Ovarian Cysts
Fluid-filled sacs on an ovary. Very common, usually harmless, and most disappear by themselves within a few months.
Quick answer: An ovarian cyst is a fluid-filled sac on an ovary. Most are functional cysts from the normal menstrual cycle; they cause no symptoms and go away on their own. Some cause pelvic pain, bloating or pain during sex. They’re found by ultrasound and often just rechecked. Surgery is for cysts that persist, are large, cause symptoms or look unusual. Sudden severe pelvic pain needs urgent care.
Types.
- Functional (follicular or corpus luteum): the commonest, from the monthly cycle, and usually short-lived
- Dermoid: slow-growing, can contain hair, fat, skin or even teeth
- Endometrioma (“chocolate cyst”): filled with old blood, linked to endometriosis
- Cystadenoma: filled with watery fluid or mucus
The “cysts” in PCOS aren’t true cysts; they’re many small follicles. Cancerous cysts are rare, especially before menopause.
Symptoms. Often none. Some people get:
- pelvic pain, dull or sharp, on one side
- bloating or feeling full quickly
- pain during sex
- needing to wee often, or constipation
- periods that are heavier, lighter or irregular
How it’s diagnosed. Usually with an ultrasound, often internal (through the vagina). A pregnancy test rules out an ectopic pregnancy. Blood tests may be done if a cyst looks unusual, but raised markers have many non-cancer causes too, such as endometriosis, fibroids, infection or a period.
Treatment
Most cysts need nothing but time and a repeat scan. Treatment depends on the type, size, symptoms and whether you’ve been through menopause.
- Step 1 · GPWatch and recheckA repeat ultrasound in a few weeks to months to confirm it has gone.
- Works
- Most functional cysts resolve on their own
- Access
- GP and imaging
- Watch for
- New or worse pain between scans.
- Step 2 · PharmacyPain reliefParacetamol or an anti-inflammatory such as ibuprofen for discomfort.
- Works
- Eases mild pain while the cyst settles
- Access
- Over the counter
- Watch for
- Don’t mask severe or sudden pain; get checked.
- Step 3 · PrescriptionCombined contraceptive pillFor people who keep getting functional cysts.
- Works
- Can help prevent new functional cysts by stopping ovulation
- Access
- GP prescription
- Watch for
- Doesn’t shrink cysts you already have; not suitable for everyone.
- Step 4 · SpecialistKeyhole (laparoscopic) surgeryRemoval is considered if a cyst lasts beyond 3 months, is over 6 cm, keeps growing, causes pain or might be cancerous. Before menopause, surgeons usually remove just the cyst to protect fertility.
- Works
- Removes the cyst and gives a definite diagnosis
- Access
- Gynaecologist
- Watch for
- Usual surgical risks; cysts can recur.
Save your money
Popular, heavily marketed or often asked about, but the evidence is weak or says no.
- Supplements or detoxes to “dissolve” cystsNo evidence. Functional cysts go away by themselves anyway, which is why these seem to work.
- Assuming PCOS means you have cysts that need removingPCOS follicles aren’t true cysts and aren’t treated with surgery.
Living with it
- Keep any follow-up scans; they confirm the cyst has gone.
- Note when pain happens in your cycle; it helps your doctor.
- Most cysts don’t affect fertility. Ask before any surgery if pregnancy matters to you.
See your GP if
- Pelvic pain that keeps coming back or doesn’t settle
- Persistent bloating, a swollen tummy, or feeling full quickly
- Pain during sex
- Any cyst found after menopause
- Changes to your periods
Get urgent help for sudden, severe pelvic or tummy pain, especially with nausea, vomiting, fever, fainting or heavy bleeding. This can mean a twisted ovary (torsion) or a burst cyst. Call 000 (Australia) or your local emergency number, or go to an emergency department.
Outlook. Most ovarian cysts are harmless and disappear without treatment. Those that need surgery usually have a good outcome, and fertility is usually preserved.
Common questions
Are ovarian cysts dangerous?
Usually not. Most are functional cysts that go away. The main dangers are twisting (torsion) or bursting, which cause sudden severe pain and need urgent care.
How long do ovarian cysts take to go away?
Functional cysts usually go within a few months. A repeat scan confirms it.
What does an ovarian cyst feel like?
Often nothing. Some cause a dull ache or sharp pain on one side of the pelvis, bloating, or pain during sex.
Can ovarian cysts affect fertility?
Most don’t. Endometriomas and PCOS can affect fertility, and surgeons aim to protect the ovaries during surgery.
What size ovarian cyst needs surgery?
Removal is often considered for cysts over 6 cm, or ones that last beyond 3 months, grow, cause pain or look unusual.
Evidence and more information
maladywise.com/ovarian-cysts/