, ovarian torsion cutting off blood flow, and immunodeficiency disorders like HIV/AIDS. But even with no specific risk factors, any woman can develop an infected cyst. Always be aware of the symptoms and seek prompt treatment when needed.

Signs of Infection

Detecting an infection starts with recognising the symptoms. Be on alert for the following signs.

1. Sudden, severe abdominal pain A ruptured or rapidly enlarging infected cyst usually causes abrupt, intense pain in the lower abdomen. The pain may start as a dull ache that quickly crescendos into cramping and stabbing sensations.
2. Fever A fever over 38 degrees Celsius, especially accompanied by chills, points to an underlying infection. Ovarian cysts related to PID or STDs often cause fevers due to pus and bacteria inside the cyst.
3. Nausea/vomiting Inflammation from the ovarian infection may cause nausea or vomiting. Severe pain may also trigger these symptoms. Vomiting, along with fever and abdominal pain, warrants an urgent trip to the ER.
4. Heavy vaginal bleeding Some light spotting may occur when a cyst ruptures, but heavy bleeding is abnormal. It indicates an infected cyst. Bleeding can be caused by the cyst bursting, twisted ovary cutting off blood supply, or endometriosis.
5. Other potential indicators Other indicators of an infected ovarian cyst include dizziness or fainting, offensive vaginal odour, and tender pelvic mass felt during a pelvic examination.

Do not try to tough out severe ovarian cyst pain. Seek medical attention immediately.

Getting an Accurate Diagnosis

Diagnosing an infected ovarian cyst requires a combination of tests and imaging. Doctors may use the following to get an accurate diagnosis of your case or condition.

Pelvic exam, pregnancy test, and ultrasound

During a pelvic exam, your gynaecologist manually palpates the ovaries, feeling for masses, tenderness, or swelling. A pregnancy test helps rule out a corpus luteum cyst. Ultrasound, on the other hand, shows a clear visualisation of ovarian cysts and assesses their size and complexity.

Laparoscopy

If imaging detects potential infection, laparoscopic surgery is often performed both diagnostically and therapeutically. Your surgeon will make a small abdominal incision to insert a camera for directly viewing the ovaries and obtaining samples.

Blood tests

Complete blood count (CBC) shows elevated white blood cell count with infection. C-reactive protein (CRP) is another marker tested. Ovarian cysts at risk for malignancy may be tested for cancer antigen 125 (CA-125).

Cultures

Lab cultures are done on fluid or tissue specimens from the ovarian cyst. Blood cultures can also detect the presence of bacteria in the bloodstream. The specific microorganism must be identified to be able to select the right antibiotics.

In certain cases…

Examination and ultrasound may suffice for diagnosis in straightforward cases. However, laparoscopy and lab work are often warranted for confirmation. Hence, it is important to get an early and accurate diagnosis because it guides the appropriate treatment of infected cysts.

Treatment Options for Infected Ovarian Cysts

The following are the common approaches for treating infected ovarian cysts. Read on.

1. Antibiotics – Broad-spectrum intravenous antibiotics are administered in cases of cyst rupture and severe infection. Targeted antibiotics may be used once lab cultures identify the specific bacteria involved. A two to four-week course is typical to resolve the infection fully.
2. Drainage procedures – Infected cysts can be drained using minimally invasive radiology procedures. An interventional radiologist will insert a needle through the abdominal wall using ultrasound guidance to drain the abscess. A catheter may be left in place for continued drainage.
3. Laparoscopic surgery –  surgeons can excise infected cysts using laparoscopic techniques. This may involve a cystectomy, removing only the mass while preserving the ovary. Or an oophorectomy may be needed to remove the entire ovary if it is extensively damaged or twisted.

In young women desiring fertility, ovarian preservation is prioritised if possible. Those nearing menopause who are at higher risk for ovarian cancer may need full removal. Your age and health status help determine the ideal surgical approach. The least invasive options are tried first, progressing to surgery for difficult cases unresolved by other treatments. The good news is that most infected ovarian cysts can be cured without complication if treated immediately.

Preventing Infections with Proper Ovarian Cyst Monitoring

Once an ovarian cyst is detected, ongoing monitoring will be important to identify complications like infection early. Here are some tips you can follow for prevention:

1. Attend all recommended gynaecology appointments for pelvic exams and ultrasound scans. Imaging will detect worrisome cyst growth or rupture.
2. Pay attention to your body between appointments. Track your menstrual cycle, watch for pelvic pain, and note any abnormal discharge. Call your women’s health clinic in Singapore if you notice potential infection symptoms.
3. Seek immediate care for severe pelvic pain, vomiting, bleeding, or fever. Don’t wait for your next scheduled visit. You will have better outcomes if the infected cysts are treated promptly.
4. Your gynecology clinic in Singapore may prescribe oral contraceptives to prevent new cyst formation during each menstrual cycle. The hormones help stabilise the endometrium.

Staying on top of recommended monitoring enables the best chance of identifying an infected ovarian cyst in its early stages, so you can have more conservative management with antibiotics instead of getting surgery. Don’t take a “wait and see” approach. Be vigilant about your appointments, symptoms, and changes in your body.

Supporting Ovarian Health Through Lifestyle Factors

Some risk factors for ovarian cysts are out of our control, but many lifestyle measures are able to lower infection risk and support ovarian health.

1. Eat an anti-inflammatory diet high in fruits, vegetables, lean proteins, and healthy fats.
2. Achieve and maintain a normal BMI through diet and exercise.
3. Get regular moderate exercise most days of the week, as activity helps reduce inflammation.
4. Manage stress through meditation, counselling, or other methods, as high cortisol negatively impacts the ovaries.
5. Avoid smoking and excessive alcohol intake, as they compromise immune function.
6. Practise safe sex and get regularly tested for STDs to prevent pelvic inflammatory disease.
7. Use gentle, non-irritating products when it comes to vaginal hygiene.
8. Consider supplements that support ovarian health and fight inflammation, like vitamin D, omega-3 fatty acids, and antioxidants. Speak to your gynecology clinic in Singapore for guidance.

Some ovarian cysts are unavoidable, but you give your body its best chance at preventing and fighting infection when you take these health habits seriously.

Conclusion

If you experience any sudden severe abdominal pain, fever, nausea, or heavy bleeding, seek emergency gynaecological care right away. Don’t wait to see if symptoms will pass. Timely diagnosis and management are crucial. At WS Law Women’s Clinic (a trusted women’s health clinic in Singapore), we provide comprehensive gynecology and obstetrics care. Book an appointment if you have concerns about ovarian health. We’re here to help you access the best treatment and support throughout your healthcare journey.  

References

https://www.hopkinsmedicine.org/
https://www.webmd.com/
https://www.ncbi.nlm.nih.gov/
https://www.medicalnewstoday.com/