What should I know about ovarian cysts?

Different Types of Ovarian Cyst
What Are the Different Types of Ovarian Cyst?
    • Feeling of bloating or indigestion
    • Increased abdominal girth
    • Pain during sexual intercourse (dyspareunia)
    • Nausea and vomiting
  • Most ovarian cysts are not cancerous.

Ovarian Cyst Symptoms and Signs

Many times ovarian cysts do not cause symptoms. When symptoms do occur, they may include the following:

  • Pain during intercourse
  • Nausea
  • Vomiting
  • Unusual bleeding
  • Abdominal fullness
  • Breast pain
  • Aching in the pelvic region

What are the ovaries and how big are they?

Picture of the female reproductive system

The ovary is one of a pair of reproductive glands in women that are located in the pelvis, one on each side of the uterus. Each ovary is about the size and shape of a walnut. The ovaries produce eggs (ova) and the female hormones estrogen and progesterone. The ovaries are the main source of female hormones, which control the development of female body characteristics such as the breasts, body shape, and body hair. They also regulate the menstrual cycle and pregnancy.

What are ovarian cysts?

Ovarian cysts are closed, sac-like structures within an ovary that contain a liquid, or semisolid substance. "Cyst" is merely a general term for a fluid-filled structure, which may or may not represent a tumor or neoplasm (new growth). If it is a tumor, it may be benign or malignant. The ovary is also referred to as the female gonad.


Ovarian Cyst Symptoms, Types, and Treatment See Slideshow

What are the signs and symptoms of ovarian cysts?


  • rupture of the cyst,
  • rapid growth and stretching,
  • bleeding into the cyst, or

If the cyst has reached a large size, other symptoms may arise as a result of pressure or distortion of adjacent anatomical structures. These other symptoms can include

  • abdominal fullness, expansion of the abdomen, or bloating,
  • low back pain,
  • indigestion,
  • feeling full after eating only a small amount (early satiety),
  • urinary urgency,
  • difficulty with emptying the bladder completely,
  • feeling an urge to defecate
  • having difficult bowel movements, or
  • pain with sexual intercourse.

What are the symptoms of a ruptured ovarian cyst?

A ruptured (burst) ovarian cyst will not always cause symptoms, particularly if the cyst is small. However, sometimes a ruptured ovarian cyst can lead to severe pain and internal bleeding. The pain with a ruptured ovarian cyst typically comes on suddenly and occurs on one side only. The pain may begin during physical activity such as vigorous exercise or may begin during sexual intercourse. A ruptured ovarian cyst usually does not cause fever or gastrointestinal symptoms.

What causes ovarian cysts? What are the types of ovarian cysts?

There are many causes of ovarian cysts, and most ovarian cysts are not cancerous.

  • Follicular cysts: The most common type is a follicular cyst, which results from the growth of a follicle. A follicle is the normal fluid-filled sac that contains an egg. Follicular cysts form when the follicle grows larger than normal during the menstrual cycle and does not open to release the egg. Usually, follicular cysts resolve on their own over the course of days to months. Follicular cysts can contain blood (hemorrhagic cysts) from leakage of blood into the egg sac.
  • Corpus luteum cysts: A Corpus luteum cyst is related to the menstrual cycle. The corpus luteum is an area of tissue within the ovary that occurs after an egg has been released from a follicle. If a pregnancy doesn't occur, the corpus luteum usually breaks down and disappears. It may, however, fill with fluid or blood and persist as a cyst on the ovary. Usually, this cyst is found on only one side, produces no symptoms and resolves spontaneously.
  • "Chocolate cysts:" Endometriosis is a condition in which cells that normally grow inside as a lining of the uterus (womb), instead grow outside of the uterus in other locations. The ovary is a common site for endometriosis. When endometriosis involves the ovary, the area of endometrial tissue may grow and bleed over time, forming a blood-filled cyst with red- or brown-colored contents called an endometrioma, sometimes referred to as a "chocolate cyst."
  • Polycystic ovarian syndrome: The condition known as polycystic ovarian syndrome (PCOS) is characterized by the presence of multiple small cysts within both ovaries. PCOS is associated with a number of hormonal problems and is the most common cause of infertility in women.
  • Dermoid cysts (benign cystic teratomas): Both benign and malignant tumors of the ovary may also be cystic. Occasionally, the tissues of the ovary develop abnormally to form other body tissues such as hair or teeth. Cysts with these abnormal tissues are really tumors called benign cystic teratomas or dermoid cysts.
  • Tubo-ovarian abscesses: Infections of the pelvic organs can involve the ovaries and Fallopian tubes. In severe cases, pus-filled cystic spaces may be present on, in, or around the ovary or tubes. These are known as tubo-ovarian abscesses.

Can ovarian cysts cause cancer?

Most ovarian cysts are not due to cancer, and having an ovarian cyst does not cause ovarian cancer. However, some ovarian cancers develop cystic areas inside the tumor. Ovarian cancer is much less common than benign ovarian cysts.


What is pelvic inflammatory disease (PID)? See Answer

What about ovarian cysts during pregnancy?


Can a woman get ovarian cysts during menopase or postmenopause?

Ovarian cysts may develop during pregnancy or at any point in a woman's life. Some kinds of ovarian cysts are related to the menstrual cycle and occur before a woman has reached menopause (the time point at which a women has not had a menstrual period for 12 consecutive months). However, postmenopausal women may still develop other types of ovarian cysts.

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Which specialties of doctors treat ovarian cysts?

Gynecologists-obstetricians are the medical specialists most likely to treat ovarian cysts.

How are ovarian cysts diagnosed?

Sometimes ovarian cysts may be noticed by a doctor during a bimanual examination of the pelvis. If a cyst is suspected based upon symptoms or physical examination, imaging techniques are used. Most cysts are diagnosed by ultrasound, which is the best imaging technique for detecting them. Ultrasound uses sound waves to produce an image of structures within the body. Ultrasound imaging is painless and harmless. Transvaginal ultrasound is a diagnostic tool to better visualize the ovaries using a thin ultrasound probe inside the vagina.


Functional ovarian cysts: If a woman is in her 40's, or younger, and has regular menstrual periods, most ovarian masses are "functional ovarian cysts," which are not really abnormal. Examples include follicular cysts and corpus luteum cysts. These are related to the process of ovulation that happens with the menstrual cycle. They usually disappear on their own during a future menstrual cycle. Therefore, especially in women in their 20's and 30's, these cysts are watched for a few menstrual cycles to verify that they disappear.

  • Because oral contraceptives work by preventing ovulation, physicians will not generally expect women who are taking oral contraceptives to have common "functional ovarian cysts." These women do not have functional ovarian cysts. They may receive further evaluation with pelvic ultrasound or possibly surgical intervention. Functional ovarian cysts do not occur in women after they have reached menopause. Small cystic arrested follicles may persist in the ovary after menopause.
  • Other factors are helpful in evaluating ovarian cysts (besides the woman's age, or whether she is taking oral contraceptives). A cyst that contains a simple sac of fluid on ultrasound is more likely to be a benign neoplasm than a cyst with solid tissue in it. So the ultrasound appearance also plays a role in determining the level of suspicion regarding an ovarian tumor.

Cancer risks: Ovarian cancer is rare in women younger than age 40. After age 40, an ovarian cyst has a higher chance of being cancerous than before age 40, although most ovarian cysts are still benign even after age 40. CA-125 blood testing can be used as a marker of ovarian cancer, but it does not always represent cancer, even when it is abnormal, and it may be normal in the presence of malignancy. CA-125 is a protein that is elevated in the bloodstream of many women with advanced ovarian cancer.

  • First, many benign conditions in women of childbearing age can cause the CA-125 level to be elevated, so CA-125 is not a specific test, especially in younger women. Pelvic infections, uterine fibroids, pregnancy, benign (hemorrhagic) ovarian cysts, endometriosis, and liver disease are some of the conditions that may elevate blood CA-125 levels in the absence of ovarian cancer.

What is the treatment for ovarian cysts?


Ultrasound is useful to determine if the cyst is simple (just fluid with no solid tissue, suggesting a benign condition) or compound (with solid components that often requires surgical resection).

In summary, the ideal treatment of ovarian cysts depends on the likely cause of the cysts and whether or not it is producing symptoms. The woman's age, the size (and any change in size) of the cyst, and the cyst's appearance on ultrasound help determine the treatment. Cysts that are functional are usually observed (watchful waiting) with frequent monitoring unless they rupture and cause significant bleeding, in which case, surgical treatment is required. Benign and malignant tumors require operation.


There are no natural or home remedies to treat ovarian cysts, other than taking non-steroidal anti-inflammatory drugs for pain management.

What about surgery for ovarian cysts?

Any type of ovarian mass, including a cyst, can be surgically removed either with laparoscopy, or if needed, an open abdominal incision (laparotomy) if it is causing severe pain, not resolving, or if it is suspicious in any way. Once the cyst is removed, the growth is sent to a pathologist who examines the tissue under a microscope to make the final diagnosis as to the type of cyst present.

What is the prognosis for a woman with ovarian cysts?

Most functional (related to the menstrual cycle) ovarian cysts resolve on their own and do not cause long-term problems. Benign cysts or benign tumors can be surgically removed. The vast majority of ovarian cysts do not cause any long-term problems. Rarely, cysts may be present within an ovarian cancer. In this case, the prognosis depends upon the extent of spread and exact type of cancer that is present.

Can ovarian cysts be prevented?

There is no known way to prevent the development of ovarian cysts.

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Medically Reviewed on 9/11/2019
REFERENCE: Grabosch, S.M., MD. "Ovarian Cysts." Medscape. Updated: Jan 18, 2017.