"Ovarian cyst" appears on ultrasound reports so often that it is worth knowing what it usually means: a fluid-filled follicle that is part of the normal cycle and will be gone by the next scan. A minority of cysts persist, cause symptoms or need removal. Here is how to tell them apart.
Symptoms of an ovarian cyst
- Usually none — most are found incidentally
- A dull ache or pressure on one side of the pelvis
- Bloating or a sense of fullness
- Pain during intercourse or bowel movements
- Periods that become irregular or heavier
- Needing to pass urine more often if a large cyst presses on the bladder
Emergency symptoms — go to hospital
- Sudden, severe pain on one side, often with nausea or vomiting — possible torsion (twisting of the ovary), which needs urgent surgery to save the ovary
- Sharp pain followed by dizziness, fainting or shoulder-tip pain — possible rupture with internal bleeding
- Pain with fever
Types of cysts
Functional cysts (follicular and corpus luteum cysts) form during the cycle and resolve within one to three months. They are the majority.
Endometriomas — "chocolate cysts" — are collections of old blood associated with endometriosis. They cause cyclical pain and can affect fertility.
Dermoid cysts contain tissue such as hair or fat, can twist, and are usually removed.
Cystadenomas are benign growths of the ovary's surface that can become large and are removed surgically.
Polycystic ovaries (in PCOS) are many small follicles — not cysts that need removal.
How a cyst is evaluated
Ultrasound tells us the size, whether it is simple (fluid only) or complex (solid areas, septations), and whether there is blood flow. A simple cyst under 5 cm in a woman of reproductive age is re-scanned after six to eight weeks. Complex or persistent cysts, and any cyst after menopause, are assessed further with blood tumour markers and sometimes MRI.
Treatment
Watchful waiting for functional cysts. Laparoscopic cystectomy — removing the cyst while preserving the ovary — for persistent, symptomatic, large or suspicious cysts. Emergency laparoscopy for torsion or rupture with bleeding. See ovarian cyst treatment and laparoscopic surgery.
Have a question about this topic? Dr. Bhavya Rathore consults at her Indirapuram clinic (Gyan Khand 4) and at Cloudnine Hospital. Book a consultation or message the clinic on WhatsApp.
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Medical disclaimer: This page is for general information and does not replace a consultation. It is not individual medical advice, and outcomes vary from person to person. If you have urgent symptoms — heavy bleeding, severe pain, fever, fainting or reduced baby movements — contact the clinic or go to the nearest emergency department immediately. Read the full disclaimer.