Ovarian Cysts

Ovarian cysts are fluid-filled sacs in or on an ovary. They are common. Most cysts form during the normal menstrual cycle, cause no symptoms, and resolve on their own within 1-3 cycles. Others need attention.

Types

• Functional cysts — follicular or corpus luteum cysts; most common; usually harmless.
• Dermoid cysts (teratomas) — benign; often in younger women.
• Endometriomas ("chocolate cysts") — from endometriosis.
• Cystadenomas — benign but can grow large.
• Cancer — rare, but a concern in post-menopausal women, complex cysts, or with worrying features on imaging.

Red flags — go to hospital

• Sudden severe lower-abdominal pain — especially with vomiting, fever, or feeling faint: possible ovarian torsion or cyst rupture, can be a surgical emergency.
• Pain with heavy bleeding, fainting, rapid heartbeat — also consider ectopic pregnancy.
• Rapidly enlarging belly, weight loss, bloating, reduced appetite in an older woman — evaluate ovarian cancer.

Symptoms (when present)

• Dull or aching lower-belly pain on one side.
• Pain during sex.
• Irregular periods; spotting.
• Pressure, fullness, or bloating.
• Frequent urination.
• Some cysts are found only on a routine scan.

Approach

• Ultrasound is the main test.
• Simple, small cysts in pre-menopausal women — watch with a repeat scan in 6-8 weeks.
• CA-125 blood test sometimes added when cancer needs ruling out (particularly post-menopausal).
• MRI in complex cases.
• Surgery (laparoscopic) for persistent large, complex, or painful cysts; urgent surgery for torsion or suspected cancer.
• Hormonal contraception does not shrink existing cysts but can prevent new functional cysts.

Getting a "cyst on the ovary" report is frightening but usually turns out to be a simple cyst that needs no more than observation. Serious conditions are identified on careful imaging and assessment — trust a good gynaecologist's review rather than self-search panic.