Ovarian cyst: common symptoms and when should you see a gynaecologist?

English version

An ovarian cyst is a fluid-filled or tissue-containing sac that develops in or on an ovary. Many cause no symptoms and are discovered incidentally during ultrasound. Most are non-cancerous, and many functional cysts resolve without treatment.

What symptoms can an ovarian cyst cause?

• Dull, heavy or intermittent lower-abdominal or pelvic pain.
• Pain mainly on one side or during sex.
• Abdominal bloating or swelling.
• Pressure on the bladder, frequent urination or difficulty emptying the bowel.
• Feeling full after eating a small amount.
• Changes in menstrual bleeding or pain during activity.

These symptoms are not specific to cysts. Fibroids, endometriosis, urinary or bowel conditions and pregnancy-related problems can cause similar symptoms.

Are all ovarian cysts the same?

• Functional cysts: Develop as part of ovulation and often disappear within one or two cycles.
• Endometriomas: Associated with endometriosis.
• Dermoid cysts or teratomas: Usually benign growths containing different tissues.
• Cystadenomas: Develop from cells on the ovarian surface.
• Complex cysts: Have solid areas, partitions or other features requiring further evaluation.

An ovarian cyst is not the same as polycystic ovary syndrome (PCOS), which is a hormonal and metabolic condition diagnosed using several clinical factors.

What does the ultrasound report mean?

Ultrasound assesses size, location, whether the cyst is fluid-filled or contains solid tissue, whether one or both ovaries are affected and other relevant features. A cyst on ultrasound does not automatically mean surgery is required. Some only need observation and a repeat scan.

Do not rely only on cyst size or an isolated blood-test result. The complete ultrasound appearance, symptoms, menopausal status and medical history must be considered together.

When should you arrange a consultation?

• Pelvic pain persists, returns or worsens.
• Pain affects work, exercise, sleep or sexual activity.
• You have persistent bloating, swelling or early fullness.
• Periods change significantly.
• A cyst persists or grows on repeat ultrasound.
• The report describes a complex cyst or solid component.
• You are pregnant, trying to conceive or the cyst was found after menopause.
• You have a strong family history of ovarian or breast cancer.

Does every ovarian cyst require treatment?

No. Management may involve watchful waiting and repeat ultrasound, treatment of an associated condition such as endometriosis, or surgery when a cyst is large, persistent, painful, increasing or has concerning features. If surgery is needed during reproductive years, preserving healthy ovarian tissue and fertility is considered whenever medically appropriate.

Avoid hormonal medicines or unverified supplements intended to “dissolve” a cyst without medical advice.