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Mesovarium cysts are fluid-filled sacs that develop in the mesovarium, which is the fold of tissue in the broad ligament that supports the ovaries. While they might sound complicated, understanding these cysts in simple terms can help you recognize symptoms early, seek appropriate medical care, and make informed decisions about your health.

The mesovarium is part of the broad ligament in a woman’s pelvis. The broad ligament is like a sheet of tissue that extends from the sides of the uterus to the walls of the pelvis, helping to hold the female reproductive organs in place. Specifically, the mesovarium is the portion of the broad ligament that attaches to the ovary.

Pathophysiology

Structure

The mesovarium is a thin, double-layered fold of tissue.
It extends from the ovary to the rest of the broad ligament.
It contains small blood vessels, lymphatic channels, and nerves that go to and from the ovary.
This fold helps keep the ovaries in a stable position within the pelvic cavity.

Blood Supply

Ovarian artery and vein: The main blood supply to the ovary (and thus the mesovarium) is through the ovarian artery, which branches from the abdominal aorta. The ovarian vein drains blood away from the ovary.
Branch of the uterine artery: A smaller contribution to the ovary’s blood supply can come from a branch of the uterine artery, which runs along the uterus.

Having a good blood supply is essential for the ovary’s normal functions, such as hormone production and egg maturation.

Nerve Supply

Sympathetic nerves: These nerves help regulate blood flow and hormone release.
Parasympathetic nerves: These nerves can influence pain and other sensations in the ovarian area.

The nerves that reach the ovary and mesovarium come from certain pelvic plexuses in the lower abdomen. These nerves help carry signals about pain, temperature, and pressure.

Functions

Support of the ovary: The mesovarium helps hold the ovary in place within the pelvis.
Pathway for vessels and nerves: It serves as a route for blood vessels, lymphatic vessels, and nerves to reach the ovary.
Protective covering: The thin tissue can also help protect the ovary by providing a small cushion.

Pathophysiology of Mesovarium Cysts

A mesovarium cyst forms when fluid collects within the tissue of the mesovarium. There are various theories about how these cysts develop, but many arise from:

Embryonic tissue remnants: During development, some leftover tissue can form fluid-filled sacs.
Blockage in ductal structures: Small ducts or glands that should drain fluid can get blocked, leading to fluid buildup.
Infections or inflammation: Occasionally, infection in the pelvic area can cause fluid-filled structures to form.

These cysts are often benign (non-cancerous). However, they can grow in size, twist on themselves (torsion), or rupture, leading to pain or other complications.

Types of Mesovarium Cysts

While “mesovarium cyst” is already a specific term, there can be variations depending on their origin and characteristics:

Simple Cysts: Fluid-filled, with thin walls and no solid areas.
Complex Cysts: May have thicker walls, internal divisions (called septations), or solid components.
Paraovarian/Paratubal Cysts: Sometimes grouped under mesovarium cysts, these develop within the broad ligament near the ovary or fallopian tube.
Dermoid Cysts (Mature Cystic Teratomas): Rare in the mesovarium; contain various tissues (like hair or fat).
Endometriotic Cysts: Uncommon in the mesovarium; formed from endometrial tissue outside the uterus.

In many cases, doctors classify mesovarium cysts based on their size and appearance on imaging scans rather than strict categories. Most mesovarium cysts remain small and asymptomatic.

Common Causes of Mesovarium Cysts

Although the exact cause of many mesovarium cysts is not always clear, several factors can contribute to their formation:

Embryonic remnants (Wolfian or Müllerian ducts)
Genetic predisposition
Hormonal imbalances (e.g., fluctuations in estrogen levels)
Chronic pelvic inflammation
Pelvic infections (e.g., pelvic inflammatory disease)
History of ovarian cysts
Blockage in the drainage system of the mesovarium
Post-surgical changes or scar tissue
Endometriosis (less commonly, can affect mesovarium)
Reproductive tract anomalies
Trauma to the pelvic area
Frequent use of fertility treatments (certain medications may stimulate cyst formation)
Weak immune system (more prone to infections and inflammation)
Hormone-producing tumors (rarely)
Structural changes in the broad ligament
Congenital cystic formations (present at birth but may enlarge over time)
Lifestyle factors (extreme stress, poor diet)
Exposure to environmental toxins (rare link, but under study)
Repeated inflammation from intrauterine devices (IUDs) – though not a direct cause, ongoing irritation might play a role
Idiopathic reasons (no known cause after thorough evaluation)

Possible Symptoms of Mesovarium Cysts

Many mesovarium cysts are small and cause no symptoms. However, larger cysts or complications can lead to noticeable signs, such as:

Lower abdominal or pelvic pain (especially on one side)
Feeling of pressure or fullness in the pelvis
Abdominal bloating or swelling
Pain during sexual intercourse (dyspareunia)
Irregular menstrual periods
Lower back pain
Frequent urination (if the cyst puts pressure on the bladder)
Constipation or difficulty with bowel movements
Nausea or vomiting (especially if torsion occurs)
Sudden sharp pain (if the cyst ruptures)
Pain that worsens during or after exercise
Fatigue or low energy (chronic discomfort can cause exhaustion)
Unexplained weight gain (in cases of large cysts)
Spotting or abnormal vaginal bleeding
Difficulty getting pregnant (rare and usually linked to other factors)
Pain that radiates to the thigh or groin area
Feeling a palpable lump or mass in the lower abdomen (in rare, large cases)
Changes in appetite
Hormonal symptoms (breast tenderness, mood swings)
General discomfort or vague pelvic heaviness

Diagnostic Tests for Mesovarium Cysts

Diagnosing a mesovarium cyst typically involves a combination of patient history, physical exam, and imaging techniques. Here are 20 possible diagnostic approaches:

Medical history and symptom review
Physical pelvic exam (to check for tenderness or masses)
Transvaginal ultrasound (common first-line imaging)
Abdominal ultrasound (especially if the cyst is large)
Pelvic MRI (magnetic resonance imaging for detailed views)
CT scan (computed tomography, less commonly used for cysts but can help)
Color Doppler ultrasound (to assess blood flow)
Pregnancy test (to rule out ectopic pregnancy)
Hormone level tests (estrogen, progesterone, LH, FSH)
CA-125 blood test (tumor marker; mostly for ovarian cancer screening)
CBC (Complete Blood Count) (to check for infection or inflammation)
Urinalysis (to rule out urinary tract issues)
Pap smear (to check cervical health; not a direct test for cysts but part of routine pelvic exam)
STD screenings (to rule out pelvic inflammatory disease)
Pelvic exam under anesthesia (rare, used if pain prevents thorough exam)
Serum Beta-hCG (more specific pregnancy-related test to exclude ectopic)
Laparoscopy (diagnostic) (a surgical procedure to look directly inside the pelvis)
Endometrial biopsy (only if there are concerns about abnormal uterine bleeding)
Vaginal swabs (to check for infections)
Genetic testing (very rare; only if there’s suspicion of hereditary conditions)

Non-Pharmacological Treatments

Many mesovarium cysts do not require aggressive treatment, especially if they are small and asymptomatic. Several non-pharmacological (non-medication) methods can help manage symptoms and improve overall pelvic health:

Watchful waiting: Monitoring the cyst size and symptoms over time.
Regular ultrasounds: Periodic imaging to track any changes in the cyst.
Heat therapy: Using a heating pad on the lower abdomen for pain relief.
Cold compresses: Applying a cold pack to reduce inflammation and discomfort.
Pelvic rest: Avoiding strenuous activities or sexual intercourse if it causes pain.
Stress management: Techniques like deep breathing, meditation, and relaxation exercises.
Yoga: Gentle yoga poses (like Child’s Pose) can help alleviate pelvic pain.
Pelvic floor exercises (Kegel exercises) to strengthen and relax pelvic muscles.
Physical therapy: A specialized pelvic physiotherapist can offer targeted exercises.
Acupuncture: Some people find relief from pelvic pain through acupuncture.
Massage therapy: Gentle abdominal or back massage can ease tension.
Aromatherapy: Essential oils (like lavender) may help with relaxation and pain relief.
Mindfulness techniques: Focusing on present-moment awareness can help manage chronic pain.
Dietary changes: Increase fruits, vegetables, and whole grains; reduce processed foods.
Hydration: Drinking enough water helps overall health and may reduce bloating.
Avoiding caffeine: Caffeine can sometimes worsen pain or bloating.
Limiting alcohol: Reduces inflammation and hormonal imbalances.
Maintaining a healthy weight: Excess weight can strain pelvic structures.
Low-impact exercises: Walking, swimming, or cycling to boost blood circulation.
Herbal teas (e.g., chamomile, ginger) for mild comfort.
Adequate rest: Ensuring 7-9 hours of quality sleep each night.
Relaxation baths: Warm baths with Epsom salts to soothe muscle tension.
Lifestyle counseling: A counselor or coach can help manage stress and emotional factors.
Biofeedback: A technique where a device helps you understand and control body responses like muscle tension.
Support groups: Sharing experiences with others who have similar conditions can relieve anxiety.
Journaling: Tracking symptoms, stress levels, and diet to identify triggers.
Avoiding heavy lifting: Reducing strain on the pelvic area.
Using supportive garments: Sometimes a gentle abdominal binder may help if recommended by a doctor.
Therapeutic ultrasound (physical therapy): Ultrasound used by therapists to reduce pain in muscles and tissues.
Homeopathy or naturopathy (with caution and professional advice): Some individuals explore alternative therapies for symptom relief.

Always consult a healthcare provider before starting any alternative therapies to ensure they are safe and appropriate for your condition.

Medications Used for Mesovarium Cysts

Medications can help manage pain, regulate hormones, or address underlying infections. Depending on the individual’s situation, doctors may prescribe:

Nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g., ibuprofen)
Acetaminophen (paracetamol)
Oral contraceptive pills (to regulate hormones and prevent new cyst formation)
Progestin-only pills
GnRH agonists (in more complex cases, to reduce estrogen)
Antibiotics (if infection is present)
Opioid pain relievers (for severe pain, short-term use)
Anti-nausea medications (if vomiting occurs)
Hormone patches (to stabilize hormone levels)
Hormone injections (rarely used, except in special cases)
Selective estrogen receptor modulators (SERMs) (experimental in some cyst-related conditions)
Danazol (older therapy for endometriosis, sometimes used off-label)
Depo-Provera (injectable medroxyprogesterone)
Transdermal pain patches (lidocaine patch) for localized pain relief
Topical NSAID gels (for mild pain over the lower abdomen)
Muscle relaxants (if pelvic muscle spasms are an issue)
Low-dose aspirin (sometimes recommended for specific vascular reasons)
Vitamin supplements (e.g., vitamin D, B vitamins) – supportive but not a direct treatment
Iron supplements (if there’s anemia due to chronic blood loss)
Herbal supplements (like chasteberry) – used cautiously and under medical guidance

Important: Always follow your doctor’s recommendations and dosage instructions when taking any medication. Do not self-prescribe or stop taking a prescribed medication without consulting a healthcare professional.

Surgical Options for Mesovarium Cysts

In some cases, surgery may be necessary—particularly if the cyst is large, causing severe symptoms, or there’s a concern about complications like torsion or rupture. Surgical options can include:

Laparoscopic cystectomy: Minimally invasive removal of the cyst while leaving the ovary intact.
Laparotomy (open surgery): Used for very large cysts or when cancer is suspected.
Laparoscopic drainage: The cyst is drained of fluid; however, this approach has a higher chance of recurrence.
Laparoscopic cyst aspiration with sclerotherapy: Fluid is removed, and a sclerosing agent is introduced to reduce re-accumulation of fluid (less common).
Oophorectomy (ovary removal): If the cyst severely damages the ovary or cancer is suspected.
Salpingectomy (fallopian tube removal): If the cyst extends into or affects the fallopian tube.
Salpingo-oophorectomy: Removal of both the ovary and the fallopian tube if severely affected.
Robot-assisted laparoscopic surgery: An advanced form of minimally invasive surgery.
Exploratory laparoscopy: To identify suspicious cysts and possibly treat them on the spot.
Cyst excision with broad ligament repair: Specifically addressing cysts within the mesovarium and ensuring the supporting tissues are repaired.

Your doctor will decide which surgical method is best depending on the cyst’s size, symptoms, and suspicion of malignancy.

Tips to Prevent Mesovarium Cysts

While not all mesovarium cysts can be prevented (especially those that form from embryonic remnants or genetic reasons), maintaining overall pelvic health can lower the risk:

Regular pelvic exams: Early detection is key.
Routine ultrasound scans: Particularly if you have a history of cysts.
Balanced diet: Focus on whole foods and avoid excessive processed items.
Exercise regularly: Helps regulate hormones and maintain a healthy weight.
Manage stress: Chronic stress may contribute to hormonal imbalances.
Limit exposure to environmental toxins: Use safe, natural products when possible.
Avoid smoking: Smoking can affect hormonal balance and overall health.
Moderate alcohol intake: Excessive alcohol can impact liver function and hormone metabolism.
Follow birth control guidance: Oral contraceptives can sometimes reduce the occurrence of ovarian cysts.
Prompt treatment of infections: Properly treating pelvic infections may help prevent cyst formation due to inflammation.

When to See a Doctor

You should see a doctor if you experience:

Severe or sudden pelvic pain
Pain accompanied by fever, nausea, or vomiting
Unusual vaginal bleeding or spotting
Persistent bloating or a sense of fullness in the abdomen
Changes in your menstrual cycle for more than two cycles
Difficulty urinating or passing stools due to pelvic pressure
Any other alarming symptoms like dizziness or fainting spells

Early medical evaluation can help rule out life-threatening conditions like ovarian torsion or ectopic pregnancy.

Frequently Asked Questions (FAQs)

Q: Are mesovarium cysts cancerous?
A: Most mesovarium cysts are benign (non-cancerous). However, any suspicious cyst should be evaluated by a healthcare professional.
Q: Can mesovarium cysts affect fertility?
A: Small, uncomplicated cysts usually do not affect fertility. Larger cysts or those causing complications might interfere with normal ovarian function, but this is less common.
Q: Do mesovarium cysts go away on their own?
A: Many small cysts resolve spontaneously over time. Regular monitoring by ultrasound can confirm any changes in size.
Q: What is the difference between a mesovarium cyst and an ovarian cyst?
A: An ovarian cyst forms within the ovary itself, while a mesovarium cyst develops in the mesovarium—part of the broad ligament attached to the ovary.
Q: Is surgery always necessary?
A: Not always. Doctors often adopt a “watch and wait” approach for small, asymptomatic cysts. Surgery is usually reserved for larger or symptomatic cysts.
Q: Does birth control help prevent mesovarium cysts?
A: Birth control pills can help regulate hormones and sometimes reduce the formation of ovarian cysts. Their direct effect on mesovarium cysts is less clear, but they may still be beneficial.
Q: Can lifestyle changes shrink a cyst?
A: Lifestyle changes like a healthy diet, exercise, and stress management may help balance hormones and possibly prevent new cysts, but they might not always shrink existing ones.
Q: Are mesovarium cysts painful?
A: Many are painless and only discovered during routine exams. Pain can occur if the cyst is large, ruptures, or undergoes torsion.
Q: Can mesovarium cysts return after surgical removal?
A: While the specific cyst removed may not return, new cysts can sometimes form depending on underlying causes or risk factors.
Q: How quickly do mesovarium cysts grow?
A: Growth rate varies. Some cysts remain stable for months or years, while others may enlarge more quickly.
Q: What is torsion?
A: Torsion happens when the cyst twists around its stalk, cutting off its own blood supply. This is a medical emergency causing severe pain.
Q: Can I travel with a mesovarium cyst?
A: In most cases, traveling is safe if you have a small, asymptomatic cyst. However, consult your doctor if you have a large cyst or severe symptoms.
Q: Do I need a special diet if I have a mesovarium cyst?
A: There is no strict cyst-specific diet, but a balanced diet can help your overall reproductive health. Avoiding processed foods and maintaining good hydration can be beneficial.
Q: Will a mesovarium cyst show up on a home pregnancy test?
A: No. A home pregnancy test detects the hormone hCG, which is unrelated to most cysts. However, if you suspect pregnancy complications, see a doctor.
Q: How often should I have follow-up scans?
A: This depends on the size and nature of the cyst. Your doctor may recommend an ultrasound in 6-12 weeks to check for changes.

Conclusion

Mesovarium cysts are fluid-filled sacs that develop in the part of the broad ligament supporting the ovaries. They are often harmless and may not produce any symptoms. However, some can cause pain, discomfort, or complications if they grow large, rupture, or twist. Recognizing the signs and symptoms, understanding diagnostic steps, and exploring treatment options are crucial to managing these cysts effectively.

Authors

The article is written by Team Rxharun and reviewed by the Rx Editorial Board Members

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Last Update: February 22, 2025.

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