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Ovarian cysts

A woman’s ovaries are two small organs that are the part of her reproductive system that produces eggs and female sex hormones. Ovarian cysts are fluid-filled sacs that develop in, or on the surface of, the ovaries. They are common before the menopause with about seven in 100 women worldwide getting one at some point in their life.

Ovarian cysts are usually benign, which means they aren't cancerous.

Most ovarian cysts don’t cause any symptoms. However, if they get larger, they may do and these can include pain in your abdomen (tummy) or pelvis.

If you need to have treatment, there’s a range available.

It’s important not to confuse an ovarian cyst with polycystic ovary syndrome (PCOS). This is a separate condition where lots of cysts develop on your ovaries. For more information about PCOS, see Related information.

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Details

  • Types Types of ovarian cyst

    There are lots of different types of ovarian cysts. These can be broadly split into two groups to help explain how they develop: functional cysts and pathological cysts.

    Functional cysts

    Most ovarian cysts are functional cysts. This means that they develop as part of your usual menstrual cycle. Different types of functional cysts can grow at different stages in your cycle.

    Each month your ovary produces several follicles (lumps filled with fluid), one of which will mature and release an egg. If a follicle doesn’t release an egg, it can carry on growing and develop into a cyst. This is called a follicular cyst.

    Another type of cyst can develop if, after the egg is released, the follicle doesn’t break down. Instead it closes back up and continues growing – this is known as a corpus luteal cyst.

    Pathological cysts

    These are also called tumours but mostly they aren't cancerous. Pathological cysts don't develop as a result of anything to do with the usual function of your ovary. They may happen because of an overgrowth of cells or be the result of a particular condition, such as endometriosis. There are different types depending on what type of cell they start in.

    Rarely an ovarian cyst can be cancerous (malignant). See our frequently asked questions for more information.

  • Symptoms Symptoms of ovarian cysts

    Most ovarian cysts don’t cause any symptoms, so you may not even realise you have one. However, depending on the type you have, it’s possible you may:

    • have pain or discomfort in your lower abdomen (tummy) or pelvis
    • feel pain during sex
    • need to go to the toilet more often or urgently
    • have pain with bowel movements or feel that you need to go more often
    • feel bloated
    • get indigestion or heartburn, or feel very full after you eat
    • have painful periods, or a change in the pattern of your periods
    • have bleeding (even if you have started the menopause)

    These can be symptoms of other problems as well as ovarian cysts. If you have any of them, contact your GP for advice.

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  • Diagnosis Diagnosis of ovarian cysts

    Most ovarian cysts don't cause any symptoms so you may only find out you have one if you’re having other tests. This could be a cervical smear or ultrasound scan, for example.

    If you see your GP because you have symptoms of an ovarian cyst, they will examine your abdomen (tummy). Your GP may also examine you internally in a vaginal examination. If your GP thinks you have a cyst that needs investigating further, you may need to have the following tests.

    • Transvaginal ultrasound. An ultrasound probe will be placed into your vagina to produce a clear picture of your ovaries.
    • Transabdominal ultrasound. You may have an ultrasound over your lower abdomen as well as a transvaginal ultrasound. This will check for any problems around your pelvic area.
    • Blood tests. You might have a blood test to see which type of cyst you have. If you’ve been through the menopause, your doctor may also look for a substance called CA-125. This can sometimes be raised if you have ovarian cancer or benign ovarian cysts. But other conditions that aren’t cancer or even to do with your ovaries can lead to a rise in this substance as well. These include endometriosis and pelvic infections. So because of that, you probably won’t have this test on its own but with an ultrasound to help diagnose an ovarian cyst.

    Your GP may refer you to a gynaecologist (a doctor who specialises in women’s reproductive health). The results of these tests will help your doctor to plan your treatment.

  • Treatment Treatment of ovarian cysts

    If you have an ovarian cyst, your treatment options will depend on a number of things. As well as your personal preference, these include the type of cyst, how large it is, whether you have symptoms and your age.

    Watchful waiting

    If you don't have any symptoms and your ovarian cyst is quite small (less than 5cm across), you won't need any treatment. And you probably won’t need any further tests unless your symptoms get worse. If your ovarian cyst is larger (between 5 and 7cm), your doctor may offer you more ultrasound scans to keep an eye on its size. If your ovarian cyst is over 7cm, you may be offered further tests, such as an MRI, as well as ultrasound scan. An MRI scan uses magnets and radio waves to produce images of the inside of your body.

    Most functional cysts are likely to disappear on their own within a few months and won't cause any problems.

    Surgery

    If your cyst is large (bigger than 7cm) and causing symptoms, your doctor may suggest you have surgery to remove it. This involves having a type of keyhole surgery called a gynaecological laparoscopy. If you have a very large ovarian cyst, you may need to have open surgery instead but this is uncommon. In this procedure, a larger cut is made in your abdomen and the cyst is removed through that.

    The type of surgery that’s best for you will vary from person to person – various things need to be taken into account.

    Your gynaecologist will help you to decide on the best option for you. For more information about the operations that can be used to remove ovarian cysts, see Related information.

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  • Causes Causes of ovarian cysts

    It’s not yet known exactly why some women develop ovarian cysts. However, we’ve put together a list of things that appear to increase your chance of getting them.

    • If you take progestogen contraception, it may increase your risk of getting functional cysts. Examples of progestogen contraception include the progestogen-only pill, the intrauterine system (Mirena) or the contraceptive implant (Implanon).
    • Some hormones that are used to treat infertility can trigger functional cysts to develop in your ovaries.
    • If you’re taking the medicine tamoxifen for breast cancer, you may develop cysts, but they usually go away when you finish treatment.
    • If you're pregnant, ovarian cysts can form as your hormones levels change during your pregnancy.
    • Having an underactive thyroid can increase your risk of getting ovarian cysts.
    • You may be at risk of ovarian cysts if you have endometriosis.
    • If you smoke, it may increase your risk of getting functional ovarian cysts.
  • Complications Complications of ovarian cysts

    Rarely, a cyst can cause your ovary to twist, which is called torsion, or the cyst itself can suddenly burst (rupture). Both of these problems can cause severe pain in your abdomen (tummy). You may also have a fever and feel sick or vomit. It’s very important that you get urgent medical attention if you have been diagnosed with a cyst and then develop these symptoms.
  • FAQs FAQs

    Will having an ovarian cyst affect my fertility?

    Answer

    Ovarian cysts don't usually affect your fertility. But if you need to have surgery to remove a cyst, this could affect your ability to have a child.

    Explanation

    Most ovarian cysts are functional ones, which means they are usually small and will go away without treatment. If you have an ovarian cyst that does need treatment, it’s important that you’re aware that some types of surgery can affect your fertility.

    If you need to have surgery, usually only the cyst is removed and your ovary won’t be. However, if your cyst is very large or you have complications, such as if the cyst has twisted, your ovary may need to be removed. If, while operating, your surgeon finds that the cyst is cancerous, you may need to have your ovary removed later in a separate operation. It’s also possible that you may need to have a hysterectomy to remove your womb if there is a risk of cancer spreading. But your surgeon will discuss this with you first.

    There are some general risks from having surgery to remove an ovarian cyst that may mean your ovary needs to be removed. These risks and how they apply to you will be explained before you have the operation. And during the operation your surgeon will make every effort to ensure your ovary doesn’t need to be removed.

    If you need to have your ovary removed, you will probably still be able to have a child. This is as long as you have one ovary left, or even part of an ovary. But if you’ve had a hysterectomy, you will no longer be able to get pregnant.

    You’ll have the chance to discuss all the options available to you with your gynaecologist or surgeon before you have surgery.

    Does having an ovarian cyst mean I have cancer?

    Answer

    No, most ovarian cysts aren’t cancerous and are what's called benign.

    Explanation

    Functional cysts (the most common type of ovarian cyst found in women who haven't started the menopause) are mostly benign.

    Some other types of ovarian cysts do turn out to be cancerous. Here we’ve outlined the risk of an ovarian cyst being cancerous.

    • About one in 1,000 ovarian cysts are found to be cancerous in women who have not yet gone through the menopause.
    • About three in 1,000 ovarian cysts turn out to be cancerous in women over the age of 50.

    However, this figure also depends on the exact type of cyst you have as well as numerous other things. These include if you've had or are able to have children, have had breast or ovarian cancer (or relatives who have) and whether you smoke. You will have a number of tests to check whether your ovarian cyst is benign or malignant.

    Talk to your GP if you're worried about ovarian cancer.

    What will happen if I'm diagnosed with an ovarian cyst while I’m pregnant?

    Answer

    Most ovarian cysts are benign and go away on their own. So if you get an ovarian cyst while you’re pregnant, your doctor will usually just need to check it regularly and you won’t need treatment. Occasionally, you may need to have the cyst removed before you have your baby.

    Explanation

    As women have a number of scans during their pregnancy, ovarian cysts are often diagnosed at this time.

    The majority of ovarian cysts found during pregnancy are small and harmless – your doctor will probably just need to monitor it. If you have a larger cyst, you may be offered extra ultrasound scans during your pregnancy to keep an eye on it.

    Having an ovarian cyst won't harm your baby. However, if your ovarian cyst is painful, or your doctor thinks it may be cancerous, you may need to have it removed. Laparoscopic (keyhole) surgery is a safe and effective procedure that can be carried out at any time while you're pregnant. However, you may be advised to wait to have the operation until after you have given birth to your baby. Ask your doctor for more information.

    Are ovarian cysts and pelvic inflammatory disease linked?

    Answer

    Although ovarian cysts and pelvic inflammatory disease can have similar symptoms, the two conditions are very different. Ovarian cysts aren't caused by an infection, but pelvic inflammatory disease is – mostly sexually transmitted infections (STIs).

    Explanation

    You might not have any symptoms if you have either ovarian cysts or pelvic inflammatory disease. Many women have these conditions without knowing it. If you do have symptoms, they may include pain in your abdomen (tummy) and pain when you have sex.

    If you have an ovarian cyst, you may have other symptoms, which could include:

    • needing to go to the toilet more often or urgently
    • pain when you have bowel movements or feeling that you need to go more often
    • indigestion or heartburn, or feeling very full after you eat

    Pelvic inflammatory disease can cause different symptoms, including:

    • an abnormal vaginal discharge that may be smelly
    • irregular periods, bleeding between periods or having heavier periods than usual
    • pain when you pass urine
    • a high temperature (over 38ºC)
    • feeling sick or vomiting

    If you have any of these symptoms, see your GP or visit a sexual health clinic.

    If you’re diagnosed with ovarian cysts, you may not need any treatment. This is because some cysts often go away on their own in about two or three months. If you’re diagnosed with pelvic inflammatory disease, your doctor will prescribe you antibiotics to treat the infection.

  • Resources Resources

    Further information

    Sources

    • Ovarian cysts before the menopause. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk, published June 2013
    • Female reproductive organ anatomy. Medscape. www.emedicine.medscape.com, published 3 October 2013
    • Management of suspected ovarian masses in premenopausal women. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk, published November 2011
    • Ovarian cysts in postmenopausal women. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk, published 2010
    • Ovarian cysts. BMJ Best Practice. www.bestpractice.bmj.com, published 16 May 2014
    • Polycystic ovarian syndrome. Medscape. www.emedicine.medscape.com, published 29 September 2014
    • Seckin B, Ozdener T, Tapisiz OL, et al. Laparoscopic treatment of ovarian cysts in adolescents and young adults. J Pediatr Adolesc Gynecol 2011; 24(5):300–3. doi:10.1016/j.jpag.2011.05.006
    • Benign ovarian masses. The Merck Manuals. www.merckmanuals.com, published July 2014
    • Ovarian cysts. Medscape. www.emedicine.medscape.com, published 25 April 2014
    • Benign ovarian tumours. PatientPlus. www.patient.co.uk/patientplus.asp, published 20 February 2012
    • Ovarian cystectomy. Medscape. www.emedicine.medscape.com, published 20 December 2012
    • Grimes DA, Jones LB, Lopez LM, et al. Oral contraceptives for functional ovarian cysts. Cochrane Database of Systematic Reviews 2014, Issue 4. doi:10.1002/14651858.CD006134.pub5
    • Fertility after treatment for ovarian cancer. Macmillan Cancer Support. www.macmillan.org.uk, published 1 June 2012
    • Ovarian cancer. PatientPlus. www.patient.co.uk/patientplus.asp, published 10 December 2013
    • Guidelines for diagnosis, treatment, and use of laparoscopy for surgical problems during pregnancy. Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). www.sages.org, published January 2011
    • Pelvic inflammatory disease. PatientPlus. www.patient.co.uk/patientplus.asp, published 22 October 2014
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