Ovarian Cysts: Causes, Symptoms, and Treatment Options
Ovarian cysts are extremely common — most women develop at least one at some point, often without ever knowing it. While the majority are harmless and resolve on their own, some need monitoring or treatment. Here's how to tell the difference.
What Is an Ovarian Cyst?
An ovarian cyst is a fluid-filled sac that forms on or inside an ovary. Most develop as a normal part of the menstrual cycle and disappear on their own within a few weeks to months, without causing any symptoms at all. Others, however, can grow large, cause pain, or signal an underlying condition that needs attention.
Common Types of Ovarian Cysts
- Functional cysts – The most common type, formed during ovulation (follicular or corpus luteum cysts). These are usually harmless and resolve on their own.
- Dermoid cysts – Present from birth, these can contain tissue like hair, skin, or teeth. They rarely become cancerous but are usually removed if found.
- Endometriomas – Cysts formed when endometriosis tissue grows on the ovary, sometimes called "chocolate cysts" due to their dark, old-blood contents.
- Cystadenomas – Cysts that develop from ovarian tissue and can occasionally grow quite large.
- Polycystic ovaries (as in PCOS) – Multiple small cysts linked to a hormonal condition rather than a single problematic cyst.
Symptoms to Watch For
Many ovarian cysts cause no symptoms at all and are found incidentally during a routine scan. When symptoms do occur, they can include:
- Pelvic pain or a dull ache on one side of the lower abdomen
- Bloating or a feeling of fullness
- Pain during intercourse
- Irregular periods
- Frequent urination or difficulty fully emptying the bladder
How Are Ovarian Cysts Diagnosed?
Ovarian cysts are usually found through a pelvic ultrasound (which shows the size, location, and appearance of the cyst), sometimes supported by blood tests such as CA-125 if there's any concern about the nature of the cyst, particularly after menopause. In complex cases, a CT scan or MRI may be used for a closer look.
Treatment Options
Treatment depends heavily on the cyst's size, type, symptoms, and the woman's age and fertility goals:
- Watchful waiting – Most small, simple cysts resolve on their own within one to three menstrual cycles. Your doctor may simply recommend a repeat ultrasound in a few weeks to confirm it's gone.
- Hormonal birth control – Can help prevent new functional cysts from forming, though it won't shrink an existing one.
- Pain management – Over-the-counter pain relief and a heating pad can ease mild discomfort while a cyst resolves.
- Surgery (cystectomy) – Recommended for cysts that are large, persistent, causing significant symptoms, or that look suspicious on imaging. Ovarian cystectomy — removing just the cyst while preserving the healthy ovarian tissue — is usually done laparoscopically and is fertility-sparing.
- Oophorectomy – In some cases (larger cysts, certain findings, or in postmenopausal women), the entire ovary may need to be removed.
Recovery After Cyst Removal
Recovery after a laparoscopic cystectomy is typically quick — most women go home the same day or the next, with a return to normal activity within one to two weeks. Fertility is usually well preserved when only the cyst (not the whole ovary) is removed.
Ovarian Cysts and Fertility
Simple functional cysts don't typically affect fertility. Endometriomas and larger cysts, however, can sometimes impact ovarian reserve, especially if surgery is needed. If fertility is a concern, discussing the specific type of cyst and treatment plan with a gynaecologist — and possibly a fertility specialist — can help you understand your individual outlook.
When to See a Doctor
- Persistent pelvic pain or bloating lasting more than a few weeks
- Pain during sex or with bowel movements
- Sudden, severe abdominal pain (seek emergency care)
- Unexplained weight change alongside pelvic symptoms
- Irregular bleeding, especially after menopause
The Takeaway
Most ovarian cysts are a normal, temporary part of the menstrual cycle and need nothing more than reassurance and monitoring. When treatment is needed, modern minimally invasive surgery makes cyst removal safe, quick, and usually fertility-preserving. If you're experiencing symptoms, a pelvic ultrasound with your gynaecologist is the best first step.