What Are Ovarian Cysts?
Ovarian cysts are fluid-filled sacs that develop inside or on the surface of the ovaries. They are very common, often harmless, and may disappear on their own without treatment. Many women will have an ovarian cyst at some point in their lives without ever knowing it.
Types of Ovarian Cysts
- Functional cysts – The most common type, linked to the menstrual cycle. They are usually benign and go away on their own.
- Follicle cysts: Occur when a follicle (sac containing an egg) does not release the egg and continues to grow.
- Corpus luteum cysts: Occur when the follicle sac does not dissolve after releasing the egg and fluid collects inside.
- Other cysts:
- Endometriomas – Associated with endometriosis.
- Dermoid cysts and cystadenomas – Noncancerous growths that may need removal if large.
- Polycystic ovary syndrome (PCOS): A condition where the ovaries may contain many small follicles. PCOS is different from having an ovarian cyst and is caused by a hormonal imbalance that can lead to irregular periods and fertility problems.
- Malignant cysts: Rare, but more common after menopause.
Causes of Ovarian Cysts
Factors that may increase the chance of cyst development include:
- Hormonal imbalances
- Pregnancy (cysts may form in early pregnancy and often go away on their own)
- Endometriosis
- Severe pelvic infections
- Previous ovarian surgery
Symptoms of Ovarian Cysts
Most ovarian cysts do not cause symptoms. When symptoms occur, they may include:
- Pressure, bloating, or swelling in the lower abdomen
- Pelvic pain, often on one side
- Pain during or after sexual intercourse
- Difficulty fully emptying the bladder
- Menstrual changes (heavier or irregular bleeding)
- Pain with bowel movements
Emergency symptoms: Seek medical care right away if you have sudden, severe pelvic pain, fever, dizziness, or rapid breathing. These may signal a ruptured cyst or ovarian torsion (twisting of the ovary).
Diagnosis
Your gynecologist may use several tools to diagnose ovarian cysts:
- Pelvic exam to check for enlargement of the ovaries
- Ultrasound to determine the size, shape, and type of cyst
- Pregnancy test to rule out pregnancy-related cysts
- Blood tests (including CA-125 in certain cases) if there is concern for cancer
- Hormone level testing if cysts are thought to be hormone-related
Treatment
Many ovarian cysts resolve without treatment. Your doctor may recommend:
- Watchful waiting: Monitoring with repeat ultrasounds if the cyst is small and not causing symptoms.
- Hormonal birth control: To help prevent the formation of new cysts.
Surgery
If a cyst is large, persistent, or causing significant symptoms, surgical removal may be recommended. The type of surgery depends on the size and appearance of the cyst:
- Laparoscopy: A minimally invasive procedure using small incisions to remove the cyst. This is common for smaller, noncancerous cysts.
- Laparotomy: A larger incision may be needed for bigger or suspicious cysts.
- Fertility-sparing surgery: When possible, only the cyst is removed (ovarian cystectomy), leaving the ovary intact.
- Removal of ovary/uterus: If cancer is suspected or confirmed, removal of one or both ovaries (oophorectomy), sometimes with the uterus (hysterectomy), may be recommended.
In all cases, cyst tissue is usually sent for laboratory analysis (biopsy) to confirm whether it is benign or malignant.
