Ovarian cysts
Fluid-filled sacs on or in an ovary. They are extremely common, most are harmless 'functional' cysts that form with the menstrual cycle and disappear on their own, and the assessment focuses on reassuring the many while identifying the few that need attention.
What it is
An ovarian cyst is a fluid-filled sac that develops on or within an ovary. They are very common in women of reproductive age, and the great majority are benign functional cysts — a follicle that grows a little larger than usual, or the structure left after ovulation (a corpus luteum cyst) — which form as a normal part of the menstrual cycle and typically resolve within a few cycles without any treatment. Most cause no symptoms and are found incidentally on a scan. Some cysts can cause a dull ache, bloating or pain during sex, and occasionally a cyst can bleed, rupture (causing sudden sharp pain) or twist the ovary (ovarian torsion — a painful emergency that threatens the ovary's blood supply). Other, non-functional types include endometriomas (from endometriosis), dermoid cysts, and cystadenomas. In women past menopause, or when a cyst is large, complex or persistent, the small possibility of ovarian cancer is considered, and blood markers (CA-125, sometimes HE4) with ultrasound help estimate that risk.
Key lab markers
- Pelvic ultrasound — the main test; describes size and features (simple versus complex) that guide management.
- CA-125 — used to help assess cancer risk, especially in postmenopausal or complex cysts; often raised benignly by endometriosis, fibroids and menstruation in younger women.
- HE4 — combined with CA-125 (ROMA score) to refine the risk estimate for a mass.
- Estradiol, LH/FSH — for hormone-producing cysts or in the context of the cycle.
- Pregnancy test — always considered in pelvic pain (to exclude an ectopic pregnancy).
Symptoms
- Often none — most are found incidentally
- A dull ache or pressure in the lower abdomen or pelvis
- Bloating or a feeling of fullness
- Pain during sex
- Changes in the menstrual cycle
- Sudden severe one-sided pelvic pain (possible rupture or ovarian torsion) — needs urgent care
- In postmenopausal women, a new cyst is assessed more carefully
Related symptoms
When to discuss with a doctor
Most ovarian cysts, especially simple ones in younger women, need no treatment and are simply monitored with a repeat scan, as they usually resolve on their own. See a doctor for persistent pelvic pain, bloating, changes in periods, or a cyst found on a scan, so it can be characterised. Seek urgent care for sudden severe one-sided pelvic pain, especially with vomiting or faintness, which can indicate a ruptured cyst or ovarian torsion (a twisted ovary) — a surgical emergency. A cyst in a woman past menopause, or one that is large, complex or persistent, is assessed more carefully with ultrasound and blood markers to gauge the small chance of cancer. Mediora.AI can show the CA-125/HE4 pattern used in that risk assessment; the diagnosis and management belong with your gynaecologist.