Being told you have an ovarian cyst can be alarming, especially if you've found out unexpectedly during a routine scan. The reassuring news is that the vast majority of ovarian cysts are completely harmless and resolve on their own without any treatment at all. Dr Mandana Master will help you understand exactly what type of cyst you have, what it means for you, and whether any action is needed.
An ovarian cyst is a fluid-filled sac that forms in or on an ovary. They’re extremely common during the reproductive years, and many women will develop one at some point in their life without ever knowing it, as most cysts cause no symptoms at all and are only discovered incidentally during a scan performed for an unrelated reason.
Cysts vary considerably in size, type, and cause. Most are what’s known as functional cysts, forming as a normal part of the menstrual cycle, while a smaller number form for other reasons and may need closer attention. Another type of ovarian cyst are those known as endometriomas, associated with endometriosis, where abnormal endometrium-like tissue grows within an ovary.
Most ovarian cysts cause no symptoms at all. When symptoms do occur, they may include:
Sudden, severe pelvic pain, particularly if accompanied by fever, vomiting, dizziness, or fainting, should be treated as a medical emergency, as this can indicate a cyst has ruptured or caused the ovary to twist (ovarian torsion), both of which require urgent attention.
Most ovarian cysts develop simply as a result of the normal hormonal fluctuations of the menstrual cycle, which is why they’re so common during the reproductive years and far less common after menopause. Other cysts form for reasons unrelated to ovulation, including endometriosis, hormonal conditions such as PMOS, or as benign growths that develop independently of hormonal activity. In most cases, there’s no specific lifestyle or behavioural cause, and cysts aren’t something that can be prevented.
Many ovarian cysts are picked up incidentally during a pelvic examination or ultrasound performed for another reason. Where a cyst is suspected or symptomatic, assessment typically involves:
To assess for any tenderness or palpable masses.
The primary tool for identifying a cyst’s size, type, and characteristics.
Including tumour marker testing in certain cases, to confirm that a cyst is benign (non-cancerous).
The vast majority of ovarian cysts identified this way are simple and benign, and the priority is determining whether a cyst is likely to resolve on its own or requires monitoring or treatment.
Treatment depends on the type, size, and symptoms associated with the cyst, as well as whether you have gone through menopause. Approaches may include:
For small, simple cysts without concerning features, simple observation with a follow-up ultrasound after a number of weeks to confirm the cyst has resolved is the usual approach.
Hormone therapies such as the contraceptive pill may help prevent new functional cysts from forming, although it won’t resolve an existing one.
A cystectomy refers to surgical removal of a cyst while leaving the ovary intact. This approach is recommended for cysts that are large, persistent, or causing significant symptoms, while still preserving your fertility.
An oophorectomy is the surgical removal of the entire ovary. It may be recommended for particularly large cysts or those that may be cancerous, but are usually reserved for women who have reached menopause or no longer wish to have children.
Dr Mandana will explain clearly which category your cyst falls into and recommend an approach suited to your individual circumstances, symptoms, and future fertility plans where relevant.
For most women, an ovarian cyst has no bearing on their fertility at all. Functional cysts in particular come and go as part of a normal cycle, and don’t reduce the number of eggs available or interfere with ovulation in any lasting way.
Certain types of cysts, however, are worth understanding more closely if you’re trying to conceive or planning to in the future. If you have a cyst and are concerned about your fertility, or are currently trying to conceive, it’s worth raising this with Dr Mandana so that any treatment decisions can take your family-building plans into account from the outset, rather than as an afterthought.
You deserve a gynaecologist who listens carefully, explains things clearly, and treats your concerns with evidence-based, patient-centred management strategies. Get in touch with Dr Mandana Master at Embrace Fertility today to arrange a consultation.
