Ovarian Cyst

Last Updated August 2021 | This article was created by familydoctor.org editorial staff and reviewed by Deepak S. Patel, MD, FAAFP, FACSM

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Overview

What is an ovarian cyst?

An ovarian cyst is a fluid-filled sac in or on a person’s ovary. The ovaries are part of the female reproductive system. They produce eggs and hormones.

Ovarian cysts are very common. They often occur during ovulation. This is when the ovary releases an egg each month. These are called functional cysts. Most are noncancerous. Many times, these cysts go away on their own without treatment.

Symptoms of an ovarian cyst

Often, functional cysts do not cause any symptoms. You may have one and not know it. Other times they can cause symptoms, including:

  • A sharp or dull pain in the lower abdomen, usually on one side
  • Bloating
  • Menstrual irregularities
  • Nausea and vomiting
  • Feeling full after eating a small amount
  • Constipation

If you are menopausal and are not having periods, functional cysts shouldn’t form. But it is possible for other types of ovarian cysts to form. Call your doctor if you experience any of the symptoms of an ovarian cyst.

What causes an ovarian cyst?

The most common causes of ovarian cysts include:

  • Hormonal problems. They can also be caused by hormone-based medicines that help ovulation.
  • Early pregnancy. It is normal for an ovarian cyst to form during early pregnancy. It helps support the pregnancy until the placenta forms.
  • Endometriosis. People with a condition called endometriosis can develop a type of ovarian cyst called an endometrioma. This is when endometriosis tissue attaches to the ovary and forms a growth.
  • Pelvic infections. Severe infections can spread to the ovaries and cause cysts to form.
  • Polycystic ovary syndrome. This is a disease where the ovaries make many small cysts. It can cause problems with the ovaries and with getting pregnant.

Who gets ovarian cysts?

It is common for a person with regular periods to develop an ovarian cyst. It is usually harmless and goes away on its own. They are less common after menopause. Individuals who have reached menopause and have an ovarian cyst are at higher risk for ovarian cancer.

How is an ovarian cyst diagnosed?

Often times, your doctor will feel a cyst during a pelvic exam. If you have a cyst, your doctor can do two things. One is to wait and watch to see if the cyst changes or starts causing symptoms. The other is to order tests to help plan treatment. What they choose to do depends on several factors. These include your age and if you’re having symptoms.

If your doctor orders tests, they will probably want you to have a sonogram (ultrasound) so they can look at the cyst. A sonogram uses sound waves to make pictures of organs in the body. With a sonogram, your doctor can see the size, shape, and location of the cyst as well as if it is solid or filled with fluid.

Your doctor could also order other tests. These could include:

  • A pregnancy test to rule out pregnancy as the cause of the cyst.
  • Hormone level tests to see if you have problems with your hormones.
  • A CA-125 blood test to measure the amount of cancer-antigen 125 in your blood. If you are past menopause, your doctor may order this test to see if your cyst could be cancerous.

Can an ovarian cyst be prevented or avoided?

If you are ovulating normally, there is nothing you can do to prevent a functional ovarian cyst from forming. If you get cysts frequently, your doctor may prescribe hormonal birth control. This will stop you from ovulating and lower your chances of getting new cysts.

Ovarian cyst treatment

The treatment for ovarian cysts depends on several things. This includes your age, whether you are having periods, the size of the cyst, its appearance, and your symptoms.

Functional cysts normally shrink on their own over time, usually in about 1 to 3 months. If you have a functional cyst, your doctor may want to check you again in 1 to 3 months to check on the status of the cyst. If you develop functional cysts often, your doctor may want you to take birth control pills or other hormonal birth control so you won’t ovulate. If you don’t ovulate, you won’t form functional cysts.

Surgery is an option for some people. You may need surgery if the cyst:

  • Doesn’t go away after several menstrual periods
  • Gets larger
  • Looks unusual on the sonogram
  • Causes pain

In addition, if you’re past menopause and have an ovarian cyst, your doctor will probably want you to have surgery. Ovarian cancer is rare, but individuals 50 to 70 years of age are at greater risk. People who are diagnosed with cancer at an early stage do much better than those who are diagnosed later.

There are 2 main ways surgery can be done on an ovarian cyst:

  • If your cyst is small (about the size of a plum or smaller) and if it looks benign on the sonogram, your doctor may decide to do a laparoscopy. This procedure is done with a lighted instrument called a laparoscope that’s like a slender telescope. It is put into your abdomen through a small incision (cut) near your navel (belly button). With the laparoscope, your doctor can see your organs. Often the cyst can be removed through small incisions at the pubic hair line.
  • If the cyst looks too big to remove with a laparoscope or if it looks suspicious in any way, your doctor will probably do a laparotomy. This surgery uses a bigger cut to remove the cyst. The cyst is then tested for cancer. If it is cancerous, you may need to have the ovary and other tissues removed. This could include the fallopian tubes, the other ovary, or the uterus. It’s important to talk to your doctor about all of this before that surgery.

Your doctor will talk to you about the risks of each kind of surgery. They will tell you how long you are likely to be in the hospital and how long it will be before you can go back to your normal activities.

Living with an ovarian cyst

If you have an ovarian cyst, you can usually just wait for it to go away on its own in a few months. But sometimes cysts can break open. This is called a rupture. This can cause a lot of pain and heavy bleeding. If you know you have an ovarian cyst and you experience any of the following symptoms, get medical help right away.

  • Sudden, severe abdominal pain
  • Abdominal pain with fever and vomiting
  • Faintness, dizziness, or weakness
  • Rapid breathing

Questions to ask your doctor

  • Do I need a sonogram?
  • What kind of cyst do I have?
  • If it’s a functional cyst, do I need any treatment?
  • How will I know if my functional cyst is getting worse?
  • If I have another type of cyst, what are my treatment options? Will I need surgery?
  • Am I at risk of having another ovarian cyst in the future?
  • Can having ovarian cysts make it harder to get pregnant?