Ovarian Cysts – Causes, Symptoms, & Treatment

Finding an ovarian cyst can feel scary, but these fluid-filled sacs are usually just a natural part of your menstrual cycle. Most are harmless and go away on their own without treatment. However, knowing the difference between a simple ache and a medical emergency is vital for your safety. In this guide, we break down hormonal triggers, the “watchful waiting” approach, and specific red flags you must never ignore.

Are you curious about natural support or when doctors recommend surgery? Dive into the full article to master your reproductive health.

What exactly is an Ovarian Cyst?

An ovarian cyst is a fluid-filled sac that develops on the ovary, often likened to a blister. Most women develop these functional cysts naturally as a by-product of the menstrual cycle. Crucially, the vast majority are benign (non-cancerous) and generally resolve on their own without medical intervention.

These sacs typically form during ovulation when a follicle fails to release an egg or reseals. Research confirms this is usually a physiological process rather than a sign of disease. A significant study published in the National Institutes of Health found they occur in 23% of women under 50, yet the cancer risk is less than 1 in 1,000. Unlike complex masses, simple cysts are generally considered normal findings requiring no surveillance, supporting a conservative “wait and see” approach over surgery.

Therefore, a diagnosis is rarely cause for alarm, as most cysts disappear spontaneously. However, understanding the biological triggers is vital for managing reproductive health.

What Causes Ovarian Cysts?

Understanding the cause begins with the menstrual cycle. Every month, follicles in the ovaries produce hormones (oestrogen and progesterone) to release an egg. If a follicle fails to release its egg or re-closes and fills with fluid, a functional ovarian cyst forms. These are typically fluid-filled, contain no solid components, and measure less than 3–5 cm. This process is driven by natural hormonal fluctuations rather than disease.

To distinguish between these natural occurrences and abnormal growths, clinical data is essential. A study of 244 cases by Abduljabbar et al. (2015) [PMC4503903] classified cysts into two main categories: physiological (functional) and pathological (tumours). The review found the most common causes to be:

• Functional Cysts (33.2%): Physiological cysts common during reproductive years (and even in a foetus).
• Benign Cystadenomas (19.3%): Pathological tumours, which are more frequent in younger females.
• Dermoid Cysts (12.3%): A common pathological variant containing other tissue types.

The study further highlighted that while benign tumours are common in younger women, malignant tumours are more frequent in older women. Ultimately, knowing whether a cyst is functional or pathological helps predict the warning signs that may follow.

What are the Symptoms of Ovarian Cysts?

Many women remain unaware they have a cyst until it is discovered during a routine examination, but when ovarian cyst symptoms do occur, they often manifest as pelvic pain or discomfort. This pain can be intermittent or constant and may be accompanied by a sensation of heaviness or bloating in the abdomen. Other common symptoms of cysts on ovaries include pain during intercourse (dyspareunia), heavy or irregular periods, and changes in urination frequency due to the cyst placing mechanical pressure on the bladder.

Emergency Red Flags

It is vital to recognise the following red flags, which may indicate a ruptured cyst:

• Severe pelvic or abdominal pain: Often sudden and sharp.
• Fever and vomiting: Signs of systemic infection or severe distress.
• Faintness or dizziness: Potential indicators of internal bleeding or shock.

Recognising these physical signals is the first step toward seeking help, but symptoms alone cannot confirm the nature of the mass or distinguish it from uterine issues. Distinguishing a cyst from other conditions requires professional medical investigation to ensure the correct treatment path.

How are Ovarian Cysts Diagnosed?

Diagnosing ovarian cysts typically begins with a visit to your GP, who will assess your symptoms and likely refer you for an ultrasound scan. A transvaginal ultrasound is the gold standard diagnostic tool; unlike a standard tummy scan, this internal scan allows the sonographer to clearly visualise the ovaries. This clarity is essential to confirm if the mass is a fluid-filled ovarian cyst or a solid mass like a uterine fibroid, effectively resolving any confusion regarding cyst in uterus symptoms versus ovarian issues.

To further assess the nature of the cyst, a CA125 blood test may be recommended, particularly if the cyst appears complex or the patient is post-menopausal. Research by Parsa Charkhchi et. al, of Women’s College Research Institute in Toronto, indicates that while CA125 detects proteins associated with ovarian cancer, levels can also be raised by benign conditions such as endometriosis or pelvic infection. Therefore, doctors use this test in conjunction with ultrasound findings to accurately determine the risk level rather than relying on it as a standalone cancer screen.

Once a clear diagnosis is established through imaging and blood work, your healthcare provider can determine the most appropriate course of action based on the cyst’s characteristics. Depending on the size and type of the cyst, the approach may range from simple monitoring to active intervention.

What are some of the Ovarian Cyst Treatments?

The most appropriate ovarian cyst treatment depends entirely on the size, type, and symptoms of the cyst. In many cases, the NHS protocol is simply “watchful waiting” (active surveillance). Patients often ask, “Do ovarian cysts go away on their own?” and the answer is frequently yes. For simple cysts under 5cm, doctors typically recommend monitoring with follow-up ultrasound scans to ensure the cyst resolves naturally.

For those seeking to support this process at home, specific lifestyle adjustments may help:

• Anti-inflammatory diet: Reducing sugar and processed foods to lower systemic inflammation.
• Magnesium supplementation: Often utilised to help balance hormones.
• Castor oil packs: A traditional remedy used to improve circulation and reduce local inflammation.

However, if a cyst persists or causes pain, medical intervention may be required. It is important to clarify that there is no specific medication to dissolve ovarian cysts directly. Instead, doctors may prescribe the Combined Oral Contraceptive Pill. A systematic review by the Cochrane Library confirmed that while oral contraceptives do not shrink existing functional cysts, they provide a significant protective effect against the formation of future cysts by inhibiting ovulation.

For larger, complex, or persistent cysts that do not respond to conservative management, surgical removal remains the gold standard. This is typically performed via laparoscopy (keyhole surgery) or, in more complex cases, laparotomy (open surgery).

While understanding treatment options provides a plan of action, effective management relies on knowing exactly what kind of cyst is present. The nature of the treatment—whether it requires surgery or simple monitoring—is dictated by the specific classification of the mass.

What are the Types of Ovarian Cysts

Ovarian cysts are generally categorised into two main groups: functional cysts (part of the normal menstrual cycle) and pathological cysts (involving abnormal cell growth).

Functional Cysts

The most common diagnosis is a simple functional cyst, which typically resolves without intervention. These present in two primary forms:

• Follicular Cysts: Occur when the follicle fails to release an egg.
• Corpus Luteum Cysts: Form after ovulation, when the follicle fills with cells that produce progesterone but accumulates fluid inside.

Pathological Cysts

Pathological cysts are distinct as they are not by-products of the cycle. Common types include:

• Dermoid Cysts (Teratomas): These contain cells capable of forming hair, skin, or teeth.
• Cystadenomas: Filled with watery or mucous-like fluid.
• Endometriomas (“Chocolate Cysts”): Specific to women with endometriosis. A study in Human Reproduction highlights that these occur in up to 44% of endometriosis cases, indicating more severe disease activity.

Identifying the specific cyst type is critical. Unlike functional cysts, pathological variants typically do not resolve spontaneously and are more likely to require surgical removal. Ultimately, the cyst type dictates both the severity of symptoms and the clinical management plan.

What Does Ovarian Cyst Pain Feel Like?

Most patients describe ovarian cyst pain location as a dull, heavy ache deep in the lower pelvis, typically concentrated on the side where the cyst has developed. This discomfort often presents as right side ovarian cyst pain or left-side pain exclusively, distinguishing it from general period cramps which are usually central. The sensation is often linked to the physical weight of the fluid-filled sac pressing against surrounding organs, creating a feeling of fullness or pressure rather than acute agony.

However, the nature of the pain can change drastically if complications arise. If a cyst ruptures or causes torsion (twisting of the ovary), the cyst in ovary symptoms shift from a dull ache to sudden, sharp, and debilitating pain. Clinical observations published in the Canadian Association of Radiologists Journal note that ruptured ovarian cysts are a frequent cause of acute pelvic pain in women of reproductive age, often mimicking appendicitis. This sharp escalation in pain intensity is a critical signal that the cyst is no longer stable and requires immediate assessment.

Understanding the difference between a manageable ache and an emergency signal is vital for safeguarding your health. While most cysts are benign, knowing when professional intervention is required ensures you do not ignore potential complications.

When Should You Visit Your Doctor

While the discovery of an ovarian cyst can be unsettling, it is important to remember that they are extremely common and usually manageable. Most women will experience a functional cyst at some point without any long-term health consequences. However, you should visit your doctor if you experience persistent bloating, changes in your menstrual cycle, or pelvic discomfort that does not resolve.

If you experience “red flag” symptoms such as sudden, severe abdominal pain, fever, or vomiting, you must seek emergency care immediately. For non-emergency concerns, proactive monitoring is the best preventative measure to rule out pathology and ensure any complex changes are caught early.

If you are looking for help or reassurance, Hormone Health is here to support you. Book a consultation with a dedicated hormone specialist for a private scan and review today to ensure your reproductive health is expertly managed.