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Ovarian Cyst: Causes, Symptoms & Treatment

An ovarian cyst is a fluid-filled sac that forms on or inside the ovary. Most ovarian cysts are benign and resolve on their own without treatment.

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Things worth knowing about "Ovarian cyst"

An ovarian cyst is a fluid-filled sac that forms on or inside the ovary. Most ovarian cysts are benign and resolve on their own without treatment.

What Is an Ovarian Cyst?

An ovarian cyst is a fluid-filled, blood-filled, or tissue-filled sac that develops on or within an ovary. Ovarian cysts are very common and can affect women of all ages, though they occur most frequently during the reproductive years. The vast majority of ovarian cysts are benign (non-cancerous) and disappear on their own without medical intervention.

Types of Ovarian Cysts

Follicular cyst: The most common type. Forms when a follicle does not release an egg and continues to fill with fluid.
Corpus luteum cyst: Develops after ovulation if the follicle reseals and fills with fluid.
Endometrioma (chocolate cyst): Caused by endometriosis, where tissue similar to the uterine lining grows on the ovary.
Dermoid cyst: Contains various tissue types such as hair, fat, or bone. Usually congenital.
Cystadenoma: A benign tumor growing from ovarian tissue, filled with watery or mucous fluid.
Polycystic ovary syndrome (PCOS): Multiple small cysts on the ovaries, associated with hormonal imbalances.

Causes

The causes of ovarian cysts depend on their type:

Hormonal changes during the menstrual cycle
Endometriosis (uterine-like tissue growing outside the uterus)
Hormonal fertility treatments (e.g., ovulation stimulation during IVF)
Genetic predisposition in dermoid cysts
Polycystic ovary syndrome (PCOS)
Previous pelvic inflammatory disease or infections

Symptoms

Many ovarian cysts cause no symptoms at all and are discovered incidentally during ultrasound examinations. Possible symptoms include:

Dull or sharp pain in the lower abdomen, often on one side
Irregular menstrual periods
A feeling of pressure or fullness in the abdomen or pelvis
Pain during sexual intercourse
Frequent urination or bowel problems (with very large cysts)
Bloating of the abdomen

When to Seek Immediate Medical Attention

The following symptoms require urgent medical evaluation, as they may indicate a ruptured cyst or ovarian torsion (twisting of the ovary):

Sudden, severe lower abdominal pain
Fever and nausea
Dizziness or fainting
Heavy vaginal bleeding

Diagnosis

The following methods are used to diagnose ovarian cysts:

Ultrasound (sonography): The primary diagnostic tool. Transvaginal or abdominal ultrasound assesses the size, location, and structure of the cyst.
Blood tests: Measurement of hormones or tumor markers (e.g., CA-125) to help rule out malignancy.
MRI or CT scan: Used for unclear findings to provide more detailed imaging.
Laparoscopy: A minimally invasive surgical procedure for direct visualization and possible removal of the cyst.

Treatment

Treatment depends on the type, size, and symptoms of the cyst:

Watchful Waiting

For small, asymptomatic cysts (especially follicular or corpus luteum cysts), a watchful waiting approach is often recommended. Regular ultrasound follow-ups monitor the cyst. Many cysts resolve on their own within a few weeks or months.

Medication

Hormonal contraceptives (the pill) may be used to regulate the menstrual cycle and help prevent new cysts from forming. Pain relievers such as ibuprofen or paracetamol can help manage discomfort.

Surgical Treatment

Surgery may be required in cases of:

Large, persistent, or growing cysts
Severe pain or complications
Suspected malignancy
Ovarian torsion or cyst rupture

Surgery is most commonly performed as a laparoscopy (keyhole surgery), which is minimally invasive and allows for a quick recovery. In rare cases, open surgery may be necessary.

Prognosis

The prognosis for most ovarian cysts is excellent. Functional cysts often resolve without treatment. Malignant cysts require prompt treatment. Regular gynecological check-ups are important for early detection of any changes.

References

Bottomley C, Bourne T. - Diagnosis and management of ovarian cyst accidents. Best Practice & Research Clinical Obstetrics & Gynaecology. 2009;23(5):711-724. PubMed PMID: 19481979.
National Health Service (NHS) - Ovarian cyst: Overview and treatment. Available at: www.nhs.uk
American College of Obstetricians and Gynecologists (ACOG) - Practice Bulletin No. 174: Evaluation and Management of Adnexal Masses. Obstetrics & Gynecology. 2016;128(5):e210-e226.

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