Ovarian Cysts: Symptoms, Causes, Types & When to See a Doctor

An ovarian cyst is a fluid-filled sac that develops in or on an ovary. Ovarian cysts are common, and many do not cause symptoms or require treatment. In many cases, they disappear on their own within a few weeks or months.

However, some ovarian cysts can become large, rupture, or cause the ovary to twist. These situations can cause significant symptoms and may require medical attention. Understanding the common types, symptoms, causes, and warning signs can help you know when it is important to speak with a healthcare professional.

What Is an Ovarian Cyst?

An ovarian cyst is a sac or pouch that develops in or on an ovary. The ovaries are two small organs located on either side of the uterus and are involved in releasing eggs and producing reproductive hormones.

Many ovarian cysts develop naturally as part of the menstrual cycle. These are called functional cysts and are generally harmless. They often disappear without treatment.

Not every ovarian cyst is the same, however. Some develop because of conditions such as endometriosis, while others result from abnormal cell growth.

What Causes Ovarian Cysts?

The causes depend on the type of cyst.

Functional Cysts

Functional cysts are the most common type and are associated with the menstrual cycle.

During ovulation, an egg develops inside a structure called a follicle. Normally, the follicle releases the egg and then changes as part of the normal cycle.

Sometimes the follicle does not release the egg as expected, or fluid continues to collect inside it. This can result in a functional cyst.

There are two common types of functional cysts:

• Follicular cysts
• Corpus luteum cysts

Most functional cysts are short-lived and resolve naturally.

Endometriomas

Endometriomas are ovarian cysts associated with endometriosis.

Endometriosis occurs when tissue similar to the lining of the uterus grows outside the uterus. When this tissue affects an ovary, it can form a cyst known as an endometrioma.

Dermoid Cysts

Dermoid cysts, also called teratomas, develop from cells involved in forming eggs. They can contain different types of tissue, including hair or skin-like tissue.

Most are benign, although they can sometimes grow large and cause complications.

Cystadenomas

Cystadenomas develop from cells on the outer surface of an ovary. They are usually benign but can sometimes grow quite large.

What Are the Symptoms of an Ovarian Cyst?

Many ovarian cysts cause no symptoms at all and may only be discovered during a pelvic examination or an imaging test performed for another reason.

When symptoms do occur, they can vary depending on the size and type of cyst.

Possible symptoms include:

• Pelvic or lower abdominal pain
• A dull ache or pressure on one side
• Abdominal fullness or heaviness
• Bloating
• Pain during sex
• Changes in menstrual bleeding
• A frequent need to urinate
• Difficulty emptying the bowels
• Feeling full after eating only a small amount

Large cysts are more likely to cause pressure or discomfort.

Can an Ovarian Cyst Affect Your Period?

It can.

Some ovarian cysts are directly related to the menstrual cycle and may be associated with changes in bleeding or pelvic discomfort. However, not every change in your period is caused by an ovarian cyst.

If your periods suddenly become unusually heavy, irregular, painful, or noticeably different for several cycles, discussing the changes with a healthcare professional can help identify the cause.

Can an Ovarian Cyst Affect Fertility?

Most ovarian cysts do not prevent pregnancy.

However, fertility can sometimes be affected depending on the underlying condition causing the cyst. For example, endometriosis can be associated with fertility difficulties. Some cysts may also require surgery, and the effect on fertility depends on the type of procedure and whether ovarian tissue can be preserved.

If you are trying to become pregnant and have been diagnosed with an ovarian cyst, discuss your fertility plans with your gynecologist before deciding on treatment.

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Diagnosis, Monitoring & Treatment:

How Are Ovarian Cysts Diagnosed?

If a doctor suspects an ovarian cyst based on your symptoms or pelvic examination, an ultrasound scan is commonly used to look more closely at the ovaries.

An ultrasound can help show:

• The size and location of the cyst
• Whether it is filled with fluid or contains solid areas
• Whether the cyst has a simple or more complex appearance
• Whether there are changes that may need further monitoring

A pelvic ultrasound may be performed over the abdomen or with a transvaginal ultrasound, depending on the situation and the healthcare professional's recommendation.

Are Blood Tests Needed for an Ovarian Cyst?

Not everyone with an ovarian cyst needs blood tests.

If an ultrasound shows features that require further evaluation, a doctor may recommend blood tests. One test that may sometimes be used is CA-125, particularly when there are concerns about ovarian cancer.

However, an elevated CA-125 level does not automatically mean cancer. Levels can also rise because of non-cancerous conditions, including endometriosis and pelvic inflammation. Doctors therefore consider blood-test results together with ultrasound findings, symptoms, age, and other clinical information.

What Is Watchful Waiting?

Many ovarian cysts do not require immediate treatment.

If a cyst appears uncomplicated, is relatively small, and is not causing significant symptoms, your doctor may recommend watchful waiting. This means monitoring the cyst rather than treating it immediately.

Follow-up may include another ultrasound after a period of time to check whether the cyst:

• Has become smaller
• Has disappeared
• Has remained the same
• Has changed in appearance or size

Many functional ovarian cysts disappear naturally within a few weeks or over a few menstrual cycles.

When Is Treatment Needed?

Treatment depends on several factors, including:

• The size of the cyst
• Its appearance on ultrasound
• Whether it is causing symptoms
• Whether it continues to grow or remains for a long time
• Whether you have gone through menopause
• Whether there are features that require further investigation

A cyst that is large, persistent, painful, growing, or has concerning features may require additional treatment or specialist assessment.

Can Medicines Treat Ovarian Cysts?

In some situations, hormonal contraceptives may be prescribed to reduce the chance of developing new functional ovarian cysts.

However, hormonal birth-control pills generally do not make an existing ovarian cyst disappear faster. Your doctor will decide whether medication is appropriate based on your individual circumstances.

When Is Surgery Recommended?

Surgery may be considered when an ovarian cyst is:

• Very large
• Causing significant or persistent symptoms
• Continuing to grow
• Unusual or complex in appearance
• Not resolving as expected
• Suspected to be cancerous

When possible, doctors may remove the cyst while preserving the ovary. This procedure is called a cystectomy.

In some situations, removal of the affected ovary (oophorectomy) may be necessary. The surgical approach depends on the cyst, its appearance, its size, your age, fertility considerations, and whether cancer is suspected.

What Is Laparoscopic Surgery?

When appropriate, an ovarian cyst can often be removed using laparoscopy, a minimally invasive procedure performed through small abdominal incisions.

If a cyst is very large or there is concern about cancer, a more extensive operation may sometimes be required. The appropriate procedure is determined by the treating surgical team.

Can an Ovarian Cyst Affect Fertility?

Most ovarian cysts do not prevent pregnancy.

Functional cysts, dermoid cysts, and cystadenomas generally are not associated with infertility. However, certain conditions associated with ovarian cysts, such as endometriosis, can affect fertility.

If surgery is needed, doctors generally consider fertility preservation when planning treatment, especially for people who want to become pregnant in the future.

Can an Ovarian Cyst Rupture or Twist?

Yes. Although complications are not common, an ovarian cyst can sometimes rupture or cause the ovary to twist, a condition called ovarian torsion.

A ruptured cyst may cause sudden pelvic or abdominal pain and, in some cases, internal bleeding.

Ovarian torsion can interfere with blood flow to the ovary and may cause sudden, severe pain, sometimes accompanied by nausea or vomiting. These symptoms require urgent medical attention.

Warning Signs, Ovarian Cysts vs PCOS & What to Know

When Should You See a Doctor About an Ovarian Cyst?

Many ovarian cysts are harmless and disappear without treatment. However, you should speak with a healthcare professional if you have ongoing symptoms such as pelvic pain, persistent bloating, unusual changes in your periods, pain during sex, or pressure in the lower abdomen.

A doctor may recommend an examination or ultrasound to determine what is causing the symptoms and whether a cyst needs monitoring or treatment.

When Is an Ovarian Cyst an Emergency?

An ovarian cyst can occasionally cause complications such as rupture or ovarian torsion.

Seek urgent medical attention if you experience:

• Sudden, severe pelvic or abdominal pain
• Severe pain accompanied by nausea or vomiting
• Severe pain with fever
• Dizziness, faintness, weakness, or rapid breathing
• Sudden worsening of symptoms when you already know you have an ovarian cyst

These symptoms can occur when a cyst ruptures or when the ovary twists and its blood supply is affected. Ovarian torsion requires prompt medical assessment.

Ovarian Cyst vs PCOS: Are They the Same?

No. An ovarian cyst and polycystic ovary syndrome (PCOS) are not the same condition.

An ovarian cyst is usually a single fluid-filled or tissue-containing sac that develops in or on an ovary. Many cysts are temporary and may disappear naturally.

PCOS is a hormonal and metabolic condition associated with features such as irregular ovulation, menstrual irregularity, and increased androgen activity. The small follicles sometimes seen in people with PCOS are not the same thing as the typical ovarian cyst discussed in this article.

Having an ovarian cyst does not automatically mean that you have PCOS.

Can Ovarian Cysts Come Back?

Yes, some types of ovarian cysts can develop again.

Functional cysts are associated with the menstrual cycle and may occur again in people who continue to ovulate. Other cysts are related to conditions such as endometriosis or abnormal cell growth and may require different management.

If cysts repeatedly occur, your healthcare professional may investigate the underlying cause and discuss ways to manage future episodes.

Can You Prevent Ovarian Cysts?

There is no guaranteed way to prevent every type of ovarian cyst.

Some functional cysts are part of the normal menstrual cycle and may develop without anything being wrong. However, if you have recurrent cysts, your doctor may discuss treatment options that can reduce ovulation and lower the chance of developing additional functional cysts. Hormonal contraceptives may be considered in some situations, but they do not generally make an existing cyst disappear faster.

Do not start hormonal medication specifically for ovarian cysts without discussing it with a healthcare professional.

Do Ovarian Cysts Always Need Surgery?

No.

Surgery is not routinely required for every ovarian cyst. Many cysts can be monitored with follow-up examinations or ultrasound, particularly when they appear uncomplicated and are not causing significant symptoms.

Surgery may be considered when a cyst is large, persistent, painful, growing, has an unusual appearance, or raises concern about cancer.

The decision also depends on factors such as age, whether you have gone through menopause, the type and appearance of the cyst, and future fertility considerations.

What Should You Remember About Ovarian Cysts?

Ovarian cysts are common, and many are temporary and harmless. Finding a cyst on an ultrasound does not automatically mean that you have a serious disease.

The most important factors are the type of cyst, its size and appearance, your symptoms, and whether it changes over time.

If your doctor recommends monitoring, attending the follow-up ultrasound is important. If you develop sudden severe pain, particularly with nausea, vomiting, fever, dizziness, or weakness, seek urgent medical care rather than waiting for a routine appointment.

Frequently Asked Questions About Ovarian Cysts

Can an ovarian cyst disappear on its own?
Yes. Many functional ovarian cysts disappear naturally within a few weeks or over one or two menstrual cycles.

Are ovarian cysts usually cancerous?
Most ovarian cysts are benign, meaning they are not cancerous. The risk of cancer is higher after menopause, which is one reason doctors may monitor ovarian cysts more carefully in postmenopausal women.

Can an ovarian cyst cause irregular periods?
Some ovarian cysts may be associated with heavy, irregular, or lighter-than-usual periods. However, menstrual changes can have many other causes, so they should not automatically be attributed to a cyst.

Can you get pregnant with an ovarian cyst?
Usually, yes. Most ovarian cysts do not prevent pregnancy. Certain conditions, such as endometriosis, may affect fertility, and treatment decisions should take future pregnancy plans into account.

What size ovarian cyst is dangerous?
There is no single size that determines whether a cyst is dangerous. Doctors consider its size together with its appearance, type, symptoms, growth, age, and menopausal status.

Can an ovarian cyst cause bloating?
Yes. Larger or symptomatic ovarian cysts can sometimes cause bloating, abdominal swelling, pressure, or feeling full quickly. Persistent bloating should still be evaluated because it can have many different causes.

Key Takeaways

• Ovarian cysts are common and many disappear without treatment.
• Functional cysts are often linked to the menstrual cycle.
• Some cysts can cause pelvic pain, bloating, pressure, or menstrual changes.
• Ultrasound is commonly used to evaluate an ovarian cyst.
• Some cysts only need monitoring with follow-up scans.
• Surgery may be considered for large, persistent, painful, or concerning cysts.
• Most ovarian cysts are not cancerous.
• Ovarian cysts and PCOS are different conditions.
• Sudden severe pelvic or abdominal pain, especially with nausea or vomiting, requires urgent medical assessment.

Conclusion

An ovarian cyst can sound worrying when you first hear the term, but many ovarian cysts are common, non-cancerous, and temporary. The appropriate approach depends on the cyst's appearance, size, symptoms, age, and individual health circumstances.

If an ovarian cyst has been found during an ultrasound, follow your healthcare professional's advice about monitoring or treatment. And if you develop sudden severe pelvic or abdominal pain, particularly with vomiting, fever, dizziness, or weakness, seek urgent medical attention.

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Medical Disclaimer

This article is intended for general health information and education only. It does not provide a diagnosis or replace advice from a qualified doctor, gynecologist, or other healthcare professional. Ovarian cysts can have different causes and may require different types of evaluation or treatment. If you have persistent symptoms or concerns about an ovarian cyst, speak with a healthcare professional. Seek urgent medical care for sudden severe abdominal or pelvic pain, particularly when accompanied by vomiting, fever, dizziness, or weakness.

References

• American College of Obstetricians and Gynecologists (ACOG) — Ovarian Cysts
• NHS — Ovarian Cyst: Overview
• NHS — Ovarian Cyst: Treatment
• U.S. Office on Women's Health — Ovarian Cysts