Women’s Health

Ovarian Cysts

Find expert diagnosis and specialized care for the various types of ovarian cysts.

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Overview

Ovarian cysts are usually harmless and benign (noncancerous). These fluid-filled sacs form on the ovary, typically during ovulation. You may not even know you have one unless it causes a problem. There are often no symptoms or complications, and they may resolve on their own. Only about 8 percent of premenopausal women who develop cysts need treatment.

Cancerous ovarian cysts are rare and there is no reliable routine screening test. If you have a family history of the disease or other risk factors, get checked regularly, especially after menopause.

Two common types of functional cysts form in premenopausal women:

Follicle cysts—form when the follicle around the egg doesn't break open to release the egg during your monthly menstrual cycle. Instead, it continues growing and becomes a cyst. These usually don't cause symptoms and go away on their own.
Corpus luteum cysts—can be quite painful. They form when the empty follicle sac fails to shrink after releasing the egg. Fluid builds up inside and they reseal, growing up to four inches wide. Most of these also resolve without treatment.

Less common cysts include:

Cystadenomas—filled with a watery fluid. These can grow large.
Dermoids—come from cells present at birth.
Endometriomas—are caused by endometriosis.
Polycystic ovary syndrome (PCOS)—occurs when the ovaries produce many small cysts. These can make getting pregnant difficult.

Causes & Risk Factors

Ovarian cysts can occur in women and girls of all ages. The most common causes of nonfunctional ovarian cysts are:

Endometriosis
Hormonal problems—natural or from ovulation drugs
Pregnancy
Severe pelvic infections

Your risk for ovarian cysts increases if you:

Have a previous history of cysts
Have irregular menstrual cycles
Have polycystic ovarian syndrome
Use the fertility drug clomiphene to start ovulation
Use low-dose progestin-only birth control

Symptoms & Seeking Care

Common symptoms that you may experience include:

Abdominal pressure, bloating and swelling
Abnormal vaginal bleeding or spotting
Changes in menstrual periods
Pelvic pain that may be sharp or dull
Pain with sexual intercourse, urination or bowel movements

If the rupture of an ovarian cyst is about to happen, you may experience severe pain along with nausea and vomiting.

Call your doctor for an appointment if you have:

Pain that impacts your activities
Painful sexual intercourse
Periods that change from regular to sporadic during the past 3 to 6 months (and you are not approaching menopause)
Periods that change from mostly pain-free to painful during the past 3 to 6 months

If you have any of the following, see your doctor right away:

Severe vaginal bleeding
Sudden dizziness with abdominal discomfort that persists for two hours or more
Sudden, severe pelvic pain with vomiting or nausea

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Diagnosis

We start by reviewing your health history for ovarian cyst risk factors and asking about symptoms. Since most ovarian cysts have no symptoms, some are discovered during a routine pelvic exam.

If a cyst is found, we may suggest a "watch and wait" approach. The concept of "watchful waiting" is to not actively treat the cyst unless it doesn't go away as your hormones change. A growing or unchanged cyst may require further testing, which can help determine the exact location, size, and type of mass. Tests include:

Ultrasound
Hormone level tests
Pregnancy test
Laparoscopy—which could include a biopsy
CA 125 blood test—typically done when a cyst is solid and you are post-menopause and at high risk for ovarian cancer

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Treatment

Many small ovarian cysts are functional, meaning the ovary ovulates normally, and they are not concerning. If your cyst is small and you have no symptoms, we may advise a “watch and wait” approach. If you have symptoms, you may require treatment. We will work with you to make the right recommendation based on your age, type of cyst and your symptoms.

The first line of treatment may include:

Hormonal birth control—to prevent ovulation and keep cysts from reoccurring
Medications—over-the-counter or prescription-strength pain medicine

Leading-Edge Surgical Treatment

Some cysts require surgery to achieve the best outcomes. Many women are concerned about after effects. We will take time to review your options, which may include a minimally invasive procedure, in which our providers are specialty-trained. Done through small incisions, this type of surgery means less pain and scarring and a shorter recovery.

Surgical options include:

Cystectomy—surgery to remove only the cyst
Laparoscopy— used to remove smaller cysts via a thin tube with a light and camera, which is inserted through a small incision in the abdomen
Laparotomy—a surgical procedure requiring a bigger abdominal incision for larger cysts
Oophorectomy—surgery to remove the cyst and ovary, usually done if you are past menopause when risk for ovarian cancer is greater, your cyst doesn't go away, or the ultrasound is suspicious

Laparoscopic surgery is very effective for removing masses, such as ovarian cysts. Benign (non-cancerous) cysts can usually be removed while preserving the ovary. However, complete removal of the ovary may be necessary, if the cyst is large or potentially cancerous. The National Institutes of Health (NIH) estimates that 5 to 10 percent of women have surgery to remove an ovarian cyst - only 13 to 21 percent of these cysts are cancerous.

Your surgery may be performed at our state-of-the-art Women’s Surgery Center, which is specifically designed for women and features innovative technology such as the da Vinci surgical system for robotic-assisted gynecologic surgery. We also feature telemedicine technology for real-time, remote consultations with pathologists.

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Ovarian Cysts

Overview

Causes & Risk Factors

Symptoms & Seeking Care

Diagnosis

Treatment

Leading-Edge Surgical Treatment

Questions or Need Help Getting Care?

Overview

Causes & Risk Factors

Symptoms & Seeking Care