What is an ovarian cyst?

An ovarian cyst is a sac filled with fluid that forms in your ovary. They are common. Almost every female will have one at some stage. Most are harmless and will go away on their own without treatment, while some can cause problems.

Functional cysts

Functional cysts are common cysts that develop during your menstrual cycle.

• Follicular cysts when your follicle (the sac that has your egg inside of it) keeps on growing instead of releasing an egg and ovulating.
• A corpus luteum cyst which develops when your follicle does not shrink after you have ovulated.

Functional cysts usually disappear within 2 to 3 months. While you have your cyst, your period might not come on time. Once your cyst has gone, your period usually goes back to normal.

Non-cancerous cysts

There are different types of non-cancerous cysts:

• Endometrioma (also known as ‘chocolate cysts') — small or large sacs filled with blood. They may make it more difficult for you to become pregnant.
• Dermoid cyst — cysts that have different types of body tissue, such as hair, fat, skin, teeth and bone. They grow very slowly.
• Cystadenoma — cysts filled with watery fluid or mucus. They keep growing and usually need keyhole surgery to be removed.
• Hydrosalpinx — occurs when your fallopian tube becomes blocked and fills with fluid. It can lower your fertility.

Ovarian cancers

• Cancerous cysts are rare, especially before menopause. There are several types of ovarian cancer.

Ovarian cysts are not related to PCOS (polycystic ovary syndrome). If you have PCOS, you may have many cysts in your ovaries. These are not true ovarian cysts. They are follicles containing eggs that have not fully developed.

What are the symptoms of ovarian cysts?

If you have an ovarian cyst, you may have some of the following symptoms:

• pain in your stomach or pelvis that comes and goes
• pain when you do a poo
• pain in your pelvis before or after you get your period
• pain during sex
• bloating or heaviness in your stomach
• irregular periods

Remember, most of the time cysts do not cause symptoms.

What causes ovarian cysts?

There are many causes of cysts, depending on the type of cyst:

• Functional cysts can be caused when your hormone levels during your menstrual cycle are not in balance. Your cycle can be interrupted and you can develop a follicular cyst or corpus luteum cyst.
• Non-cancerous cysts can have many causes including endometriosis and sexually transmitted infections.
• Cancerous cysts can be caused by ovarian cancer.

When should I see my doctor?

You should see your doctor if you think you have an ovarian cyst or you have symptoms caused by an ovarian cyst.

Symptoms such as pelvic pain and irregular periods can be mistaken as normal when they are not. You are not alone if you feel your symptoms have not been properly addressed. If you you are not satisfied with the care you received from your doctor, go back and ask for more help.

As part of your basic healthcare rights, you have a right to access the healthcare services you need and to be treated with respect and dignity.

You can ask your doctor to clarify anything you have not understood. You also have the right to ask for advice from another doctor. This is called a second opinion.

Read more about your healthcare rights.

How are ovarian cysts diagnosed?

Your doctor can diagnose you with an ovarian cyst by examining you, asking you about your symptoms and doing some tests, including:

• an ultrasound (usually done through your vagina)
• a pregnancy test to rule out an ectopic pregnancy, which can cause symptoms similar to a cyst
• blood tests
• Sometimes, you might be diagnosed with an ovarian cyst when your doctor does an ultrasound for another reason.

How are ovarian cysts treated?

Treatment for your cyst depends on what type of cyst you have, how big it is, your symptoms and if you have gone through menopause or not.

Most cysts do not need treatment. Your doctor may recommend you monitor it for a few months. Usually your cyst will go away on its own.

Your doctor may recommend you have your cyst removed if it:

• does not go away after 3 months
• is bigger than 6cm
• keeps growing
• causes your severe pain or pressure
• may be cancerous

Your doctor can remove your cysts via keyhole (laparoscopy) surgery. If your cyst is very large, you may need open (laparotomy) surgery. You may need to stay in the hospital for 2 to 3 days after open surgery. Your recovery will be longer.

If you have not gone through menopause, your surgeon will usually try to remove just the cyst and not your whole ovary. Even if your ovary needs to be removed, your fertility and hormones are usually not affected, if you still have a second ovary. If you have already gone through menopause, your doctor may recommend removing your ovary and fallopian tube with the cyst.

What are complications of ovarian cysts?

Ovarian cysts can sometimes cause sudden complications:

• Ovarian torsion — your ovary moves or becomes twisted, reducing or stopping the blood flow to your ovary.
• Haemorrhage or rupture — your cyst can break open and cause bleeding.

These complications can be very painful and cause nausea.

They can be medical emergencies. You may need emergency surgery.

Can ovarian cysts be prevented?

Many ovarian cysts can't be prevented.

If you develop functional ovarian cysts often, your doctor may recommend you take the oral contraceptive pill. The pill can help prevent these cysts from developing.

Resources and support

• Learn more about ovarian cysts at Jean Hailes for Women's Health.
• Read about irregular vaginal bleeding at Safer Care Victoria.
• Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.

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Jean Hailes for Women's Health has resources translated in many community languages.

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