Ovarian Cysts

What is an ovarian cyst?

An ovarian cyst is a small sac filled with fluid or semisolid material that forms on or within one or both of your ovaries. There are different types of ovarian cysts, most of which are painless and noncancerous (benign). Ovarian cysts don’t always cause symptoms. You likely won’t know you have one unless your healthcare provider finds one during a pelvic exam or pelvic ultrasound.

Rarely, ovarian cysts can cause complications. Scheduling regular pelvic exams and speaking with your provider about any symptoms you may be experiencing can help troubleshoot any problems with an ovarian cyst.

Ovarian cysts are extremely common, especially if you haven’t gone through menopause yet.

Types of ovarian cysts

Most ovarian cysts are functional cysts. They form in response to your body’s changes during your menstrual cycle. Less commonly, ovarian cysts form for reasons unrelated to your period.

Functional ovarian cysts

Functional cysts are the most common type of ovarian cyst and aren’t disease-related. They occur as a result of ovulation. These cysts can be a sign that your ovaries are functioning as they should. Functional cysts generally shrink over time, usually within 60 days, without treatment. Sometimes, functional cysts are called simple cysts. They include:

• Follicular cysts. A small sac in your ovary, called a follicle, releases an egg each month as part of your menstrual cycle. A follicular cyst forms when the follicle doesn’t release an egg. Instead, the follicle fills with fluid and forms a cyst.
• Corpus luteum cysts. After the follicle releases an egg, it forms a hormone-producing structure called the corpus luteum. If conception doesn’t take place, the corpus luteum dissolves. But sometimes, instead of breaking down, it fills with fluid and forms a cyst.

Other ovarian cysts

Not all ovarian cysts form in response to your menstrual cycle. They aren’t always signs of disease, but your provider may want to monitor them to ensure that they don’t cause complications. Other types of ovarian cysts include:

• Cystadenomas. These cysts form on the surface of your ovary. They can be filled with fluid that’s thin and watery or thicker and mucous-like.
• Dermoid cysts (teratomas). Dermoid cysts contain cells similar to the tissue in your hair, teeth or skin. They’re smooth, rubbery and noncancerous.
• Endometriomas. These cysts are filled with menstrual blood and are typically a sign of having endometriosis.
• Ovarian cancer cysts. Unlike the conditions above, ovarian cancer cysts are solid masses of cancer cells. This can happen at any age, but are more common after menopause.

Are ovarian cysts serious?

Usually, no. Most ovarian cysts are harmless, and they often eventually go away on their own. Some types of cysts are more likely to become cancerous or cause complications, but this is rare. Less than 1% of ovarian cysts are cancerous. Your healthcare provider can closely monitor any concerning cysts to reduce your risk of experiencing complications.

What are the symptoms of an ovarian cyst?

Some smaller cysts cause no symptoms. In these cases, you may not even know you have a cyst. Larger cysts may cause:

• Pelvic pain or a dull ache in your back
• A feeling of fullness (bloating in your lower belly) — it may feel more pronounced on one side of your body
• Pain during sex (dyspareunia)
• Painful periods and/or irregular periods
• Trouble pooping or needing to pee frequently

Symptoms that linger could indicate a condition called polycystic ovary syndrome (PCOS). PCOS is a condition that causes irregular menstrual cycles and an increase in androgens that may cause cystic acne, difficulty with conception and weight gain.

What does an ovarian cyst feel like?

The experience of having an ovarian cyst varies from person to person. You may feel:

• No pain at all
• Mild discomfort or a feeling of fullness
• Pain that could be described as sharp or like a dull ache
• Discomfort or pain that comes and goes without explanation
• Pain during certain parts of your menstrual cycle.

What causes an ovarian cyst?

Ovulation is the leading cause of ovarian cysts. It’s a natural process that happens during your menstrual cycle. Other causes include:

• Abnormal cell reproduction. Unusual cell reproduction can cause dermoid cysts or cystadenomas to form.
• Endometriosis. Endometriomas (or chocolate cysts) often form on your ovary if you have advanced endometriosis.
• Polycystic ovary syndrome (PCOS). PCOS can cause multiple small cysts to form on your ovaries.
• Pelvic inflammatory disease (PID). Severe pelvic infections can spread to your ovaries, causing cysts.

What are the risk factors for ovarian cysts?

Anyone with ovaries can develop an ovarian cyst. Your chances increase based on your:

• Age. Ovarian cysts are more common if you haven’t gone through menopause.
• Pregnancy status. Cysts are more likely to form and remain during pregnancy.
• History of ovarian cysts. You’re more likely to have an ovarian cyst if you’ve had one before.
• Current medical conditions. You’re more likely to get an ovarian cyst if you have endometriosis, PCOS or another hormone disorder.
• Fertility medication. You’re more likely to get a cyst if you’re taking medications to help with ovulation, like clomiphene (Clomid­­©).

What are the complications of an ovarian cyst?

Most cysts don’t cause any serious complications. Your healthcare provider can let you know if they think an ovarian cyst is likely to lead to complications. Some of the most common complications are:

• Cancer. Ovarian cysts that develop after menopause are more likely to be cancerous than cysts that form before menopause.
• Ruptured ovarian cyst. Functional cysts commonly rupture (break open) without causing any symptoms. But sometimes, a ruptured cyst can cause severe pain, dizziness or weakness. The larger it is, the greater likelihood it has of breaking.
• Ovarian torsion. Cysts can grow so big that they distort the shape of your ovary, increasing the likelihood that it’ll twist. The twisting can prevent blood flow to your ovary, causing it to die. Extreme pain, nausea and vomiting are all signs of ovarian torsion.

Seek medical assistance right away if you’re experiencing the symptoms of a ruptured ovarian cyst or ovarian torsion.

What does a burst ovarian cyst feel like?

A ruptured or burst ovarian cyst typically feels like sudden, sharp pain in your pelvis (typically lower and off to the side). The pain is often intense and severe. Other symptoms of a burst ovarian cyst are:

• Vaginal bleeding
• Nausea or vomiting
• Bloating or a feeling of fullness in your abdomen
• Pressure or aching in your abdomen

How is an ovarian cyst diagnosed?

Your healthcare provider will first rule out pregnancy as the cause of your symptoms by giving you a pregnancy test. Then, they may use the following tests to diagnose an ovarian cyst:

• A pelvic exam. Your provider will feel inside your pelvis for any lumps or changes.
• Ultrasound. This imaging procedure uses sound waves to create images of your pelvic organs. It can detect cysts on your ovaries, including their locations and whether they’re primarily fluid or solid.
• Laparoscopy. This is a procedure performed in an operating room. Your provider inserts a camera through an incision (cut) in your abdomen and can view your reproductive organs and pelvic cavity. If your provider diagnoses a cyst at this time, they can remove it.

How is an ovarian cyst treated?

Treatment will depend on factors like your symptoms, the type of cyst and what’s causing it. Options could include monitoring the cyst over time, medication or surgery to remove the cyst. Treatment can also depend on your age and if you’ve reached menopause.

Watchful waiting

Functional ovarian cysts usually go away without treatment. If your cyst is likely functional, your provider may suggest a wait-and-see approach. You may have a follow-up ultrasound within a few weeks or months after your diagnosis to see if your cyst is getting larger, smaller or changing in any other way. This is typically the first treatment approach since most ovarian cysts are small and benign.

Ovarian cyst medications

Your provider may give you medications containing hormones (such as birth control pills) to stop ovulation and prevent future cysts from forming.

Ovarian cyst surgery

If a cyst is causing symptoms and getting bigger, you may need surgery to remove it. The type of surgery depends on the size of the cyst and how it appears on the ultrasound. The different procedures used include:

• Laparoscopic surgery. This is a procedure where your provider inserts a small camera through a small incision in your abdomen. They view your reproductive organs and pelvis using the device. A provider can remove the ovarian cyst through tiny incisions (ovarian cystectomy).
• Laparotomy. Your provider may perform this procedure if the cyst is very large or if there are other concerns. It involves making a larger incision in your abdomen.

If your provider suspects a cancerous cyst, they may consult with a cancer specialist, or gynecological oncologist, about the best treatment options for you.

When does an ovarian cyst need to be removed?

Healthcare providers determine if they need to remove a cyst based on a few factors:

• Size of the cyst. Your provider may recommend removing a cyst larger than 10 centimeters as larger cysts tend to cause discomfort.
• Symptoms. Your provider may recommend removal if the cyst causes you pain, interferes with menstruation or is a factor in being unable to get pregnant.
• Suspicion for cancer. Your provider may want to remove a cyst if there’s any concern that it’s cancerous, especially if you’re at a higher risk for ovarian cancer.
• Type of cyst. Functional cysts tend to stay small and go away after a few menstrual cycles. Other types of cysts get larger and don’t go away on their own, which means your provider is more likely to recommend removing them.

Your provider will also consider factors like your age, health history and if you wish to pregnant. Be sure to ask your provider any questions you have about removing an ovarian cyst.

What can happen if a cyst is left untreated?

It depends on the type and the cause. Some ovarian cysts don’t need treatment and go away on their own over time. Others require treatment or immediate removal because they’re signs of more serious health conditions. You should discuss all the treatment options with your healthcare provider and see what they recommend based on your diagnosis.

Can ovarian cysts be prevented?

Taking medications that contain hormones will stop ovulation. Once ovulation stops, some cysts won’t grow. Some studies suggest that a birth control pill reduces the chances that certain types of cysts will come back. But medications that contain hormones aren’t for everyone.

Usually, ovarian cysts are harmless enough that prevention shouldn’t be a concern. Instead, take note of any unusual symptoms in your pelvis and tell your provider about them. Schedule regular pelvic exams so that your provider can find any cysts that require treatment.

What can I expect if I have an ovarian cyst?

Most cysts are functional cysts and will go away within a few months. You may need follow-up appointments with your provider to make sure a cyst isn’t growing or causing symptoms. Follow your provider’s advice closely if they see a cyst that could cause complications in the future. Your provider may suggest watchful waiting, prescribe medications or recommend a mixture of both. For more concerning cysts, you may need surgery.

When should I be concerned about an ovarian cyst?

Most ovarian cysts aren’t a cause for worry. Your healthcare provider can tell you when a cyst needs closer attention or if it’s completely harmless. Cysts that cause symptoms or that keep growing bigger require closer monitoring than others. Keep track of any symptoms you’re experiencing so that you can tell your provider about them. Follow their advice on how often you should be scheduling appointments to monitor your cysts.

When should I call my healthcare provider?

Call your healthcare provider if any of the following occur:

• Your menstrual periods are late, irregular or painful.
• Your abdominal pain doesn’t go away.
• Your abdomen becomes enlarged or swollen.
• You have pain during intercourse.
• You have feelings of fullness (bloating), pressure or discomfort in your abdomen.

Get help immediately if you notice signs of ovarian torsion or ovarian cyst rupture:

• Severe abdominal pain that comes on suddenly, accompanied by vomiting or fever
• Feeling light-headed or faint and breathing rapidly
• Cold, clammy skin

How long can you have an ovarian cyst?

You can have an ovarian cyst for several months or years and not know. Often, cysts don’t cause symptoms and your provider finds them accidentally.

How long you have a cyst can also depend on what type it is and if your healthcare provider recommends removing it or letting it go away on its own. For example, a simple or functional cyst goes away on its own within a few months. You can have a dermoid cyst for years and not receive treatment for it until it becomes large and uncomfortable. But if an ovarian cyst is suspicious, your provider may recommend removing it and testing it for cancer cells right away.

Will I lose weight when they remove an ovarian cyst?

Maybe. Since some cysts can cause bloating, you may find removing a cyst makes you feel lighter.