An ovarian cyst is a fluid-filled sac that develops in or on an ovary. Ovaries normally form small cyst-like structures each month as part of ovulation, and most of these are harmless and temporary. Cysts vary in size. Some stay small and never cause symptoms, while others grow large enough to cause discomfort, pressure, or cycle changes. In rare cases, cysts can lead to urgent problems like internal bleeding, or ovarian torsion, where the ovary twists around the ligaments that support it, often involving the fallopian tubes as well.
Common Types of Ovarian Cysts
Functional cysts are the most common type of ovarian cyst, and are linked to ovulation. A follicular cyst can form when a follicle does not release an egg and continues to grow. A corpus luteum cyst can form after an egg is released, when the follicle closes and fluid builds inside. These cysts often resolve on their own over one to three cycles, and many women never know they had one unless an ultrasound finds it.
Hemorrhagic cysts occur when blood flows into a cyst, which can cause sudden pelvic pain. Some resolve without treatment, but your provider may recommend follow-up imaging depending on symptoms.
Dermoid cysts, also called mature cystic teratomas, are less common but usually benign. They can contain different types of tissue, tend to grow slowly, and may increase the risk of ovarian torsion. Surgical removal may be recommended, depending on their size.
Endometriomas are cysts related to endometriosis, sometimes called “chocolate cysts” because they can contain old blood. They may be associated with painful periods, pelvic pain, and fertility challenges. Treatment depends on symptoms, cyst size, and fertility goals.
Cystadenomas develop from the surface of the ovary and may be filled with watery or mucous material. They can grow large and may need removal if they cause pain or keep growing.
Symptoms You Might Notice
Many ovarian cysts cause no symptoms at all. Others create mild discomfort that is easy to brush off as normal cycle pain. Common symptoms include pelvic pressure or heaviness, dull aching on one side, bloating, or a feeling of fullness. Some women notice pain with exercise, pain during sex, or discomfort that worsens around ovulation or right before a period.
Cysts can also affect your cycle. You may notice irregular bleeding, heavier periods, or spotting between periods. These symptoms can have many causes, so an evaluation is important rather than assuming an ovarian cyst is the reason.
Sometimes the signs are subtle. You might notice jeans feel tighter from bloating or feel pressure when sitting in one position for long periods. It is also possible to have no symptoms and still have a cyst found during imaging for another reason.
When to Seek Urgent Care
Most ovarian cysts are not an emergency. However, certain symptoms should be treated as urgent because they can signal ovarian torsion, cyst rupture, or internal bleeding.
Call your provider or seek urgent care if you experience sudden, severe pelvic or lower abdominal pain, especially on one side. Pain with nausea or vomiting can be a sign of torsion, which happens when the ovary twists and cuts off its own blood supply. Severe pain with dizziness, fainting, shortness of breath, or shoulder pain can signal significant internal bleeding after a rupture. Fever along with pelvic pain is another red flag that needs quick attention. If you are pregnant and have pelvic pain, contact your provider since symptoms can overlap with other pregnancy-related concerns.
What Causes Ovarian Cysts
Many cysts form as part of normal ovarian function. Hormonal changes can influence cyst formation, and certain fertility medications may increase the chance of cysts because they stimulate the ovaries. Endometriosis can lead to endometriomas, and polycystic ovarian syndrome (PCOS) is associated with many small follicles on the ovaries and irregular cycles, though those follicles differ from a single large ovarian cyst. Some women are simply more prone to forming cysts, especially during certain life stages or hormonal transitions.
How Ovarian Cysts Are Diagnosed
Diagnosis usually starts with a conversation about your symptoms and health history. Your provider may ask about pain location, duration, cycle changes, bloating, or pain with sex. Past cysts, endometriosis, PCOS, recent pregnancy, or fertility treatments all shape the evaluation.
A pelvic exam can detect tenderness or an enlarged ovary but cannot confirm the cyst type. Pelvic ultrasound is the most common test and helps determine the cyst’s size, location, and appearance. A pregnancy test is often part of the workup if you have pelvic pain or irregular bleeding. In some cases, blood work may be ordered depending on your symptoms and the clinical picture.
Treatment Options
For many women, the best first step is monitoring. If the cyst appears benign and symptoms are mild, your provider may recommend a repeat ultrasound in several weeks to confirm it is shrinking or resolving. This is especially common with functional cysts, which often resolve naturally.
If a cyst is causing discomfort, treatment often focuses on symptom relief with over-the-counter pain medications, heating pads, gentle movement, and temporary activity adjustments. Hormonal birth control may be suggested in some cases to reduce the chance of forming new functional cysts, though it does not always make an existing cyst resolve faster.
Surgery may be recommended if a cyst is large, persistent, suspicious in appearance, or causing significant symptoms. The goal is often to remove the cyst while preserving the ovary when possible, especially for women who wish to become pregnant in the future.
Ovarian Cysts and Fertility
Most ovarian cysts do not cause infertility. However, cysts related to endometriosis can be associated with fertility challenges, and large or persistent cysts that require surgery can raise questions about ovarian reserve. If you are trying to conceive, it is important to share that with your provider since treatment decisions may differ when pregnancy is a near-term goal.
Managing Ovarian Cyst Risks
You cannot prevent all ovarian cysts, especially functional cysts that form with ovulation. Regular gynecologic care can help catch issues early. Tracking symptoms like recurring one-sided pelvic pain, frequent bloating, or irregular bleeding — and noting the timing of these symptoms — can be useful for diagnosis and follow-up planning.
At Legacy For Women, we provide careful evaluation, clear explanations, and personalized treatment plans based on your symptoms, ultrasound results, and long-term goals. If you are experiencing pelvic pain, bloating, irregular bleeding, or you have been told you have an ovarian cyst, schedule an appointment so we can help you understand what is happening and create a plan that supports your comfort and health.
