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Ovarian Cysts - Symptoms, Causes, Risk Factors, Diagnosis, Treatment

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Diagnosed with fluid-filled cysts on your ovaries? Read about its somitingigns and symptoms, causes, risk factors, diagnosis, treatment options, and much more.

Medically reviewed byDr. Sangeeta Milap
Published At August 10, 2021
Reviewed AtDecember 22, 2023
Ovarian Cysts - Symptoms, Causes, Risk Factors, Diagnosis, Treatment

What Is an Ovarian Cyst?

An ovarian cyst, a sac that is filled with fluid, is usually present in or on the surface of the ovary, which is an organ in the female reproductive system. Females have a pair of ovaries that are the size of an almond. One ovary is present on either side of the uterus in the lower abdomen. It is the reservoir of egg cells, and it also produces the female hormones estrogen and progesterone. These egg cells mature into eggs (ova) in the ovaries and are released during each menstrual cycle.

Most women have one or more ovarian cysts at some time. They rarely produce any pain or discomfort. Most of the cysts do not need treatment and disappear in a few months. But, cysts that rupture can result in severe symptoms. It is important to understand the symptoms that might occur due to ovarian cysts, as it will help in getting prompt medical help. Also, regular pelvic exams are a must for all women.

What Are the Signs and Symptoms of an Ovarian Cyst?

Most of the time, an ovarian cyst does not result in symptoms. But if the cyst grows too big, the following symptoms might be experienced:

  • Abdominal swelling or bloating.

  • Severe pelvic pain during periods.

  • Nausea.

  • Vomiting.

  • Pain during bowel movements.

  • Pelvic pain before periods.

  • Pain during sex.

  • Lower back pain.

  • Pain in the thighs.

  • Painful or tender breasts.

When to Consult a Doctor?

In case you experience sharp and unbearable pelvic pain, fever, feel dizzy, and are short of breath, immediate medical attention is required. A ruptured cyst or a condition called ovarian torsion can result in such symptoms. Failure to get help immediately can result in serious consequences.

What Are the Types of Ovarian Cysts?

The main types of ovarian cysts are:

  1. Functional Ovarian Cysts - It is the most common type of ovarian cysts seen. They are usually formed during the woman’s normal menstrual cycle, are painless, and usually resolve on their own in weeks. The types of functional ovarian cysts are -

    1. Follicle Cysts - In the ovaries, the mature egg is released from the ovaries into the fallopian tube for fertilization with sperm. Inside the ovary, the egg is protected by a fluid-filled follicle, which bursts, and the egg is released into the fallopian tube. Sometimes, the follicle does not shrink after it releases the egg, or the egg itself is not released, resulting in a follicular ovarian cyst. They are the most common type of functional ovarian cyst and are usually harmless. It normally disappears within a few weeks.

    2. Corpus Luteum Cysts - When the egg is released from the ovary, the leftover tissue in the ovary is called corpus luteum. This corpus luteum can fill with blood and result in a luteal cyst or corpus luteum cyst. This cyst takes a few months to disappear and is less common. If this cyst ruptures, it can result in sudden pain and internal bleeding.

  2. Pathological Cysts - Cysts that grow in the ovaries can be harmless or malignant (cancerous).

    1. Dermoid Cysts - Otherwise called cystic teratomas. It is normally a benign cyst that is formed from the cells that mature into the ovum or eggs. They have to be surgically removed. They are commonly seen in women under 30 years of age.

    2. Cystadenomas - Ovarian cysts that form from the cells that cover the ovary is called cystadenomas. They do not grow inside the ovary but are attached to the outer layer of the ovary. They are either filled with a mucus-like thick substance or a watery liquid. They can grow big, can be cancerous, and have to be removed surgically. This ovarian cyst is commonly seen in women over the age of 40 years.

    3. Endometrioma - The membrane that makes the inner layer of the uterus (endometrial tissue) can sometimes grow outside the uterus and get attached to the ovaries (endometriosis). An ovarian cyst that develops from this tissue is called an endometrioma. It results in severe pelvic pain during menstruation and is seen in women in their reproductive years.

Polycystic Ovary Syndrome:

Polycystic ovary syndrome or PCOS is a common hormonal disorder affecting women in the child-bearing years. Women with this condition have large numbers of small cysts, resulting in enlargement of the ovaries. This condition has to be treated promptly, or it can lead to infertility.

What Are the Risk Factors for an Ovarian Cyst?

These factors increase your risk of developing an ovarian cyst:

  1. Hormonal imbalance.

  2. Pregnancy.

  3. Pelvic infection.

  4. Previous ovarian cysts

  5. Endometriosis.

What Are the Complications of Ovarian Cysts?

The other possible complications include:

  1. Ovarian Torsion - When the ovarian cyst grows big, they push on the ovaries, which increases the risk of the ovaries twisting, called ovarian torsion. It is a painful condition and needs immediate medical help, as it can stop the blood flow to the affected ovary. The symptoms include severe pelvic pain, vomiting, and nausea.

  2. Cyst Rupture - If the ovarian cyst ruptures, it can cause severe pain and internal bleeding. The chances of the cyst rupturing increase as it grows in size. The other risk factors include vigorous exercise and vaginal sex.

  3. Ovarian Cancer - In some very rare cases, ovarian cysts might be an early form of ovarian cancer. It is commonly seen after menopause.

How Is an Ovarian Cyst Diagnosed?

Most of the time, ovarian cysts are found during a routine pelvic examination or accidentally during an abdominal ultrasound. If the doctor notices swelling on your ovaries, you might have to get some of the following tests done:

  • Ultrasound - to confirm the presence of the cyst. Here, high-frequency sound waves are used to get images of the ovaries, uterus, etc. This test helps determine the location, size, and if the cyst is filled with fluid or is solid. There are two types of ultrasound tests available, abdominal (transabdominal) and vaginal (transvaginal). The abdominal ultrasound is taken across the abdomen, and the transvaginal ultrasound is taken through the vagina.

  • CT scan - here, X-rays are used to produce cross-sectional images of the ovaries and cyst.

  • MRI - a test that uses magnetic fields to produce in-depth images of the ovaries.

As most cysts disappear within a few weeks or months, the doctor might not treat them immediately. Instead, you will be asked to get another ultrasound test after a few weeks or months. If the cyst is still present or has increased in size, then the doctor will suggest you perform the following tests to determine the cause:

  1. Pregnancy test - As luteal cysts are commonly seen during pregnancy, and the doctor will check if you are pregnant.

  2. Hormone levels.

  3. CA-125 blood test - The protein, cancer antigen 125 (CA-125), is elevated in women who have ovarian cancer.

What Are the Treatment Modalities for Ovarian Cysts?

In most women, the doctor will ask the patient to wait and get re-examined in a few weeks or a month to see if the cyst goes away on its own, in case you do not have symptoms. If you have symptoms, then depending on your age, the size of the cyst, and its location, the treatment options include:

1) Hormonal Contraceptives - Birth control pills are prescribed if you have recurrent ovarian cysts. These pills will not shrink the cysts that you already have, but they will prevent cysts from recurring.

2) Surgery - Cysts that are growing in size, causing symptoms, and do not look like functional cysts are removed surgically.

  • Ovarian Cystectomy - If it is possible, the surgeon will remove the cyst alone without removing the ovary.

  • Oophorectomy - It is when the ovary is removed along with the cyst.

  • Total Hysterectomy - For ovarian cancers, the uterus, ovaries, and fallopian tubes are surgically removed.

There is no possible way to prevent ovarian cysts. This is why routine gynecological examinations are important to detect cysts early. Please consult a doctor immediately in case you notice changes in your menstrual cycle, experience pelvic pain, unintentional weight loss, and abdominal fullness. To know more about ovarian cysts, consult a doctor online now.

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Frequently Asked Questions

- Hormonal imbalances.
- Drugs used to induce ovulation.
- Pregnancy.
- Pelvic infection spread.
- Endometriosis.
Ovarian cysts are more common among women of menstruating age. But they are less common in postmenopausal women, young girls, and neonates.
Small ovarian cyst’s symptoms cannot be felt. But larger cysts or growing cysts tend to give a feeling of pressure, pain, swelling, and bloating on the affected side of the abdomen with low back pain. Sometimes they can press nearby bladder and bowel and cause urinary incontinence and constipation.
Most times, they are symptomless. Listed below are symptoms indicative of ovarian cysts.
- Pain, bloating and swelling in the lower abdomen on the side of the cyst.
- Pressure on the side of the cyst.
- Lower back pain.
- Ruptured cysts tend to cause sudden and severe pain.
- Painful sex.
- Abdominal bloating.
- Pain during defecation.
- Low backache.
- Nausea.
- Vomiting.
- Tender breasts.
- Weight gain.
- Problem emptying the bladder.
- Unusual vaginal bleeding.
- Frequent urge to urinate.
- Constipation.
Benign ovarian cysts are slow growers, especially dermoid cysts with a growth rate of a few millimeters per year.
Large ovarian cysts that rupture cause bleeding in association with sudden severe abdominal pain.
Although ovarian cysts commonly occur in women of the reproductive age group it does happen after menopause. Ovarian cysts occurring after menopause have a high risk of malignant transformation.
Ovarian cysts are of many types and are unique. But most of the ovarian cysts last between one to three months and disappear on their own within three months, even without treatment.
Ovarian cysts can become as large as up to 4 inches in diameter or even more.
Large ovarian cysts cause abdominal pain on the side of the affected ovary. With increasing size, they cause abdominal swelling, bloating, pressure, difficulty emptying the bowel and bladder, and pain during sex. This is because they exert pressure on the nearby structures.
Benign ovarian cysts appear smooth, round, oval, with thin walls, and without any septations within. They appear dark or black in the ultrasound image as they are filled with fluid.
Not all ovarian cysts turn into cancer. Most ovarian cysts are benign. In postmenopausal women, the chances that an ovarian cyst will transform into cancer are very high.
Burst ovarian cysts and cysts that cause ovarian torsion (twisting of the ovaries) are emergency conditions requiring immediate medical attention. They exhibit the following symptoms.
- Nausea and vomiting.
- Sudden and severe abdominal pain.
- Fever.
- Faintness and dizziness.
- Rapid breathing.
Women with polycystic ovary disease should avoid the consumption of,
- Processed foods.
- Canned foods.
- Refined carbohydrates.
- White bread.
- Potatoes.
- Pastries.
- Sugar-rich foods and drinks.
In most cases, ovarian cysts do not hinder fertility, and women do get pregnant. Some ovarian cysts like endometrioma and cysts of polycystic ovary disease affect pregnancy, while others do not. In some cases, ovarian cysts make it hard to get pregnant. In extensive cysts, removal of both ovaries might be needed upon which pregnancy cannot be achieved.
Not all ovarian cysts affect pregnancy. Cysts like a follicular cyst, corpus luteum cyst, cystadenoma, dermoid cyst, paraovarian cyst, and hemorrhagic cysts do not hinder pregnancy. Women with such cysts should conceive like every other woman without a cyst. Women with endometriosis and cysts due to PCOS have difficulties getting pregnant. If removing endometriomas and medications for PCOS, regular exercise, healthy weight, and nutritional diet does not solve the problem, in vitro fertilization must be of help as a last resort.
Ovarian cysts due to polycystic ovary syndrome (PCOS) and hormone-secreting cysts affect body metabolism and hormonal levels leading to weight gain.
Most ovarian cysts regress on their own when the hormonal imbalance gets corrected.
- Massage the lower abdomen region.
- Try some stretchings and physical exercise.
- Hot compress on the lower back and stomach.
- Over-the-counter pain medications like Ibuprofen.
- If the pain does not subside and is sharp and unbearable, immediately seek medical attention. The cyst might have ruptured within.
- Birth control pills.
- Laparoscopic or laparotomy surgery based on the size of the cyst.
Though management of ovarian cysts are mostly non-surgical, ruptured ovarian cysts and cysts suspected to be cancerous or grow larger might require surgical excision with or without involving the ovaries and/or uterus.
Small ovarian cysts can be managed non-surgically with medications like birth control pills and Metformin for polycystic ovarian syndrome (PCOS). Most cysts regress on their own within three months. Repeated ultrasound scans might be needed to confirm its shrinkage.
Cysts measuring more than 10 cm in diameter necessitate surgical removal.
Although ovarian cysts are common in girls and women of reproductive age, they also occur in small girls in their pre-pubertal stages. Such ovarian cysts arise due to alteration in the hormonal levels in a girl’s body to attain puberty earlier. Ovarian cysts can also be present in neonates due to hormonal exposure while in the womb.
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Dr. Sangeeta Milap from iCliniq
Dr. Sangeeta Milap

Obstetrics and Gynecology

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