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Ovarian Cysts

Ovarian cysts are fluid-filled sacs that form on or inside your ovaries. They can form during ovulation if the egg isn't released or if the egg sac doesn't dissolve.

Ovarian cysts are common during your childbearing years and often don't cause symptoms. Most go away on their own without treatment.

Looking for Ovarian Cyst Care?

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  • What Are Ovarian Cysts?
  • What Are the Symptoms of Ovarian Cysts?
  • How Do You Diagnose Ovarian Cysts? 
  • How Do You Treat Ovarian Cysts?

What Are Ovarian Cysts?

Doctors define ovarian cysts as fluid-filled sacs that form on or inside one or both ovaries.

Ovarian cysts are small egg follicles that didn't grow to ovulation and may result from altered hormone levels. They usually are harmless and don't cause symptoms, which is why many people don't know they have them. Occasionally, ovarian cysts may cause pelvic pain.

Most cysts disappear on their own over time. Any pain, swelling, pressure, or other pelvic issues should be examined by a doctor.

How common are ovarian cysts?

Ovarian cysts are very common during childbearing years.

Types of ovarian cysts

There are a few types of ovarian cysts, but most are benign (noncancerous).

Ovarian cyst types include:

  • Functional cysts — The most common type of ovarian cysts. They are formed during ovulation when the ovary either doesn't release the egg or releases the egg, but the sac (follicle) in which the egg forms does not dissolve.
  • Cystadenomas — Cysts formed out of cells on the surface of the ovary. They are often filled with fluid.
  • Dermoids — Cysts filled with hair, teeth, and other tissues.
  • Endometriomas — Cysts formed in people with endometriosis.
  • Pathological cyst — Abnormal cell growths related to menopause that are formed from either the cells used to create eggs or cells that cover the outer part of the ovary. Occasionally, a pathological cyst may burst, twist, or grow large, blocking the blood supply to the ovaries. In the rare case that a pathological cyst is malignant (cancerous), it often will be surgically removed.

What causes ovarian cysts?

Ovarian cysts are often linked with the menstrual cycle or menopause.

During ovulation, the ovaries release an egg which travels down the fallopian tube to be fertilized by sperm. Eggs form in the ovaries inside a structure called a follicle. During the menstrual cycle, numerous follicles are produced each month, but only one follicle matures and releases an egg. 

A follicle contains fluid that protects the egg as it grows. When the egg is released, the follicle bursts. Occasionally, the follicle either doesn't release an egg or doesn't discharge its fluid and instead bursts after the egg is released. When this happens, the follicle can swell and become a cyst.

Underlying conditions like endometriosis or polycystic ovary syndrome can also cause ovarian cysts. 

Ovarian cyst risk factors and complications

Ovarian cyst risk factors

Age is the most important risk factor for ovarian cysts. Postmenopausal people are at higher risk of an ovarian cyst being malignant (cancerous).

Other risk factors include:

  • Cigarette smoking.
  • Hypothyroidism — underactive thyroid.
  • Infertility treatment.
  • Maternal gonadotropins — may result in fetal ovarian cysts.
  • Pregnancy.
  • Tamoxifen — a hormone therapy used to treat hormone receptor-positive breast cancer.
  • Tubal ligation.

Complications of ovarian cysts

The most common complications of ovarian cysts are:

  • Hemorrhage.
  • Ovarian torsion — the obstruction of blood flow to the ovary due to complete or partial twisting of the ovarian vessels.
  • Rupture.

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What Are the Symptoms of Ovarian Cysts?  

There often are no symptoms with ovarian cysts smaller than 2 centimeters.

In the case of larger ovarian cysts, some people may experience mild to moderate symptoms, like abdominal pain.

Other symptoms of larger ovarian cysts include:

  • Dull ache in the lower back.
  • Pain, pressure, or bloating in the abdomen.
  • Nausea or vomiting.
  • Pain during intercourse.
  • Painful periods and abnormal bleeding.
  • Trouble urinating.
  • Weight gain.

If an ovarian cyst ruptures or you have ovarian torsion, the symptoms may include severe pain, nausea, and vomiting. You should call your doctor right away if you have these symptoms.

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How Do You Diagnose Ovarian Cysts? 

Ovarian cysts most often are diagnosed during a routine pelvic exam. Your doctor may notice swelling on one of your ovaries and order an imaging test.

They may first do a urine pregnancy test to make sure you're not pregnant.

Tests to diagnose ovarian cysts

If your doctor sees evidence of a cyst on an ovary, they order:

  • Transvaginal ultrasound — To confirm the presence of a cyst.
  • Diagnostic laparoscopy — A minimally invasive procedure in which a small camera and blade are used to confirm the diagnosis of and/or treat ovarian cysts.

If a cyst is found to be larger than 10 centimeters or has irregularities, it may be an indication of malignancy (cancer). Your doctor may do urinalysis to rule out a urinary tract infection or kidney stones, and collect endocervical swabs to rule out pelvic inflammatory disease.

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How Do You Treat Ovarian Cysts?

Because most ovarian cysts are functional and benign, 70% to 80% will go away on their own after a few weeks or months.

Wait and see approach for ovarian cysts

Since cysts often resolve without treatment, your doctor may take a watchful waiting or “wait and see” treatment approach. In this case, they may also order repeat ultrasounds to monitor the cyst.

This approach is a common treatment option for women who:

  • Are in their childbearing years.
  • Have a fluid-filled cyst.
  • Have no symptoms of an ovarian cyst.

Medicine to treat ovarian cysts

If your ovaries continue to form functional cysts, your doctor may prescribe birth control pills or shots to stop ovulation and prevent new cysts from forming.

Surgery for ovarian cysts

If your cyst doesn't go away on its own after several menstrual periods, grows larger, or causes pain, your doctor may want to treat your cyst.

Treatments for ovarian cysts at UPMC include:

  • Minimally invasive surgery — If your cyst is small and benign, your doctor may perform a laparoscopic ovarian cystectomy to remove the cyst or entire ovary.
  • Surgery — If your cyst is large and may be cancerous, your doctor may advise surgery to remove the cyst through a large abdominal incision.

By UPMC Editorial Staff. Last reviewed on 2024-09-05.

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