As a result of ovulation, a fluid-filled sac known as an ovarian cyst can form on one or both ovaries.1
Ovarian cysts are not uncommon, with 20% of women developing at least one in their lifetime.1
In women of reproductive age, most ovarian cysts do not require surgical intervention.1
However, ovarian cysts can lead to complications such as pelvic pain and cyst rupture that require prompt management.1
A cyst does not always show symptoms.1 But if you have the following symptoms, you should see a gynecologist:
A cyst can cause an emergency situation when the membrane ruptures and the liquids are in the abdomen causing severe pain. Torsion of the fallopian tube leeds to cutting the ovary of its blood supply causing severe cramping pain in the abdomen.3
An abdominal examination and imaging scan will be performed to specify the type of the cyst.
In most cases an ultrasound scan is sufficient. When more information is needed additional imaging scans such as computer tomography (CT) or magnetic resonance image (MRI) can be performed.
Treatment depends on your age, the type and size of your cyst, and your symptoms. Your doctor might suggest:4
If the cyst doesn’t have any sign of malignancy on ultrasound (small, fluid-filled cyst, thin walls, etc.) and if you have no symptoms — regardless of your age — it does not need to be operated straight away and may disappear spontaneously. You can wait and be re-examined to see if the cyst goes away within a few months.
Your doctor might recommend hormonal contraceptives, to keep resting the ovaries and prevent the cyst from recurring. However, contraceptive pills will not make an existing cyst disappear.
Your doctor might suggest removing a large cysts, cysts with worrying features on ultrasound or if the cyst continuous growing over two or three menstrual cycles or causes pain.
Some cysts can be removed without removing the ovary (ovarian cystectomy), in order to preserve a maximum chance for a future pregnancy in young women. In some cases, your doctor might suggest removing the affected ovary and leaving the other intact. When an ovarian cyst develops after menopause, it is usually proposed to remove both ovaries and both tubes. These surgical procedures are usually performed laparoscopically, using a camera and surgical instruments introduced through small abdominal holes.4
1. Mobeen S, Apostol R. Ovarian Cyst. [Updated 2021 Jun 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.
2. Thornton KL, DeCherney AH. Laparoscopic management of ovarian cysts: an endocrinologist view. Yale J Biol Med. 1991 Nov-Dec;64(6):599-606. PMID: 1839754; PMCID: PMC2589426.
3. Bottomley C, Bourne T. Diagnosis and management of ovarian cyst accidents. Best Pract Res Clin Obstet Gynaecol. 2009 Oct;23(5):711-24. doi: 10.1016/j.bpobgyn.2009.02.001. Epub 2009 Mar 18. PMID: 19299205
4. Diagnosis and treatment - Mayo Clinic. (n.d.-b). Https://Www.Mayoclinic.Org/Diseases-Conditions/Ovarian-Cysts/Diagnosis-Treatment/Drc-20353411?P=1. https://www.mayoclinic.org/diseases-conditions/ovarian-cysts/diagnosis-treatment/drc-20353411?p=1