What is an ovarian cyst?

An ovarian cyst is a fluid-filled sac that develops in or on an ovary. Ovarian cysts are very common and are often detected during a routine ultrasound scan.

Most ovarian cysts are benign (non-cancerous) and many disappear on their own without treatment.

Why do ovarian cysts occur?

Functional (normal) cysts

These develop as part of the menstrual cycle and usually resolve naturally.

Examples:

Follicular cyst

Corpus luteum cyst

Other types of benign cysts

Endometriotic cysts (chocolate cysts)

Dermoid cysts

Serous or mucinous cysts

Polycystic ovaries (different from ovarian cysts)

What symptoms can ovarian cysts cause?

Many women have no symptoms at all.

Possible symptoms include:

Lower abdominal or pelvic pain

Bloating or abdominal fullness

Pain during periods

Pain during intercourse

Irregular menstrual bleeding

Frequent urination if the cyst is large

What happens after an ovarian cyst is detected?

Your doctor will consider:

1. Your age

Premenopausal

Perimenopausal

Postmenopausal

2. Size of the cyst

Small cysts often need only observation

Larger cysts may require further evaluation

3. Appearance on ultrasound

The scan helps determine whether the cyst appears:

Simple (fluid-filled)

Complex (contains solid areas or septations)

Suspicious for malignancy

4. Your symptoms

Pain, pressure symptoms, or menstrual disturbances may influence treatment.

Will I need more tests?

Depending on the ultrasound findings, your doctor may advise:

Blood testsCA-125 (especially in postmenopausal women)

Other tumour markers in selected cases

Repeat ultrasound

Many cysts are rechecked after 6–12 weeks to see whether they have disappeared or changed in size.

MRI scan

Occasionally required when ultrasound findings are unclear.

When is treatment NOT required?

Usually when:

The cyst is simple

Small in size

You have no symptoms

Ultrasound features appear benign

In such cases, observation and follow-up scans may be sufficient.

When is surgery recommended?

Surgery may be advised if:

The cyst is large

It continues to grow

It causes significant pain

It looks suspicious on ultrasound

It persists after follow-up

There is concern about ovarian cancer

Most benign cysts can be removed using laparoscopic (keyhole) surgery.

Warning Signs – Seek Urgent Medical Attention

Contact your doctor or visit the emergency department if you develop:

Sudden severe abdominal pain

Nausea and vomiting with pain

Dizziness or fainting

Fever with pelvic pain

These symptoms may indicate:

Ovarian torsion (twisting of the ovary)

Rupture of the cyst

Internal bleeding

These conditions may require emergency treatment.

Frequently Asked Questions

Can ovarian cysts cause infertility?

Most ovarian cysts do not affect fertility. However, some conditions such as endometriosis or severe ovarian disease may influence fertility.

Do ovarian cysts always need surgery?

No. Most ovarian cysts are managed with observation and follow-up.

Does an ovarian cyst mean cancer?

No. The vast majority of ovarian cysts are benign. Your doctor will assess ultrasound features and, if necessary, perform additional tests.

Can ovarian cysts come back?

Some types can recur, especially functional cysts and endometriotic cysts.

Key Message

Finding an ovarian cyst on ultrasound is common and usually not a cause for alarm. Most cysts are harmless and many disappear naturally. The next step depends on your age, symptoms, the size of the cyst, and its appearance on ultrasound. Regular follow-up with your gynecologist will help determine the safest and most appropriate management.