What are ovarian cysts?

A cyst is a closed sac filled with fluid, a solid mass, or a mix, that occurs in the body’s tissue. In the case of ovarian cysts, they are sacs that grow on the ovaries in women. The ovaries are organs that make up the female reproductive system, one on each side of the womb. The ovaries release an egg as part of the menstrual cycle and both sex hormones oestrogen and progesterone.

Cysts can affect one or both ovaries at a time. Most cysts are naturally occurring, non-cancerous, and won’t require treatment.

What causes ovarian cysts?

Ovarian cysts can be caused by a variety of factors, which differ depending on the type of cyst involved. Functional cysts, like follicular and corpus luteum cysts, result from normal menstrual cycle irregularities, often linked to hormonal imbalances and disrupted ovulation. Pathological cysts, such as dermoid cysts, endometriomas, and cystadenomas, have distinct origins, including genetic factors, endometriosis, and abnormal cell growth.

Who is at risk of getting ovarian cysts?

Women likely to develop ovarian cysts are those who:

Have regular periods
Are pregnant
Haven’t gone through menopause
Are taking a fertility drug to help with ovulation
Have a severe pelvic infection
Previously have had an ovarian cyst

Ovarian cysts are less likely in women who have gone through menopause, but these women have a higher risk of developing cancerous cysts.

What are the symptoms of ovarian cysts?

Usually, ovarian cysts are symptomless. If they are large, are ruptured, or block the blood supply, then they can cause symptoms. Common symptoms include:

pelvic pain
bloating and swollen stomach
heavy periods
breast tenderness
unexplained weight gain
needing to urinate often
difficulty passing stool
pain during intercourse
a feeling of heaviness within the abdominal area

What are the different types of ovarian cysts?

There are two main types of ovarian cysts, functional and pathological.

Functional ovarian cysts are the most common and develop as part of the menstrual cycle. In a woman’s body, eggs are formed inside the ovaries in something called a follicle. When the follicle doesn’t release the egg as it normally does each month, or if the fluid inside it is not released, it can swell which causes cysts. This type of cyst is benign, meaning it is non-cancerous.

Pathological cysts, on the other hand, can develop both before and after menopause as they are caused by abnormal cell growth. Sometimes these cysts can be cancerous.

Conditions that can cause cysts to form include endometriosis and polycystic ovary syndrome (PCOS).

When should I visit a doctor?

If you experience sudden and severe pain in the pelvis you should immediately contact your GP.

How are ovarian cysts diagnosed?

Normally cysts that are symptomless will be found during routine pelvic exams.

Your GP will refer you to a gynaecologist, a specialist in female reproductive health, if they suspect the presence of an ovarian cyst. Ultrasounds, CT and MRI scans can be used to diagnose an ovarian cyst.

If the cyst could potentially be cancer, blood tests will be carried out. Blood tests will also be used to diagnose other conditions that can cause cysts.

Can ovarian cysts go away on their own?

Most cysts actually will clear on their own. Rather than act immediately, your doctor will adopt a "watchful waiting" policy, which means the cysts are monitored and checked at a later time to see if they have indeed gone. If scans show the cyst has gone, treatment is not necessary.

How are ovarian cysts treated?

If cysts are causing symptoms, if they are particularly large, or if the patient has gone through menopause, then treatment may be necessary. Cysts can be removed through surgery, which is often performed as a minimally-invasive, laparoscopic procedure. If the cyst needing removal is cancerous, then additional tissue may need to be removed, and in some cases, both ovaries and the womb. If the cysts are caused by an underlying condition, then the condition itself will also be treated or managed.

Are ovarian cysts ever a medical emergency?

Cysts can become a medical emergency if they rupture or if they have caused the ovary to twist. Symptoms such as severe abdominal pain, fever, nausea, dizziness, weakness, or rapid breathing may indicate that medical attention is required.

Can ovarian cysts be prevented?

Functional ovarian cysts can’t be prevented as they are a natural part of the menstrual cycle. Doctors may prescribe birth control pills that inhibit ovulation and can help to prevent new cysts from forming.

What are the potential complications of ovarian cysts?

Unusual but potential complications that can arise from an ovarian cyst could be:

Ovarian torsion, the twisting of the ovaries
Rupturing
Infection, leading to an abscess

Regular check-ups and pelvic exams can monitor changes in ovarian cysts, which may be operated on to prevent complications.

Do ovarian cysts affect fertility?

Fertility is usually unaffected by ovarian cysts. Sometimes the condition causing the cyst can affect fertility. A cyst can, however, sometimes make it more difficult to conceive but pregnancies will be unaffected. If operative treatment is needed, fertility will be preserved as much as possible. In extreme cases, the ovaries may need to be removed, meaning no more eggs will be produced. Prior to any surgery, the potential impact it may have on fertility will be discussed.

What happens if a cyst develops during pregnancy?

This is very common and your doctor will monitor the cyst closely, as in any case, to prevent complications from developing.

Can ovarian cysts lead to cancer?

Most ovarian cysts are benign (non-cancerous), but a very small number are malignant (cancer). Cancerous cysts are more likely to occur in post-menopausal women.