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Overview

What Is an Ovarian Cyst?

An ovarian cyst is a fluid-filled sac or other growth that develops in or on an ovary. Many cysts are benign, meaning they are not cancerous, and some cause no symptoms at all. Ovarian cysts commonly form during the menstrual cycle, but they can occur before or after menopause. The term can describe several types of cyst, including a cyst on the ovary related to normal ovulation or another condition.

Symptoms

Ovarian Cyst Symptoms

  • Pelvic pain, which may be dull, aching, or sharp on one side.
  • Pressure or fullness in the lower abdomen or pelvis.
  • Bloating or a swollen feeling in the abdomen.
  • Menstrual changes, such as heavier, irregular, or painful periods.
  • Pain during sex (dyspareunia).
  • Pressure on the bladder, causing urinary frequency or difficulty emptying the bladder.
  • Pressure on the bowel, causing constipation or discomfort with bowel movements.
  • Sudden severe pelvic or abdominal pain, which can occur with rupture or ovarian torsion.

Seek urgent care

Know the warning signs

Sudden severe pelvic or abdominal pain, vomiting, faintness, marked weakness, or heavy vaginal bleeding needs urgent medical assessment. These symptoms may signal a ruptured cyst, internal bleeding, or ovarian torsion rather than a mild ovarian cyst symptom.

Causes

What Causes Ovarian Cysts?

Many ovarian cysts develop as part of the normal menstrual cycle. A follicle may not release an egg, or it may fail to shrink after releasing one, allowing a functional cyst to form. Other causes include endometriosis, pregnancy-related changes, benign growths, and some hormonal conditions. Polycystic ovary syndrome (PCOS) can affect ovulation and the appearance of the ovaries, but PCOS is not the same as having one ovarian cyst.

COMMON FUNCTIONAL CYSTS

Follicular cyst: forms when a follicle does not release an egg. Corpus luteum or hemorrhagic cyst: develops when the follicle changes after ovulation and may fill with blood. These cysts often resolve without treatment.

OTHER CYST TYPES

Endometrioma: is linked to endometriosis. Dermoid cyst: develops from cells present from birth and may contain different tissue types. Cysts can also occur with pregnancy, and some ovarian tumors may have cystic areas, so their appearance requires medical assessment.

Risk Factors

Ovarian Cyst Risk Factors

  • Being of reproductive age increases the chance of functional ovarian cysts because ovulation is occurring.
  • Pregnancy can be associated with cysts that develop or remain visible during early pregnancy.
  • Endometriosis can lead to endometriomas, a type of cyst linked to endometrial-like tissue.
  • Having had ovarian cysts before may increase the chance of developing them again.
  • Fertility treatments or ovulation-inducing medicines can increase the likelihood of functional cysts.
  • Hormonal conditions, including problems with ovulation such as PCOS, may be associated with cyst-like ovarian findings.
  • After menopause, a new cyst is not automatically cancerous but should be evaluated carefully.

Age, reproductive biology, endometriosis, and some medical treatments are factors a person may not be able to change. Many ovarian cysts cannot be prevented through diet, exercise, or other personal lifestyle choices. Following medical advice and attending recommended imaging can help identify cysts that need monitoring.

Complications

Ovarian Cyst Complications

RUPTURE OR TORSION

A cyst may rupture and cause sudden pain, irritation, or internal bleeding. A larger cyst can also cause ovarian torsion, in which the ovary twists and its blood supply is reduced. Sudden severe pain, nausea or vomiting, faintness, or weakness needs emergency assessment.

INFECTION OR CANCER CONCERN

Infection is uncommon but may cause fever and worsening pelvic pain. Most ovarian cysts are benign, although an unusual, growing, complex, or persistent mass may need evaluation for a less common cancerous cause, especially after menopause.

No single ovarian cyst size automatically determines whether it is dangerous. Clinicians consider the ultrasound appearance, growth, symptoms, age, and menopausal status together when deciding whether an adnexal cyst needs observation, further testing, or treatment.

Diagnosis

How Is an Ovarian Cyst Diagnosed?

Evaluation usually begins with questions about symptoms, menstrual cycles, pregnancy possibility, medical history, and medicines, followed by a pelvic examination when appropriate. Pelvic ultrasound is the main imaging test; a transvaginal ultrasound can provide a close view of the ovaries and help show whether a cyst is fluid-filled, solid, simple, or complex. The scan also helps estimate the cyst’s size and location.

  • A pregnancy test may help explain symptoms and guide safe evaluation and treatment.
  • Blood tests may be used when infection, bleeding, hormonal causes, or a concerning mass is suspected.
  • A repeat ultrasound may show whether a cyst is shrinking, stable, or growing over time.
  • MRI can provide more detailed images when ultrasound does not clearly identify the cyst.
  • Surgery may be needed to examine or remove a persistent or unclear cyst when imaging cannot determine the diagnosis.

Treatment & Management

Ovarian Cyst Treatment and Management

ApproachWhen it may be usedWhat to expect
Watchful waitingA small, simple, or likely functional cyst causes few or no symptoms.Symptoms are monitored and a follow-up ultrasound may be recommended. The advantage is avoiding unnecessary treatment; the trade-off is the need for follow-up.
MedicinesPain relief may be used for symptoms, while treatment may target an underlying condition such as endometriosis.Medicines may reduce discomfort or treat the cause but do not remove every type of cyst. Hormonal contraception may prevent some new functional cysts but does not reliably shrink an existing cyst.
SurgeryA cyst is persistent, large, painful, complex, growing, or concerning on imaging, or complications are suspected.Laparoscopic surgery uses small incisions and often allows removal of only the cyst. Open surgery may be needed for a very large or suspicious mass; surgery has recovery time and other procedural risks.

Management may include a follow-up ultrasound to check whether the cyst resolves. When surgery is needed, laparoscopy is often considered when appropriate, while open surgery may be recommended for a large or potentially cancerous mass. Surgeons try to remove only the cyst when possible, but treatment planning considers fertility goals, menopause, cyst appearance, persistence, symptoms, and possible cancer.

Outlook and Prognosis

Outlook and Prognosis for Ovarian Cysts

Many functional ovarian cysts resolve on their own within several weeks to a few months. A persistent, recurrent, large, or complex cyst may need closer follow-up or treatment, and cysts found after menopause are evaluated carefully. The outlook for a dermoid cyst or an endometrioma depends on its size, symptoms, and whether it returns after treatment.

When Should You See a Doctor

When Should You See a Doctor for an Ovarian Cyst?

GET EMERGENCY HELP

Do not wait with severe warning signs

Seek emergency care for sudden severe pelvic or abdominal pain, pain with vomiting, fainting or marked weakness, heavy vaginal bleeding, or fever with severe pain. Get urgent help for possible pregnancy accompanied by pain or bleeding, because these symptoms may indicate a serious complication.

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