Ovarian Cysts

An ovarian cyst is a fluid-filled sac that forms on or inside an ovary. Most cysts are harmless and go away on their own. Some can cause symptoms and may require treatment. 

If you have concerns about ovarian cysts, Banner Health is here to support you. Keep reading to learn more about ovarian cysts, their causes and how they are treated.

What is an ovarian cyst?

Ovarian cysts are sacs filled with fluid or semi-solid material that form on or within an ovary. Women usually have two ovaries. One ovary is on each side of the uterus, in the lower part of the belly (abdomen). They produce and store your eggs and make hormones that control your menstrual cycle.

There are different types of ovarian cysts. A cyst can vary in size, from small and almost microscopic to larger than a grapefruit. They can occur for many reasons and may require different treatments. 

What causes ovarian cysts?

Women can develop ovarian cysts at any age. But ovarian cysts most often occur during a person’s reproductive years, from puberty to menopause. 

Several factors can contribute to cysts forming on the ovaries:

• Monthly menstrual cycle
• Hormonal problems
• Hormone-based medicines like clomiphene (Clomid) or letrozole (Femara)
• Pregnancy
• Endometriosis
• Severe pelvic infections
• A history of previous ovarian cysts

Types of ovarian cysts

Ovarian cysts come in different types. Most of them are noncancerous (benign). They often occur during your menstrual cycle. These types are called functional cysts and happen during ovulation (when your ovary releases an egg each month during your menstrual cycle). Functional cysts usually only happen in premenopausal people. 

There are two types of functional cysts:

• Follicular cyst: A small sac in your ovary called a follicle releases an egg each month. A follicular cyst occurs when the follicle doesn’t open to release the egg. Instead, it fills with fluid and grows bigger inside the ovary. Follicle cysts often have no symptoms and go away in one to three months.
• Corpus luteum cyst: After the follicle releases the egg, it shrinks (dissolves) and turns into the corpus luteum (a temporary collection of cells that release a hormone to prepare your uterus for pregnancy, if needed). If the sac doesn’t shrink after releasing the egg, it can fill with fluid and form a luteal cyst. Most luteal cysts go away after a few menstrual cycles. Some can grow to almost four inches wide and cause pain and bleeding.

Other cysts

There are other types of cysts that aren’t related to menstrual cycles:

• Dermoid cysts (teratomas): This cyst develops from ovarian cells and eggs. It is made of different types of tissues, such as hair, skin and teeth. Dermoid cysts develop from cells that can produce all kinds of human tissues. They are usually benign.
• Cystadenomas: These cysts form on the surface of the ovary. They are filled with watery or mucous material. While they are usually benign, they can grow quite large and cause pain.
• Endometriomas: Endometriosis is a condition where the tissue that normally lines the inside of the uterus starts growing outside of it. Some of the tissue can attach to the ovary and form a cyst or endometrioma. These cysts are often called chocolate cysts because of the dark color of the fluid within them. Endometriomas can cause pelvic pain, especially during your period.
• Ovarian cancer: Unlike the conditions above, ovarian cancer cysts (tumors) are solid masses of cancer cells. Ovarian cancer is rare. 

What are the symptoms of an ovarian cyst?

Many ovarian cysts don’t cause symptoms. When symptoms do occur, they may include:

• Pelvic pain or discomfort that may come and go
• Bloating or swelling in your abdomen
• Pain in the lower back or thighs
• Pain during bowel movements or sex
• Weight gain
• Pain during your period
• Tender breasts
• Unusual vaginal bleeding
• Needing to pee more often
• Problems emptying the bladder completely 

How is an ovarian cyst diagnosed?

If you have symptoms of ovarian cysts, see your health care provider. They might be able to feel a large ovarian cyst during a pelvic exam. Your provider may also use the following methods to confirm a diagnosis: 

• Ultrasound: This imaging test uses sound waves to create an image of the ovaries, helping to determine the cyst’s location, size and type.
• MRI: This imaging test uses large magnets and a computer to create a detailed picture of the area.
• Blood test: Tests such as CA-125 can help determine if a cyst might be cancerous, especially in postmenopausal women.
• Pregnancy test: This test is done to check if pregnancy may be the cause of the cyst.
• Hormone level test: This test looks to see if you have problems with your hormones to help determine the type of cyst and evaluate for cancer (tumor markers).
• Laparoscopy: A minimally invasive surgical procedure where a camera is inserted into the abdomen to view the ovaries directly and, if necessary, remove the cyst.

How do you treat an ovarian cyst?

Treatment is different for each person. Common ovarian cyst treatments include:

• Watchful waiting: For functional cysts, your provider may recommend monitoring the cyst with repeated ultrasounds to see if it goes away on its own.
• Medications: Birth control pills or other oral contraceptives can help regulate the menstrual cycle, decrease the size of current cysts and prevent new cysts from forming. Pain relievers may also help with pain and discomfort.
• Surgery: You may need surgery to remove the cyst or ovary if:
  • Cancer is suspected.
  • The cyst does not go away or appears to be growing.
  • The cyst causes ongoing symptoms.

Surgery can be done in two different ways:

• Laparoscopy: If your cyst is small and appears benign, your provider may decide to do a laparoscopy. With a laparoscope, your provider can see your organs using 2-4 small cuts (incisions) on the abdomen.
• Laparotomy: If the cyst is very large or if there is a concern of cancer, your provider may recommend a laparotomy. This surgery uses a longer incision in the abdomen to remove the cyst.

What are the possible complications of an ovarian cyst?

Ovarian cysts are often harmless, but in some cases they can lead to complications. Get emergency medical attention right away if you have any of the following symptoms:

• Sudden, sharp pain in the lower belly
• Pain with nausea and vomiting
• Rapid breathing 
• Faintness, dizziness or weakness

These symptoms could mean your cyst has broken open (ruptured) or the cyst caused twisting (torsion) of the fallopian tube. Ovarian torsion cuts off the blood supply to the ovary and can lead to tissue death. If a cyst ruptures or causes torsion, you may need surgery to remove it.

Can an ovarian cyst be prevented or avoided?

Ovarian cysts can’t be prevented if you are ovulating. If you get ovarian cysts often, your provider may prescribe hormonal birth control to stop you from ovulating. Taking antibiotics for pelvic infections may also prevent a cyst.

Can an ovarian cyst affect pregnancy or make it harder to get pregnant?

Most ovarian cysts don’t affect your fertility or ability to get pregnant. Sometimes, the condition causing the cyst, such as PCOS or endometriosis, can make it harder to get pregnant. In rare cases where ovarian cysts continue to grow during pregnancy, they can cause problems during childbirth. 

If you’re trying to get pregnant or are pregnant and have concerns, talk to your health care provider for personalized advice and treatment options. 

What is the long-term outlook for people with ovarian cysts?

The long-term outlook for people with ovarian cysts is generally good. Here’s what you need to know:

Most cysts go away on their own: Many ovarian cysts, especially functional cysts, disappear without treatment.

• Regular monitoring: Your health care provider may recommend regular check-ups to monitor the cysts and ensure they aren’t growing or causing problems.
• Treatment options: If a cyst is causing pain, grows larger or doesn’t go away, treatments are available. These might include medications or, in some cases, surgery.
• Low risk of cancer: Most ovarian cysts are noncancerous. The risk of an ovarian cyst being cancerous is higher in women who have gone through menopause, but it’s still relatively low.
• Fertility: Most ovarian cysts don’t affect your ability to have children. But conditions like PCOS or endometriosis may require special management if you’re planning to get pregnant.

With proper care and regular check-ups, most people with ovarian cysts lead healthy, normal lives. 

Schedule an appointment

If you have concerns about ovarian cysts, speak with a health care provider at Banner Health to discuss your symptoms and the best course of action. We’re here to provide expert guidance and treatment options tailored to your needs.