Most women will have an ovarian cyst sometime during their life. In fact, it’s possible you’ll get a cyst on a monthly basis, but never have any symptoms. Ovarian cysts are usually harmless and occur most often in menstruating women. In most cases, they go away on their own. However, if you have persistent symptoms or you’re getting older, an ovarian cyst warrants follow-up. Talking to your doctor about your symptoms will allow you to get the testing and help you need.

Symptoms

Most ovarian cysts don’t have any symptoms. That being said, if you have a larger ovarian cyst you may notice the following symptoms:

• Bloating
• Heaviness in your abdomen
• Pelvic pain consisting of a dull or sharp ache in your lower abdomen
• Nausea or vomiting
• Painful bowel movements
• Pain during sex

Types of cysts

Not all ovarian cysts are the same. Your cyst might function or even look different, depending on how it was formed.

Follicular cysts

Most follicular cysts will go away on their own within three months. During ovulation, one of your ovaries will release an egg from a tiny sac called a follicle. A cyst can happen if the follicle grows an egg, but doesn’t release it for ovulation. This type of cyst can also happen if a mature follicle collapses on itself. These types of cysts grow up to 2-3 inches in diameter. You probably won’t experience pain with a follicular cyst, but if you do it can cause a sharp, severe pain on the side of your ovary when it ruptures.

Corpus luteum cysts

After your ovary releases an egg during ovulation, the empty follicle the egg was released from typically shrinks back down. However, sometimes a follicle will close and start to collect fluid inside. This fluid-filled follicle is called a corpus luteum cyst. In most cases, these types of cysts are only found on one ovary at a time and produce few to no symptoms. In some cases, a corpus luteum cyst will bleed or cause pain.

Nonfunctional cysts

A nonfunctional cyst can grow on your ovaries whether or not you’re ovulating. These types of cysts might be one of the following:

• Endometriomas are cysts that develop due to a condition called endometriosis, in which uterine endometrial cells grow outside of your endometrium and can present as endometriomas. Endometrioid cysts are usually filled with dark, reddish-brown blood. They can grow up to 8 inches in diameter.
• Dermoid cysts, also called teratomas, are formed from embryonic cells, and can contain tissue like hair, skin, or even teeth. Dermoid cysts aren’t typically cancerous. These cysts usually affect younger women; they can grow up to 6 inches in diameter.
• Cystadenomas grow on the surface of your ovary. They may be filled with serous fluid or mucous.
• Polycystic ovaries occur in women with polycystic ovarian syndrome (PCOS). If you have PCOS, you’ll have many small cysts on the surface of your ovary. But these types of cysts aren’t painful.

Risk factors

Although it’s difficult to predict when or if you’ll develop an ovarian cyst, certain factors put you at risk. They include:

• A history of ovarian cysts
• A diagnosis of endometriosis or polycystic ovary syndrome
• Hormonal problems (some fertility drugs can contribute to the development of ovarian cysts)
• Pregnancy
• A pelvic infection

Diagnosis

Your doctor may be able to detect the presence of an ovarian cyst — if it’s large enough— during a pelvic exam. When an ovarian cyst is suspected, your doctor will likely order a transvaginal ultrasound and/or some blood work. These tests will allow your doctor to confirm the presence and characteristics of an ovarian cyst.

Treatment

The good thing about most ovarian cysts is that they typically go away on their own. When you have an ovarian cyst, your doctor may recommend the following treatments:

• Watchful waiting. It might seem hard to wait, but unless your cyst doesn’t go away, is large, or is causing you problems, waiting is usually the best answer. Keep in contact with your doctor so he or she can monitor the situation, especially if you’re having severe pain.
• Your doctor may prescribe birth control pills to help prevent the growth of new cysts.
• Surgery. Large cysts, or cysts in women who are experiencing menopause (when the risk of a cyst being cancerous is higher), may need to be surgically removed. Your doctor can use laparoscopy for most cysts. This type of surgery is less invasive and allows you to go home quickly. However, if you have a cyst that may be cancerous, your doctor may refer you to a gynecologist oncologist.

When to see a doctor

Although most ovarian cysts go away on their own, you should see your doctor immediately if you experience these symptoms:

• Feeling faint, dizzy, or weak
• Fast breathing
• Fever with pain
• Throwing up
• Severe belly pain that comes on quickly

These symptoms could mean your ovary has twisted because of an ovarian cyst.