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<\/figure>\n\n\n\nAn ovarian cyst is a fluid-filled sac that develops on or inside one of the ovaries. The ovaries are two small organs on either side of the uterus that produce eggs and hormones (oestrogen and progesterone).<\/p>\n\n\n\n
Cysts vary enormously in size, from a few millimetres (smaller than a pea) to several centimetres (the size of an orange or larger). They can occur on one or both ovaries.<\/p>\n\n\n\n
The vast majority of ovarian cysts are functional cysts<\/strong>; a normal part of the menstrual cycle and disappear without treatment within a few weeks to months.<\/p>\n\n\n\n Understanding the type of cyst matters because it determines the risk level and what management is needed.<\/p>\n\n\n\n Follicular cysts:<\/strong> Each month, a follicle in the ovary grows and releases an egg during ovulation. If the follicle does not rupture and release the egg, it continues to grow, forming a follicular cyst. These are extremely common, usually cause no symptoms, and almost always resolve within 1-3 menstrual cycles.<\/p>\n\n\n\n Corpus luteum cysts:<\/strong> After ovulation, the empty follicle (now called the corpus luteum) normally breaks down. If it seals off and fills with fluid, a corpus luteum cyst forms. These can grow larger than follicular cysts (up to 10 cm) and may cause some pelvic discomfort. They also typically resolve on their own within a few weeks.<\/p>\n\n\n\n Dermoid cysts (teratomas):<\/strong> Develop from cells that can produce hair, skin, teeth, or other tissues. They are not cancerous but can grow large and may cause complications. Surgical removal is usually recommended.<\/p>\n\n\n\n Endometriomas:<\/strong> Cysts formed when endometrial tissue (the lining of the uterus) grows on the ovary and fills with dark, old blood, sometimes called “chocolate cysts.” Strongly associated with endometriosis<\/strong> and can significantly affect fertility.<\/p>\n\n\n\n Cystadenomas:<\/strong> Develop from cells on the outer surface of the ovary. Can grow very large. Two types: serous (filled with watery fluid) and mucinous (filled with thick mucus). Usually benign but require removal.<\/p>\n\n\n\n Polycystic Ovaries (PCOS):<\/strong> In Polycystic Ovary Syndrome, the ovaries contain multiple small follicular cysts and do not release eggs regularly. This is a hormonal condition, not simply a cyst problem; it causes irregular periods, excess androgens, and fertility challenges.<\/p>\n\n\n\n The most feared concern. Ovarian cancer can present as a cyst, but the vast majority of ovarian cysts, especially in women of reproductive age, are benign. Features that raise concern for malignancy include: solid components, irregular borders, internal blood flow on ultrasound Doppler, large size, multiple internal compartments, and associated fluid in the abdomen (ascites). These features require urgent further investigation.<\/p>\n\n\n\n Most ovarian cysts cause no symptoms at all<\/strong> and are found incidentally during a pelvic ultrasound done for another reason. When symptoms do occur, they may include:<\/p>\n\n\n\n A dull, aching pain or pressure on one side of the lower abdomen, the side where the cyst is located. The pain may be constant or come and go. It may worsen during periods, during sex, or with certain movements.<\/p>\n\n\n\n A feeling of fullness, bloating, or heaviness in the lower abdomen. Larger cysts can cause visible abdominal swelling.<\/p>\n\n\n\n Cysts can disrupt the hormonal cycle, causing irregular, heavier, lighter, or missed periods.<\/p>\n\n\n\n Particularly with deeper penetration, if the cyst is in a position where pressure is applied to it.<\/p>\n\n\n\n Larger cysts pressing on the bladder.<\/p>\n\n\n\n Cysts pressing on the rectum can cause constipation or a feeling of incomplete emptying.<\/p>\n\n\n\n Particularly if a cyst twists (ovarian torsion – see below).<\/p>\n\n\n\n Most ovarian cysts are not emergencies. But two complications require immediate hospital attention:<\/p>\n\n\n\n When a cyst causes the ovary to twist on its supporting ligaments, cutting off its blood supply. This is a surgical emergency<\/strong>.<\/p>\n\n\n\n Symptoms:<\/strong> Sudden, severe one-sided pelvic pain often described as the worst pain the woman has experienced. May be accompanied by nausea, vomiting, and fever. The pain may come and go initially if the ovary is twisting and untwisting, then become constant.<\/p>\n\n\n\n What to do:<\/strong> Go to a hospital immediately. Delayed surgery can result in loss of the ovary.<\/p>\n\n\n\n A cyst that bursts, releasing its contents into the abdominal cavity. Most ruptured cysts, particularly small functional cysts, cause temporary sharp pain that resolves within hours and requires only pain management and monitoring.<\/p>\n\n\n\n However, a ruptured cyst with significant internal bleeding is a medical emergency<\/strong>.<\/p>\n\n\n\n Symptoms of serious rupture:<\/strong> Sudden severe abdominal pain, dizziness or fainting, rapid heartbeat, signs of shock. Requires immediate hospital care.<\/p>\n\n\n\n The primary and most accessible diagnostic tool. Ultrasound clearly visualises ovarian cysts their size, location, internal characteristics (purely fluid-filled vs. solid components), and number. A transvaginal ultrasound<\/strong> (probe inserted gently into the vagina) gives a more detailed view than an abdominal scan and is the preferred method for ovarian assessment.<\/p>\n\n\n\n CA-125<\/strong> is a tumour marker in the blood that can be elevated in ovarian cancer. However, it is also elevated in many benign conditions, such as endometriosis, fibroids, pelvic infection, pregnancy, and even menstruation, making it an unreliable standalone test for cancer. It is most useful when interpreted alongside ultrasound findings and clinical context.<\/p>\n\n\n\nTypes of Ovarian Cysts<\/h2>\n\n\n\n
Functional Cysts (Most Common – Usually Harmless)<\/h3>\n\n\n\n
Non-Functional Cysts (May Require Treatment)<\/h3>\n\n\n\n
Ovarian Cancer<\/h3>\n\n\n\n
Symptoms of Ovarian Cysts<\/h2>\n\n\n\n
Pelvic Pain or Discomfort<\/h3>\n\n\n\n
Bloating and Abdominal Fullness<\/h3>\n\n\n\n
Irregular Periods<\/h3>\n\n\n\n
Pain During Sex<\/h3>\n\n\n\n
Frequent Urination or Difficulty Emptying Bladder<\/h3>\n\n\n\n
Difficulty with Bowel Movements<\/h3>\n\n\n\n
Nausea and Vomiting<\/h3>\n\n\n\n
When Ovarian Cysts Become Emergencies<\/h2>\n\n\n\n
Ovarian Torsion<\/h3>\n\n\n\n
Ruptured Cyst<\/h3>\n\n\n\n
How Ovarian Cysts Are Diagnosed<\/h2>\n\n\n\n
Pelvic Ultrasound<\/h3>\n\n\n\n
Blood Tests<\/h3>\n\n\n\n