Ovarian cysts

Expert reviewer, Dr Robin Crawford, Consultant Gynaecologist
Next review due March 2022

Ovarian cysts are fluid-filled sacs that develop in or on your ovaries. They’re quite common and girls and women of any age can get them.

Most ovarian cysts don’t cause any symptoms and they’re usually benign (non-cancerous). Many will go away without treatment, but sometimes an ovarian cyst needs to be removed in a surgical procedure. This may be because the cyst is large, is causing symptoms or there’s a risk it might be cancerous.

An image showing the female reproductive system

Types of ovarian cyst

There are lots of different types of ovarian cyst. These can be split into two groups: 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.

Each month, your ovary produces several follicles (tiny fluid-filled sacs). One of these will mature and release an egg. After releasing the egg, the follicle normally changes into something called the corpus luteum. The corpus luteum releases hormones that help the lining of your uterus (womb) prepare for pregnancy. If the egg isn’t fertilised, the corpus luteum begins to break down.

The two main types of functional cyst form at different stages in this cycle.

  • A follicular cyst can happen if a follicle doesn’t release an egg but carries on growing.
  • A corpus luteum cyst can form if the corpus luteum doesn’t break down. It may continue to grow and become filled with blood.

Pathological cysts

These may happen because of an overgrowth of cells. You may hear these types of ovarian cyst referred to as ‘tumours’, but this doesn’t necessarily mean that they’re cancerous. Most aren’t. To find out more about ovarian cysts and cancer, see our FAQ below.

You can also get ovarian cysts if you have endometriosis or polycystic ovary syndrome (PCOS). For more information about the difference between ovarian cysts and PCOS, see our FAQ below.

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)
  • feel pain during sex
  • need to pass urine more often or urgently
  • find it more difficult to poo or feel pressure in your back passage that makes you feel you need to go to the toilet
  • 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

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

Diagnosis of ovarian cysts

Because most ovarian cysts don't cause any symptoms, you may only find out you’ve got one if you’re having tests such as an ultrasound scan.

If you see your GP because you’ve got symptoms of an ovarian cyst, they’ll ask about these and examine your abdomen (tummy). Your GP may also examine you internally with a vaginal examination. If your GP thinks you have a cyst that needs investigating further, they may recommend the following tests.

  • Transvaginal ultrasound – an ultrasound probe placed into your vagina to produce a clear picture of your ovaries.
  • Transabdominal ultrasound – a scan over your lower abdomen to check for any problems around your pelvic area.
  • Blood tests to help rule out cancer, including a test for a substance called CA-125. Your level of CA-125 can be high if you have ovarian cancer, but it may also be raised due to other conditions.

Depending on the results, your GP may refer you to a gynaecologist (a doctor who specialises in women’s reproductive health).

Treatment of ovarian cysts

If you have an ovarian cyst, you may not need any treatment. Whether or not you need treatment will depend on:

  • the type of cyst
  • how large it is
  • whether or not you have symptoms
  • if you’ve been through the menopause

Your personal preferences will also be taken into account.

'Watchful waiting'

If your cyst is small and isn’t causing any problems, your GP or gynaecologist may suggest keeping a close eye on it for a while with ultrasound scans. This is called ‘watchful waiting’. Most small cysts disappear on their own within a few months and don't cause any problems. So this approach helps you avoid having treatment you don’t need.

Your GP or gynaecologist will discuss with you when you should have a repeat ultrasound scan. This may be:

  • after a year if you’re still having periods
  • every four to six months for a year if you’ve been through the menopause

You may also be asked to have another blood test for CA-125. If your cyst doesn’t go away, your gynaecologist may then recommend surgery to remove it.


Ovarian cysts during pregnancy nearly always go away without treatment. Your gynaecologist will usually only recommend surgery if the cyst is causing symptoms or is very large.


If your cyst is large, causing symptoms or doesn’t go away, your gynaecologist will probably suggest you have surgery to remove it. They‘ll also recommend surgery if there’s a risk your cyst may be ovarian cancer.

There are two ways of carrying out surgery for an ovarian cyst:

  • keyhole surgery (laparoscopy)
  • open surgery (laparotomy)

You’re most likely to be offered keyhole surgery, which is usually done as a day-case procedure.

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Causes of ovarian cysts

Most ovarian cysts form in response to hormonal changes in your body, so anything that affects your hormone levels can sometimes lead to cysts forming. These include:

  • using progestogen contraception – the progestogen-only pill, the intrauterine system (the coil – for example, Mirena) or the contraceptive implant
  • being pregnant
  • taking hormones used to treat infertility
  • taking hormone therapy for breast cancer
  • having an underactive thyroid

You can also get ovarian cysts if you have endometriosis or polycystic ovary syndrome (PCOS).

Complications of ovarian cysts

Having an ovarian cyst doesn’t usually cause any serious problems. But occasionally a cyst can cause your ovary to twist. This is called torsion and cuts off the blood supply to your ovary. Or the cyst itself can suddenly burst (rupture). Both of these problems can cause severe pain in your abdomen (tummy) and make you feel very unwell.

If you have been diagnosed with an ovarian cyst and get sudden, severe lower abdominal pain, go to your nearest A&E department straightaway. You may need to have surgery.

Frequently asked questions

  • Probably not – most ovarian cysts are benign, which means they aren’t 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.

    You’ll have a number of tests to check whether your ovarian cyst is benign or cancerous. These will include an ultrasound scan which looks at the structure of your cyst, and a blood test. See our section on diagnosis for more information.

    It’s natural to be concerned about having cancer. If your gynaecologist thinks that your ovarian cyst may be cancer, they’ll discuss this with you.

  • Small ovarian cysts don't usually affect your fertility. Most ovarian cysts are functional cysts which are usually small and go away without treatment. See our section on types of ovarian cyst above for more information about these.

    Endometriosis and polycystic ovary syndrome (PCOS) are conditions that can cause ovarian cysts and can also cause problems with fertility.

    In some cases, ovarian cysts need to be removed by surgery. If at all possible, only the cyst will be removed and your ovary won’t be. If you do have to have an ovary removed, you can still get pregnant if your remaining ovary is working normally.

    Talk to your gynaecologist if you have ovarian cysts and you’re worried about your fertility.

  • Probably not. For many years, doctors have prescribed the combined oral contraceptive pill for women with ovarian cysts, in the hope that this would help to make the cysts shrink. This was based on the fact that women who take the combined oral contraceptive pill are less likely to get cysts. It was thought that if the pill could help prevent ovarian cysts happening in the first place, then they might be able to make existing cysts go away.

    But researchers have now found that taking the combined oral contraceptive pill seems to have no effect on any ovarian cysts that a woman already has. It doesn’t make the cyst get smaller or go away. So this contraceptive pill isn’t usually recommended for treating ovarian cysts.

    If your doctor recommends that you take the contraceptive pill for ovarian cysts, ask them to explain how it may help you in your particular circumstances.

  • Many women have one or more cysts on their ovaries at some point in their lives. These often cause no symptoms and go away without treatment. If you have 12 or more cysts in one ovary, you may be said to have ‘polycystic ovaries’. But this is not the same thing as having polycystic ovary syndrome (PCOS).

    Polycystic ovary syndrome is the name given to a collection of symptoms caused by abnormalities in the way your body produces and manages sex hormones. Having cysts on your ovaries can be just one aspect of this syndrome. Hormone imbalances in PCOS may cause a number of different symptoms, including:

    • infertility
    • increase in facial and body hair (hirsutism)
    • lack of periods (amenorrhoea) or infrequent periods
    • acne
    • baldness
    • weight gain

    On average, women with PCOS have ovaries three times normal size. Confusingly, some women with PCOS don’t have cysts on their ovaries at all.

  • Not usually. The most common type of ovarian cyst – a functional cyst linked to your menstrual cycle – is relatively small and is unlikely to affect your weight. But feeling bloated can be a symptom of having an ovarian cyst and this might make you feel as though you’ve put on weight.

    If you have polycystic ovary syndrome (PCOS), you may put on weight as part of that condition and you may also have cysts on your ovaries. Your doctor will advise you to lose weight if you can because even a small amount of weight loss can help your symptoms. For more information on the difference between ovarian cysts and PCOS, see our FAQ above.

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Related information

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    • Ovarian cysts. Medscape., updated December 2018
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    • Personal communication, Dr Robin Crawford, Consultant Gynaecologist, January 2019
  • Reviewed by Dr Kristina Routh, Freelance Health Editor, Bupa Health Content Team, March 2019
    Expert reviewer Dr Robin Crawford, Consultant Gynaecologist
    Next review due March 2022