If you have ovaries, you can develop an ovarian cyst. They’re common, especially before menopause: around 10 in 100external link, opens in a new tab people with ovaries have one, and the number might actually be higherexternal link, opens in a new tab. Most of the time they’re nothing to worry about and disappear on their own, but some can cause discomfort, and others can linger or even twist and rupture.
What Is an Ovarian Cyst?
An ovarian cyst is a sac filled with fluid or sometimes semi-solid materials that can develop on one or both of your ovaries, each of which sits on each side of your uterus. The cysts are usually small—around 1 to 3 cmexternal link, opens in a new tab. For scale, ovaries themselves are typically the size and shape of almonds. Some cysts can grow to between 15 and 30 cm, but this is rare.
Are Ovarian Cysts Cancer?
You may sometimes hear ovarian cysts referred to as “tumors.” People who aren’t medical professionals often assume that “tumor” means “cancerous,” but the term actually refers to a variety of swellings, masses, and rapid growths that can regularly occur in the body, many of which are not cancerous (also known as benign). Cells in the body usually only reproduce to replace lost or damaged tissue, but sometimes things get scrambled and they keep growing, creating a tumor. Ovarian cysts are not cancerous.
Ovarian cancer tumors are solid masses that contain cancer cellsexternal link, opens in a new tab: They will continue to divide uncontrollably and start to spread to other areas of the body. These are known as “malignant” cells.
That said, ovarian cysts and ovarian cancer can cause some of the same symptoms and complex ovarian cysts (explained in the next section) have solid components that sometimes make them hard to distinguish from cancerous tumors, so getting a proper diagnosis is important.
Types of Ovarian Cysts—The Good, the Bad, and the … Hairy?
It’s time to talk about types of cysts.
Functional ovarian cysts
Functional cystsexternal link, opens in a new tab (also called simple cysts) are the most common type of ovarian cyst. They develop as part of your menstrual cycle and usually shrink away on their own within 60 days. There are two types:
- Follicular cysts form when a follicle in your ovary doesn’t release an egg—as typically happens once during most people’s menstrual cycles—and instead fills with fluid.
- Corpus luteum cysts can form if the follicle releases an egg, but you don’t get pregnant. Normally the egg dissolves, but sometimes instead of dissolving, it fills with fluid.
Ovarian dermoid cysts
Dermoid cysts are smooth ovarian cysts that are filled with fluid but also contain tissue from other parts of your body like your hair, teeth, and skin. They’re present at birth and form when germ cells, which normally differentiate into eggs or sperm during fetal development, instead develop the characteristics of other cells and collect in the ovaries and form a mass. Most don’t get diagnosed until a person has an ultrasound later in life, like during pregnancy.
While not cancerous, they have a slightly higherexternal link, opens in a new tab risk of becoming cancer—in about one to two percent of cases—especially after the age of 45 or the bigger they get. This happens when something goes wrong with the dividing and growing cells in the dermoid cyst. They can be unsettling to think about, but they don’t need to be removed unless they’re large or causing symptoms.
Ovarian cystadenomas
Ovarian cystadenomas develop on the surface of the ovary and can be filled with watery fluid (called serous cystadenoma) or a thicker, mucous-like substance (called mucinous cystadenoma). They’re common and usually measure between 1 to 3 cmexternal link, opens in a new tab. Like a lot of other ovarian cysts, they often don’t cause any symptoms unless they’re especially large and are usually only found when you have imaging.
Ovarian endometrioma (Chocolate cyst)
Endometriomas are also called chocolate cysts because of their appearance—they’re filled with old blood, which is brown. They’re caused by endometriosis, a painful condition that happens when tissue similar to the tissue in your uterus grows outside of your uterus.
Around 10 percentexternal link, opens in a new tab of people who menstruate have endometriosis and up to 44 percent of them develop an endometrioma.
Having one is usually a sign of advanced endometriosis, so they’re often accompanied by symptoms of the condition like severe pelvic pain and bloating; heavy periods; and pain during sex, peeing or pooping.
Endometriomas have a small risk of becoming cancerous. Since they’re usually the result of advanced-stage endometriosis, your doctor might recommend surgeryexternal link, opens in a new tab to remove the cyst and possibly other endometrial lesions if you’re having symptoms.
PMOS cysts: Sort of ovarian cysts, but not really
Polyendocrine Metabolic Ovarian Syndrome (PMOS)—formerly known as Polycystic Ovarian Syndrome (PCOS)—is a hormonal disorder that can mess with your ovaries. It can involve ovarian cysts, but not always, so the name’s a bit misleading.
Diagnosing PMOS can take time and may involve some process of elimination. To meet the criteriaexternal link, opens in a new tab for a PMOS diagnosis, you need to have cysts on your ovaries and high androgen hormones; or irregular periods and high androgen hormones; or all three. And the cysts associated with PMOS aren’t true cysts; they’re follicles containing immature eggs. You may have many of them visible on the ovaries seen during an ultrasound or you may have enlarged ovaries, or neither.
Missed or wonky periods, acne, weight gain around the belly and extra body hair on places like your neck, chin and chest are common symptoms.
Ovarian Cancer—Just an FYI
Again, ovarian cysts are not the same as ovarian cancerexternal link, opens in a new tab tumors, and the chance a cyst will turn cancerous is very low. So why talk about ovarian cancer? Ovarian cancer doesn’t always cause symptoms until the tumor grows large or the cancer spreads within your belly. Because cysts and ovarian cancer have overlapping symptoms, distinguishing between the two and getting a diagnosis is super important.
Here are some possible symptomsexternal link, opens in a new tab of ovarian cancer to have on your radar you should report to a doctor ASAP if you experience them:
- Pelvic, belly pain or back pain
- Bloating
- Abnormal vaginal bleeding
- Always feeling like you need to pee and peeing more than usual
- Trouble eating or feeling full quickly
- Constipation that doesn’t improve
- Feeling unusually tired all the time
- Abdominal swelling with unintentional weight loss
Remember, having these symptoms doesn’t mean you have ovarian cancer, but if they’re new or persistent, hightail it to a doctor. Your doctor can review your symptoms and medical history and suggest diagnostic testing for possible causes, including cancer.
How Ovarian Cysts Feel—Not That You Can Always Feel Them
Small ovarian cysts don’t usually cause symptoms, but larger ones can. If you have one (or more) you might feel pain that comes and goes that can be dull or sharp. You might also have a feeling of pressure or fullness in your lower belly.
Common ovarian cyst symptoms include:
- Pelvic pain or pressure
- A dull ache in your lower back
- Pain during sex
- Painful periods
- Irregular periods
- Bloating in your lower belly that might be more noticeable on one side
Who’s More Likely to Get Ovarian Cysts?
Anyone with ovaries can get them, but there are a few things that increases a person’s chances of getting ovarian cysts, including:
- Being of reproductive age, meaning you haven’t gone through menopause yet.
- Having already had an ovarian cyst makes you more likely to get another.
- Having endometriosis, PMOS, or another condition that affects your hormones.
- Being pregnant, as cysts are more likely to develop during pregnancy.
- Taking fertility medications to help ovulation, like Clomid.
- Pelvic inflammatory disease, which is any bacterial infection of the reproductive organs that can spread to the ovaries.
When to See a Doctor
You can’t know for sure if you have an ovarian cyst without the help of a healthcare professional and some tests, even if you have all the common symptoms. Other conditions can cause the same symptoms, including PMOS, fibroids, and endometriosis. And as we already covered, ovarian cancer can also cause a lot of the same symptoms, but so can other cancers, including colorectal cancer.
Here’s a rundown on tests or examinations your doctor may recommend to diagnose an ovarian cyst:
- Physical exam: After asking about your symptoms, a doctor will perform a physical exam to check for signs of ovarian cysts and other problems that can cause the same symptoms. This will include pressing on your abdomen to feel for lumps, swelling and pain, and a pelvic exam to feel for the same and other abnormalities, like signs of infection.
- Pelvic ultrasound: An ultrasound uses soundwaves to create pictures of the inside of your pelvis, including your uterus. Having a full bladder helps the tech get a clearer view, so you’ll be asked to drink a certain amount of water before your test. During the test, the technician glides a wand-like device called a transducer over your lower abdomen to see your pelvic organs, including your ovaries. It’s a pretty quick and painless test but may cause some pressure or discomfort if you’re bloated or having pain.
- Transvaginal ultrasound: A transvaginal ultrasound is usually part of a pelvic ultrasound. Once the pelvic ultrasound is done, you’ll be able to go pee before starting the transvaginal portion of the test. The technician will insert a narrow wand into your vagina and move it around to get images of your pelvic organs. It may feel a bit uncomfortable and you may notice some pressure, but otherwise it’s usually mostly painless.
- Blood tests: Blood tests can’t diagnose ovarian cysts, but they can help check for conditions that may be causing your symptoms. This can include a CA-125 test to check for blood levels of a protein that’s often elevated when a person has ovarian cancer. It’s sometimes also elevated when a person has endometriosis or pelvic inflammatory disease.
- CT scan: A CT scan—or computed tomography scan if you want to be a fancy-pants—is a quick test that takes a series of X-rays to create 3D images of your organs. You lie on a table that slides through a donut-shaped machine.
- MRI: Short for magnetic resonance imaging, this test uses magnets and radio waves to produce images of your organs. Like a CT scan, you lie on a table that slides into a machine, only this machine is a long tube. The space is tight and the machine makes loud noises. It doesn’t hurt, but it can be unnerving for some people. If you’re claustrophobicexternal link, opens in a new tab or have anxiety, your doctor can prescribe medication to help you relax.
And just a heads up: If you see a doctor about ovarian cyst symptoms, there’s a good chance they’ll want to give you a pregnancy test to rule that out as a cause of your symptoms, something that’s done with almost any possible reproductive health issue. Even if you are 100% sure that you are not pregnant, they’ll want to test you and record the result in your chart to document the steps they took in your diagnosis.
How They’re Treated
Ovarian cysts don’t always need to be treated. Functional cysts usually go away on their own. A lot of times doctors just recommend watchful waiting to see if it grows or causes symptoms. In this case, you may need a follow-up ultrasound in a few months.
Treatment is usually recommended when a cyst is large, causing symptoms, affecting menstruation or fertility, or if they suspect it could be cancerous.
If you and your doctor decide that treatment is best, here are some of the options that may be used depending on the type and size of the cyst and your symptoms:
- Medication: Hormonal methods of birth control are a common treatment for ovarian cysts because they stop ovulation and can prevent future cysts. Over-the-counter pain relievers can help manage your pain.
- Surgery: Surgery for an ovarian cyst is an option for bigger cysts or potentially cancerous tumors. The type of surgery recommended depends on the size and type of cyst. Laparoscopic surgery can remove small cysts through tiny incisions using a thin tube with a camera on the end. Larger cysts or suspicious cysts are usually removed with open surgery through a large incision.
Your doctor will factor in your health, age and whether you want to get pregnant one day when deciding on the best treatment for you. Don’t hesitate to ask questions and bring up any concerns about treatment if it’s on the table. It’s your body, after all.
Possible Complications
Bad enough these little mo-fos invade your ovaries, but some have the audacity to cause trouble, too. Bigger cysts are more likely to cause complications, like bleeding or rupturingexternal link, opens in a new tab, which can be painful. A ruptured cyst causes extreme pain on one side of your pelvis/lower abdomen that typically comes on suddenly.
Ovarian cysts can also change the shape of your ovary and cause it (and sometimes your fallopian tube) to twist. This is medically referred to as ovarian torsionexternal link, opens in a new tab, and the twisting can prevent blood flow to the ovary and cause the tissue in the ovary to die. If this happens you can expect severe pain, nausea and vomiting. If you have any of these symptoms, get medical care right away. Ovarian torsion is a medical emergency that requires surgery to save the ovary and try to protect fertility.
Some types of ovarian cysts, including endometriomas and those caused by PCOS, can affect fertilityexternal link, opens in a new tab and make it difficult to get pregnant. If you have an ovarian cyst and want to get pregnant one day, mention this to your doctor. They can recommend treatments that may be able to help.
Getting Help for Ovarian Cysts When You Don’t Have a Doctor
If you don’t have a family doctor or a gynecologist, a reproductive health clinic—like a Planned Parenthood branch, an independent clinic, or a public health clinic—can diagnose and treat reproductive health problemsexternal link, opens in a new tab, including ovarian cysts and related conditions, like PMOS and endometriosis. They’ll usually work with you to provide affordable care even if you don’t have health insurance, so there’s no need to put off getting checked out.
In Canada, some walk-in clinics offer referral services. You can visit one for a referral without a family doctor as long as you have your provincial health card.
If you’re in the UK, you’ll need to get a referral to a gynecologist from a GP. Ovarian cyst monitoring and treatment is covered on the NHS. If you’re not registered with a GP surgery, you can register with one on the NHS websiteexternal link, opens in a new tab.
No matter where you are in the world, you can visit your local urgent care clinic or emergency department even if you don’t have a family doctor. If you have symptoms of an ovarian cyst, they’ll usually perform an exam and an ultrasound and proceed from there.
