Ovarian cysts are quite common; these small, fluid-filled sacs develop on or within the ovaries and are generally not harmful.
Dr. Mary Jane Minkin, an ob-gyn at Yale Medicine, explains that the ovulation process itself—where an egg matures and is released—creates a small cyst. This cyst then ruptures when the egg is released and typically resolves on its own. These “functional cysts” usually disappear without intervention.
Other types of ovarian cysts exist, including hemorrhagic cysts (which cause pain and bleeding), dermoid cysts (potentially containing skin cells and sebaceous glands), and endometriomas (filled with thick, dark blood due to endometriosis). Polycystic ovary syndrome (PCOS) can also involve ovarian cysts, but this isn’t always the case.
Here’s some essential information about ovarian cysts.
How ovarian cysts affect women
Most ovarian cysts, around the size of a grape or cherry, don’t produce symptoms. However, rapidly growing cysts can cause pelvic pain near the hip bone and a persistent feeling of pressure. Dr. Kelli V. Burroughs, an ob-gyn at UT Health—University of Texas Medical School at Houston, notes that this discomfort can be intermittent or constant, and may feel sharp or dull.
Minkin states that ruptured cysts can cause intense pelvic pain and minor bleeding. As the fluid is absorbed by the abdominal cavity lining, the pain should subside.
Dr. Michael B. Baldonieri, an ob-gyn at the Case Western University School of Medicine, explains that a large cyst can cause ovarian torsion, where the ovary twists around its supporting tissue. This can result in severe, continuous lower pelvic pain, along with nausea and vomiting. This is a medical emergency because the torsion can block blood supply to the ovary, potentially causing it to die if surgery isn’t performed to untwist it.
How most ovarian cysts are treated
Dr. Daniel Ginn, an assistant clinical professor of obstetrics and gynecology at UCLA, says treatment is determined by the cyst’s appearance on a transvaginal ultrasound and its impact on the woman. If the cyst resembles a fluid collection in a small pouch or balloon and the woman experiences minimal or no symptoms, doctors might recommend “watchful waiting”. This involves monitoring symptoms and repeating pelvic ultrasounds every six to eight weeks to check for changes in size.
Burroughs explains that during an ultrasound, clinicians will evaluate the mass’s size, structure, location, and other features to help distinguish between benign and potentially malignant growths.
Women with ovarian cysts are often concerned about the possibility of ovarian cancer. Although it is possible, it is rare. A mass containing both fluid and solid components could indicate ovarian cancer. Minkin notes that ultrasounds usually provide a good indication if a cyst has solid components.
However, the risk of cancer is low if the cyst is clearly fluid-filled and hasn’t changed over time, even in older women. A study in a 2024 issue of the American Journal of Obstetrics & Gynecology found that women aged 50 and older with stable ovarian cysts detected on ultrasound had a 0.27% risk of ovarian cancer over a 3.5-year follow-up.
Ginn says that cysts that increase in size are a concern. He adds that abnormal blood flow or fingerlike projections on the cyst’s periphery are also concerning. In such cases, doctors may order blood tests to measure cancer antigen 125 (CA 125), a protein often elevated in ovarian cancer, and other tumor markers.
If a cyst’s appearance is concerning, especially with elevated CA 125 levels, the woman will likely be referred to a gynecologic oncologist for specialized evaluation and treatment.
Ovarian cysts that cause no or only mild symptoms might not require treatment and can be monitored. Ginn notes that two-thirds of ovarian cysts resolve on their own.
How to feel better
Baldonieri suggests using medications like acetaminophen, ibuprofen, or other non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief. Applying heat or ice packs to the painful area, depending on personal preference, can also help.
Ginn says that large or seriously uncomfortable cysts can be removed via laparoscopic surgery, which involves small abdominal incisions. He emphasizes that ovarian preservation is always a priority to maintain hormone production, which is important for heart, bone, and cognitive health.
For women who frequently develop large or painful cysts, Ginn mentions that doctors try to prevent ovulation, which is the root cause of ovarian cysts. This is typically achieved using oral contraceptives (or their hormonal equivalents) to prevent new cyst formation.
