A doctor talks to a smiling young patient
By Betsy Taylor, MD

Ovarian Cysts: What to Know and When to See the Doctor

Ovarian cysts are common and usually painless and harmless, but they might present painful symptoms that are treatable with medication or surgery

Before you get your period, your ovaries make small sacs on your ovary. In that sac, an egg develops. If you don’t get pregnant that month, the sac opens, the egg is released, and you get your period.

Sometimes the sacs don’t open, and the sac grows or bursts. And sometimes, the sac opens but a clump of cells takes its place, which can grow and swell. When either situation happens, it is called an ovarian cyst.

Ovarian cysts are most common in teens through pre-menopause. Most ovarian cysts don’t cause symptoms and go away on their own after your period is over. Most women have at least one in their lifetime, though most don’t know it. But if a cyst grows large—up to the size of an orange—or bursts, it can cause symptoms such as:

  • Bloating and pressure
  • Dull or sharp belly or low-back pain
  • Painful periods
  • Painful sex
  • Problems with bowel movements
  • Skipped or late periods
  • Spotting between periods

If you have symptoms, talk with your doctor. Treatments can get rid of different types of cysts and help you feel better.

Types of Ovarian Cysts

Most ovarian cysts develop because of your period, and those are called functional cysts. There are two main types of functional cysts:

  • Follicle cyst: When the sac doesn’t open to release the egg. These cysts can grow to the size of an orange. This type of cyst can cause pelvic pain and pressure and may possibly rupture, causing more pain and bleeding.
  • Corpus luteum cyst: When a group of cells takes the place of the sac. These cysts can grow to the size of a walnut. This type of cyst can bleed into itself, release hormones that cause a false-positive pregnancy test and cause the ovary to twist. This cyst can also rupture.

Ovarian cysts can also be unrelated to your period:

  • Cystadenomas, which form on the surface of the ovary, are filled with clear, watery fluid. They can grow extremely large, twisting the ovary and moving nearby organs.
  • Dermoid cysts, which can grow in the ovaries and can contain hair, fluid, teeth or skin cells. These cysts can twist the ovary and cause infection. Rarely, these cysts can lead to cancer.
  • Endometriomas, which form due to endometriosis. This cyst grows if excess tissue that grows outside the uterus attaches to the ovary. These are often called “chocolate cysts” due to their dark color.

Most ovarian cysts don’t cause symptoms. However, the larger the cyst is, the more likely it is to cause pain, irregular bleeding and other serious problems. If you have changes with your period, talk with your doctor about checking for cysts.

Call the doctor right away if you have sudden, severe pain with dizziness, a fever or nausea and vomiting. The cyst may have burst (ruptured) or might be twisting your ovary (torsion). Without medical care, you may have heavy bleeding or infection.

Treatment Options

Most ovarian cysts don’t need treatment. Big or painful cysts can be treated with medication or surgery. The first step is to find out where the cyst is and how big it is.

Your doctor will give you a pregnancy test to learn if you are pregnant or if you might have a corpus luteum cyst. Your doctor might also ask for a few tests or exams to diagnose your condition:

  • Blood tests
  • Pelvic exam
  • Pelvic ultrasound

If a cyst is found, your doctor might recommend using pain medications, such as ibuprofen, to manage symptoms. If a cyst causes pain and doesn’t go away on its own, you may need surgery. Two types of surgery for ovarian cysts include:

  • Laparoscopy for smaller cysts. During this minimally invasive procedure, we make small incisions in the belly and use tiny tools to remove the cyst. We close the incisions with dissolvable stitches. Most patients go home the same day.
  • Laparotomy for bigger and more serious cysts. During this procedure, we make one incision in the belly to inspect inside and remove the cyst and/ovary. We close the incision with stitches or staples. Patients may need to stay in the hospital for a few days after the procedure.

If you get ovarian cysts on a regular basis, your doctor may prescribe hormonal birth control to prevent ovulation and reduce the risk of additional cysts. Birth control methods that might work include combined estrogen-progestin birth control pills, the patch, the ring or an intrauterine devices (IUDs).

Ovarian cysts are common and symptoms are treatable. The UNM Women’s Health team is here to answer your questions and help you feel better.


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Categories: Women's Health