Ovarian Cysts

Ovarian Cysts Overview

Ovarian cysts are fluid-filled sacs that develop in or on the ovary. Ovarian cysts occur commonly in women of all ages. Some women with ovarian cysts have pain or pelvic pressure, while others have no symptoms. Irregular menstrual periods are not usually related to an ovarian cyst.
Fortunately, most ovarian cysts do not require surgical removal and are not caused by cancer. Cysts can vary in size from less than one centimeter (one-half inch) to greater than 10 centimeters (4 inches).

Ovarian Cysts Causes

The most common causes of ovarian cysts depend upon whether you are still having menstrual periods (premenopausal) or have stopped menstruating for at least one year (postmenopausal).

Premenopausal women – For premenopausal women, the most common causes of ovarian cysts include:

  • Ovulation - "Functional" ovarian cysts develop when a follicle (sac) grows, but does not rupture to release the egg. These cysts usually resolve without treatment.
  • Dermoid cysts - Dermoid cysts (teratomas) are one of the most common types of cysts found in women between age 20 and 40 years. A dermoid cyst is made up ovarian germ cells (germ cells are reproductive cells [eg, eggs]) and can contain teeth, hair, or fat. Most dermoid cysts are benign, but rarely, they can be cancerous.
  • Polycystic ovary syndrome (PCOS) - Women with PCOS may have many small cysts. These cysts do not need to be removed or treated with medication, but women with PCOS may need treatment for other PCOS problems, such as irregular menstrual periods.
  • Endometriosis - Women with endometriosis can develop a type of ovarian cyst called an endometrioma, or "chocolate cyst."
  • Pregnancy - An ovarian cyst normally develops in early pregnancy, to help support the pregnancy until the placenta forms. In some cases, the cyst stays on the ovary until later in the pregnancy.
  • Severe pelvic infections - Severe pelvic infections may spread to involve the ovaries and fallopian tubes. As a result, pus-filled cysts form close to the ovaries and/or fallopian tubes.
  • Noncancerous growths
  • Cancer - Cancer is a relatively uncommon cause of ovarian cysts in premenopausal women; less than 1 percent of new growths on or near the ovary are related to ovarian cancer.
  • Postmenopausal women - In women who have stopped having menstrual periods, the most common causes of ovarian cysts include:
  • Noncancerous growths
  • Fluid collection in the ovary

In postmenopausal women, new growths on or around the ovary are somewhat more likely to be caused by cancer than in premenopausal women.

Ovarian Cysts Symptoms

Ovarian cysts can sometimes be detected during a pelvic examination, although an imaging test, usually a pelvic ultrasound, is necessary to confirm the diagnosis. Computed tomography (CT) scan or magnetic resonance imaging (MRI) are also sometimes used, but less commonly. These imaging tests can also provide information about the cyst’s size, location, and other important characteristics.

Blood testing – One or more blood tests may be recommended if you are found to have an ovarian cyst. The blood test(s) can help to determine the nature of the cyst.

  • Pregnancy testing -A blood or urine pregnancy test is often performed in premenopausal women with an ovarian cyst. Ovarian cysts are common during pregnancy.
  • Blood tests are also available for testing women with an ovarian cyst for ovarian cancer.
  • Next steps - Depending upon the results of the imaging test, your age, symptoms, results of blood tests, and your family history, your health care provider may recommend watchful waiting or surgery.

Ovarian Cysts Treatment

Ovarian cysts do not always require treatment. In premenopausal women, ovarian cysts often resolve on their own within one to two months, without treatment. In postmenopausal women, ovarian cysts are less likely to resolve. If a cyst is large, causing pain, or appears suspicious for cancer, treatment usually involves surgery to remove the cyst or the entire ovary.

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