Ovarian cysts are sacs with fluid or tissue that form within the ovaries or on their surface.

This is a very common phenomenon during the reproductive age, and it is not uncommon after menopause. The vast majority are benign and disappear without any treatment. Rarely does a cyst indicate malignancy.


Most frequent types of cysts

Functional Cyst: This is the most common type of ovarian cyst in young women. Most of the time it is asymptomatic and resolves on its own within 1.5 – 2 months without requiring any therapeutic intervention.

Ochraimatoma: corpus luteum cyst generated due to bleeding after ovulation. It often appears but is absorbed by itself and almost never needs surgery.

Teratoma: is a type of cyst that contains tissues of a different type, such as skin or hair. The teratoma can exist by birth and may grow during the woman’s pregnancy. There are very rare cases that it can turn into malignancy.

Cystadenoma: Grows on the outer surface of the ovary and can grow very large, so removal is recommended. In most cases they are benign.

Endometrioma: is a cyst that occurs when endometriosis is present. Usually, in addition to fluid, it also contains oxidized blood, which is why it is also called chocolate cyst. As it grows older, it is common to cause pain, so it needs to be removed.


In most cases, ovarian cysts show no symptoms and are usually diagnosed during a gynecological or imaging examination for some other reason.


Sometimes, they cause discomfort during intercourse, pain that can be diffuse or acute, and if they are large, they can cause ovarian twisting – in this case the usual symptom is pain that can start suddenly, recede and comes back. Sudden, acute pain may be the result of cysts that bleed or break.

If the doctor estimates that you may have a cyst, he will perform an ultrasound to determine its location, size and shape, as well as its blood supply, and may, if necessary, recommend further tests to determine the nature of the cyst.


Many cysts disappear in the time between one or two menstrual cycles. Administration of contraceptives for 1 to 3 months helps extinction (absorbance) of the cysts.

Puncturing the cyst to remove the fluid they contain is a method that is no longer applicable, as the wall remains, and the cyst is usually reshaped. Surgical removal of the cyst is performed if it is considered that there is a possibility of malignancy. In postmenopausal cysts, the approach is most often invasive, as there are no functional cysts at this time, so further investigation may be needed.

Surgery to remove a cyst can also be done if it is large in size or causes pain. Most often, the removal is done through laparoscopy.


CONTRACEPTION: Everything you need to know

Greece is the last in contraception among the countries of the European Union and, therefore, first on the corresponding list of pregnancy terminations. But today, the options to avoid an unwanted pregnancy are more than ever.

The basic forms of contraception, however, remain the condom, the pill and the spiral. The latter is widespread abroad, but not in our country, as many Greeks “resist” its use, often by inadequate information. We must emphasize that its use is safe and reassure the fears of many women about the presence of a “foreign body” inside them – much more so that sometimes there are foreign bodies in the body – such as an earring in the tongue – in which no importance may be given.


In addition, the potential complications of terminating an unwanted pregnancy are far greater than any side effects of spiral or contraceptive pills. The phrase “I don’t want to burden my body with contraceptive hormones” is unfounded, especially when the woman delivering it has undergone pregnancy terminations.


The factors that influence the choice of method of contraception are certainly related to the effectiveness of each method, its ease of application, its cost, as well as your age and your state of health. Your doctor will weigh all of the above and suggest methods that are right for you to choose. Here is a list of most methods, from the most classic to the most sophisticated.

Male condom

Widely available, affordable and easy to apply, it offers effective protection against unwanted pregnancy and most sexually transmitted diseases. It is a good idea to buy a recognized brand condom, and it is important to use it correctly. When applied since the start of sex, the condom has an efficacy of over 95% over a period of one year.

Contraceptive pill

Its action is based on the inhibition of ovulation. New-generation contraceptives contain smaller amounts of estrogen and progesterone and their side effects are rare. On the contrary, receiving them has side benefits:

  • It regulates the cycle, so the woman knows exactly what days she will have her period. In addition, it may extend or expedite this date if she wishes for social reasons (e.g. travel, vacations, etc.).
  • It mitigates the severity of the symptoms of the period, which for many women are quite annoying: it reduces both the duration and amount of blood lost during the period, reduces or even eliminates the pain of the period, and can often improve the premenstrual symptoms , such as headache, nervousness, bad mood, etc.
  • It reduces the incidence of cyst in the ovaries as well as some gynecological cancers. In particular, its long-term use reduces the risk of endometrial and ovarian cancer by approximately 50%. As for breast and cervical cancer, the use of the pill seems to neither protect nor burden the woman.

The absolute contraindications to the contraceptive pill are thrombosis in the past, thrombophilic diseases, liver diseases, rare neurological diseases and natural neoplasms. Related contraindications are smoking, age (usually over 40 years), recent pregnancy and lactation. Your doctor will determine which pill is right for you (essentially what the estrogen and progesterone ratio will be), based on your health, your history and your age. The effectiveness of the method exceeds 99%, provided that the woman does not neglect her daily intake.


It is one of the most effective methods of contraception, with a success rate exceeding 98%. It is placed by the doctor in the intrauterine cavity and lasts for 3-5 years, depending on its type. It can be used safely in both women who have given birth and in women who have not, and placement is almost always done in the doctor’s office without the need for anesthesia. It is not perceived by either the woman herself or her partner during sexual intercourse.

There are two categories of spirals: those containing copper and those that consistently deliver extremely low amounts of progesterone to the uterus. The latter have the added advantage of making the symptoms of the period milder by significantly reducing blood flow.

It should be noted that the use of spiral is not associated with increased rates of extrauterine pregnancies, a view that has been mistaken in the past.

Finally, we point out that spiral does not provide protection against sexually transmitted diseases, so in unstable sexual relations condoms should also be used.

Adhesive patch

It is considered as effective as the pill for preventing unwanted pregnancy, and it works in the same way, except that the hormones it contains are gradually pumped into the body through the skin. The contraceptive patch is placed on the arm, abdomen or buttock and needs to be changed every week, three times in each menstrual cycle. It therefore has an advantage over the pill in terms of the possibility of forgetting its application. Its disadvantages are the possibility of an allergic reaction at the application site, and the use of the patch appears to be a greater risk of blood clots than the pill.

Vaginal ring

It is a flexible ring that is inserted into the woman’s vagina by herself once a month. Remains in place for three weeks and then removed for menstruation. Its action is also based on the release of hormones, its effectiveness is comparable to other methods using the same mechanism (patch, pill), while its contraindications and side effects are similar.

Vaginal sponge

It is a small spermicidal sponge that is impregnated with water and placed in the vagina shortly before sexual intercourse and may remain in place for up to 24 hours. It is an easy-to-apply method, not associated with serious side effects, but its success rates are quite low: around 85% in women who haven’t still given birth and 70% in those who have given birth.


Elastic dome that must be coated with some spermicide and placed in the vagina before contact to prevent sperm from reaching the cervix. After intercourse it needs to remain in place for at least 6 hours. Its efficacy reaches 85%, with the major side effects associated with its use being local irritation and a relatively increased risk of urinary tract infection.

Female condom

It looks like a male condom, is about 15 cm long and can be placed in the vagina up to 8 hours before contact. Its effectiveness is slightly lower than that of a male condom, and so is its protection against sexually transmitted diseases.

Method of rhythm

It consists in abstaining from sexual intercourse during her fertile days or using a barrier method at the same time. The method assumes that your menstrual cycle is stable and that you will be trained by your doctor in identifying the “dangerous” days by monitoring your cycle and your body temperature. Even so, the chances of failure reach 25%.

Intermittent intercourse

However, “convenient” practice is accompanied by an increased risk of conception, and even before the penis is removed from the vagina, sperm can be secreted. In addition, it creates stress for the couple and reduces sexual pleasure.

Morning after pill

It should not be seen as a method of contraception, but as a last resort to avoid unwanted pregnancy, rather than abortion. If you have had sex without protection or are afraid that the protection has not worked, you can contact your doctor within three days. He will give you the substance you need to avoid pregnancy. The odds of success are around 85%.
The Doctor

Dr. Nikolopoulos maintains a private practice in ATHENS, while collaborating exclusively with MITERA’s maternity hospital and the new HYGEIA IVF Athens Assisted Reproduction Unit. At the same time, he is in charge of the Fertility and In Vitro Fertilization clinic at City Hospital, in the city of KALAMATA.