Ovarian Cysts: Causes, Symptoms and Treatments

Most ovarian cysts are harmless and cause no pain. They go away on their own, and you never even knew they existed. But sometimes ovarian cysts can be more serious and require medical attention.

We talked to OB-GYN James Hardy, MD, to find out the difference.

What is an ovarian cyst?

An ovarian cyst is a fluid-filled pocket inside or on the surface of an ovary. There are two types of ovarian cysts: simple and complex. Simple cysts contain only fluid. Complex cysts are filled with both fluid and solid components.

What are the symptoms of an ovarian cyst?

Most women who have ovarian cysts don’t have any symptoms. For those who do experience symptoms, common ones are:

  • Abdominal pain
  • A fullness or pressure in the stomach or lower abdomen
  • Feeling a more frequent urge to urinate or have a bowel movement
  • A feeling of pressing on the bladder
  • Pain during sex

Why do some ovarian cysts hurt?

The pain comes from the pressure on the layer of cells covering the ovary, caused by the growth of the cyst. This pressure causes stretching, which hurts.

Do ovarian cyst symptoms ever get confused for other conditions?

Yes. Most symptoms of ovarian cysts are not specific to ovarian cysts, meaning that these symptoms do not immediately signal that an ovarian cyst is present. Doctors first have to rule out other possibilities.

Most of the symptoms associated with ovarian cysts can also indicate other health conditions. For example, if the cyst is on the right ovary, its symptoms could make doctors suspect appendicitis.

If it’s a very large cyst, there could be pain throughout the abdomen, which could indicate gastrointestinal or other disease.

If you have a cyst near your bladder and feel that you have to go to the bathroom with increased frequency, a doctor may suspect a urinary tract infection.

What causes ovarian cysts?

By far the most common type of ovarian cyst is a functional cyst, a cyst that occurs as part of the natural functioning of the ovaries. These are common and don’t cause major health problems.

When women who have periods ovulate, the ovarian follicles produce eggs. Follicles, in this sense, don’t refer to the ones that create hairs on your skin. Instead, we’re talking about the collection of cells in the ovary. Follicles on your skin produce hairs; follicles in your ovary produce eggs.

Sometimes the follicle does not release an egg but instead makes a perfectly normal cyst. This is a follicular cyst, and it’s very common.

Another type of ovarian cyst is the corpus luteum cyst, which forms after a follicle has released an egg. It usually carries no symptoms and is also a totally normal, functional cyst.

Other cysts, however, are related to abnormal functioning of the ovary and require medical attention. These can include benign or malignant tumors and endometriomas, the specific type of benign tumors or cysts that occur with endometriosis.

If you have pain associated with an ovarian cyst, your doctor will do some tests, depending on your symptoms.

Can ovarian cysts rupture? What risks are present in the case of a rupture?

If an ovarian cyst ruptures, it’s possible that you won’t even notice.

Sometimes when a cyst ruptures, there’s some acute pain associated with the rupture. However, any ongoing pain from the cyst typically goes away after the initial pain from the rupture passes.

There are some risks, though. Sometimes when cysts rupture, internal tissue might bleed. If it’s internal bleeding that doesn’t stop, it can become a surgical emergency.

Signs of dangerous internal bleeding include continued pain and pain that gets worse in the abdomen (blood in the abdomen hurts). If you lose enough blood and don’t seek medical attention, you could have other symptoms of blood loss, including weakness and dizziness.

What should I do if I think I may have a cyst or even a ruptured cyst?

If you’re having symptoms of a ruptured cyst, including worsening pain or feeling lightheaded and dizzy, you should seek medical attention immediately. Call your doctor. Or, if you can’t immediately reach a doctor and feel that your symptoms are significant, go to the emergency department.

What are the most common treatments for ovarian cysts?

Most functional ovarian cysts resolve without significant symptoms. Most of these cysts do not need to be medically treated.

If a functional cyst is causing some symptoms, doctors will often use conservative management, such as over-the-counter or prescription pain management, depending on your symptoms. Doctors don’t want to operate unless it’s necessary.

Surgery is usually done if the cyst is a tumor, is bleeding excessively or is otherwise a life-threatening event.

Talk to your doctor if you think you’re experiencing symptoms of an ovarian cyst, or find an OB-GYN near you.