Patient education: Ovarian cysts (The Basics)

What is an ovarian cyst? — 

This is a fluid-filled sac that develops on or in an ovary (figure 1). The ovaries are part of the female reproductive system. If you are still having a monthly period, your ovaries release an egg about once a month.

Often, an ovarian cyst goes away on its own. Sometimes, the cyst gets bigger, breaks open, or causes the ovary to twist. If this happens, you might need surgery.

Many people worry about cancer when they learn they have ovarian cysts. But most of the time, cysts are not cancer.

What are the symptoms of ovarian cysts? — 

You might have no symptoms. If you do have symptoms, they can include pain or pressure in your lower belly on 1 side. The pain can be dull or sharp, and it can come and go.

It is common for ovarian cysts to break open, or "rupture." This does not always cause symptoms. But if a cyst breaks open and releases a lot of blood and fluid into your belly, it can be very painful.

Other times, a cyst can cause the ovary to twist. This can be a serious problem and needs to be treated right away. Symptoms can include:

●Sudden, intense pain in your lower belly – Pain is usually on 1 side and doesn't go away. It might make you double over or be unable to walk.

●Nausea or vomiting

●Fever

What causes ovarian cysts? — 

There are many possible causes. The most common causes include:

●Ovulation or pregnancy – Ovulation is when an egg is released from the ovary each month. For this to happen, the ovary grows a sac, called a "follicle." Sometimes, a follicle grows but does not release an egg and instead forms a cyst. Or if you get pregnant after the egg is released, a cyst can stay on the ovary for weeks or months. These kinds of cysts are not harmful and usually go away on their own.

●Dermoid cysts – These are a common type of cyst. They sometimes have teeth, hair, or fat in them. That might sound strange. Dermoid cysts are normally not harmful to your health, but your doctor might want to remove them with surgery.

●Polycystic ovary syndrome ("PCOS") – In this condition, the ovary grows many small cysts, instead of 1 big follicle that goes away each month. These cysts usually do not go away, but the cysts themselves do not need to be treated or removed. PCOS does sometimes require treatment with medicine for reasons unrelated to the cysts.

●Endometriosis – This is a condition where tissue normally found in the uterus grows outside the uterus. Endometriosis can also form cysts on the ovary. People with endometriosis might have belly pain during their periods or at other times, pain in the belly during sex, or trouble getting pregnant.

●Ovarian cancer – This is the cause of ovarian cysts in less than 1 in 100 cases. It is most likely to affect older people who have been through menopause (no longer have a monthly period) or who have a family history of ovarian cancer.

How big are ovarian cysts? — 

They are usually 1 to 2 inches (2.5 to 5 cm) wide. But they can be bigger.

Is there a test for ovarian cysts? — 

Yes. Common tests include:

●Imaging tests – The most common is a pelvic ultrasound. It uses sound waves to create pictures of your uterus and ovaries. The pictures can show if you have cysts. They can also show where the cysts are and how big they are. Your doctor might also take pictures with an MRI or a CT scan.

●Blood tests – These can check for pregnancy or the possibility of cancer.

How are ovarian cysts treated? — 

It depends on what is causing your cysts and what your symptoms are. Possible treatments include:

●Waiting – Your doctor might want to do an ultrasound every couple of months. Your cysts might stay the same size, get smaller, or even go away. In those cases, you usually don't need any treatment. If the cysts grow or change, you might need treatment.

While waiting, your doctor might have you take over-the-counter medicines to help with pain. Examples include acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), and naproxen (sample brand name: Aleve).

●Birth control pills – These can stop some types of new cysts from forming.

●Surgery – This can involve removing a cyst or the whole ovary.

What if I want to get pregnant? — 

It depends on what is causing your ovarian cysts. Most people with cysts can get pregnant. Even if 1 of your ovaries is removed, it is usually still possible to get pregnant. If you can't get pregnant, medicines or other treatments can help. If you want to have a baby, talk with your doctor about your options.

When should I call the doctor? — 

Call your doctor right away or go to the emergency department if you have ovarian cysts and have:

●Sudden, severe pain in your lower belly

●Nausea or vomiting

●Fever

You should also call your doctor or nurse if you:

●Have new or worsening pain

●Have pain when urinating

●Have pain with sex

●Miss a period or have bleeding between periods

More on this topic

Patient education: Menstruation (The Basics)
Patient education: Polycystic ovary syndrome (The Basics)
Patient education: Endometriosis (The Basics)
Patient education: Ovarian cancer (The Basics)
Patient education: CA 125 test (The Basics)
Patient education: Pelvic ultrasound (The Basics)
Patient education: Pregnancy tests (The Basics)
Patient education: Hormonal birth control (The Basics)
Patient education: Oophorectomy (The Basics)
Patient education: What you should know about oophorectomy (The Basics)

Patient education: Ovarian cysts (Beyond the Basics)
Patient education: Polycystic ovary syndrome (PCOS) (Beyond the Basics)
Patient education: Endometriosis (Beyond the Basics)
Patient education: Screening for ovarian cancer (Beyond the Basics)
Patient education: Ovarian cancer diagnosis and staging (Beyond the Basics)
Patient education: Hormonal methods of birth control (Beyond the Basics)