What does it mean when you have ovarian cysts? A clear medical answer

By Sina Hartung, MMSC-BMI, Harvard Medical SchoolReviewed by Eureka Health Medical Group
Published: July 9, 2025Updated: July 9, 2025

Summary

Most ovarian cysts are fluid-filled sacs that form during the normal menstrual cycle and disappear within two months without treatment. About 8–18 % of women will have one in any given year. Simple cysts rarely cause symptoms, but persistent, large, or complex cysts can lead to pain, cycle changes, or, rarely, cancer. An ultrasound and follow-up plan with your clinician clarify whether you need observation, medication, or surgery.

What is an ovarian cyst and is it normal?

An ovarian cyst is a pocket of fluid or semi-solid material that grows on or inside an ovary. Up to 70 % of pre-menopausal women will develop at least one functional cyst—usually a follicular or corpus luteum cyst—before age 50. "A simple cyst under 4 cm that appears thin-walled on ultrasound is almost always benign," explains the team at Eureka Health.

  • Functional cysts come from normal ovulationFollicular and corpus luteum cysts form when the egg sac fails to release or reseal after ovulation; they usually shrink within 6–8 weeks.
  • Most are found incidentally on ultrasoundOver half of simple cysts are discovered during imaging done for unrelated reasons.
  • Size matters less than appearanceA smooth, clear-fluid cyst up to 5 cm is unlikely to cause trouble, while a 3 cm complex cyst with solid areas needs closer follow-up.
  • Post-menopausal cysts raise more concernOnly 18 % of cysts in women after menopause are functional; any new cyst after age 55 warrants prompt evaluation.
  • Only 8 % of pre-menopausal women need treatment for a cystThe Office on Women’s Health reports that although cysts are common, just 8 % of pre-menopausal women will develop a cyst large enough to require medical or surgical intervention. (OWH)
  • Sudden severe pain may signal rupture or torsionMayo Clinic notes that a cyst that bursts or twists the ovary can cause intense, rapid-onset pelvic pain and demands urgent evaluation. (Mayo)

References

When should you worry about an ovarian cyst?

Certain symptoms or imaging findings signal that a cyst could rupture, twist, bleed, or hide a tumor. "Sharp pelvic pain, especially with fever or vomiting, is not just ‘period pain’—seek care the same day," advises Sina Hartung, MMSC-BMI.

  • Sudden, severe one-sided pain can signal torsionOvarian torsion occurs in 3 % of cysts larger than 5 cm and can cut off blood supply within hours.
  • Pain plus fever may indicate infection or ruptureUp to 13 % of ruptured cysts present with low-grade fever and rebound tenderness—an ultrasound with Doppler is urgent.
  • Unexpected bloating or early satiety needs a checkPersistent abdominal distension for more than two weeks can be an early sign of epithelial ovarian cancer, even in small cysts.
  • CA-125 over 35 U/mL in post-menopause is a red flagWhen combined with a complex cyst, an elevated CA-125 raises malignancy risk to 29 % and warrants gynecologic oncology referral.
  • Post-menopausal cysts carry higher cancer oddsWebMD notes that once periods have stopped, any new ovarian cyst is treated with more caution because “the risk of a cyst being cancerous increases after menopause,” so earlier referral or removal is common. (WebMD)
  • Pain with dizziness or weakness can mean ruptureThe Cleveland Clinic stresses that sudden pelvic pain accompanied by dizziness, fainting, or weakness may signal internal bleeding from a burst cyst and warrants emergency evaluation. (Cleveland Clinic)

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Why do ovarian cysts form in the first place?

Hormones, genetics, and medical conditions influence cyst formation. "Conditions like endometriosis or polycystic ovary syndrome change the ovary’s micro-environment and predispose to cyst growth," notes the team at Eureka Health.

  • Hormonal surges trigger functional cystsA mid-cycle LH peak stimulates follicle growth; if the egg is not released, the follicle can swell beyond 3 cm.
  • Endometriomas stem from endometriosis implantsChocolate cysts affect 17 % of women with endometriosis and often recur after drainage unless hormone therapy is started.
  • Dermoid cysts are congenitalMature teratomas contain tissue like hair or teeth and account for 10–20 % of benign ovarian tumors in women under 40.
  • PCOS causes many small cysts, not one big massIn polycystic ovary syndrome, at least 20 tiny follicles per ovary create the classic ‘string-of-pearls’ ultrasound pattern.
  • Large cysts require care in 8 % of premenopausal womenThe Office on Women's Health reports that while functional cysts develop routinely with each menstrual cycle, about 8 percent of women before menopause will form a cyst large enough to need medical treatment. (OWH)
  • Fertility drugs can trigger clusters of ovarian cystsUF Health notes that medications used to induce ovulation may overstimulate the ovaries, causing several fluid-filled sacs to appear in a single cycle. (UFH)

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How can you manage a simple ovarian cyst at home?

For small, symptom-free cysts, observation is often enough. "Heat pads and scheduled non-prescription pain relievers reduce cramping while the cyst resolves," says Sina Hartung, MMSC-BMI.

  • Track symptoms on a calendarNote pain days, bloating, and cycle length; up to 60 % of simple cysts disappear by the next period.
  • Use heat for short-term reliefApplying a 40 °C heating pad to the lower abdomen for 20 minutes reduces pain scores by 30 % in clinical trials.
  • Stay hydrated and avoid high-impact exerciseFull bladders and jumping increase intra-pelvic pressure, raising rupture risk in cysts over 4 cm.
  • Follow up with repeat ultrasound in 6–8 weeksA size reduction of at least 50 % confirms benign behavior; lack of change may prompt hormonal therapy.
  • Most people form at least one functional cyst per menstrual cycleMedical News Today explains that nearly everyone with ovaries develops at least one follicular or corpus luteum cyst each cycle, and these typically resolve without treatment—supporting a watch-and-wait plan for small, symptom-free cysts. (MNT)
  • Severe sudden pain with nausea or fever is an emergency signVerywell Health advises seeking prompt medical attention if abrupt, intense pelvic pain is accompanied by nausea, vomiting, or fever, as this can signal cyst rupture or ovarian torsion. (Verywell)

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Tests, imaging, and treatments your clinician may order for ovarian cysts

Ultrasound is the starting point, but lab tests and medications refine management. The team at Eureka Health reminds patients: "Asking for the cyst’s ‘IOTA-Simple Rules’ description can clarify whether surgery is needed."

  • Transvaginal ultrasound grades cyst complexityColor Doppler flow and IOTA Simple Rules accurately classify 90 % of cysts as benign or suspicious.
  • CA-125, HE4, and ROMA score stratify cancer riskCombining CA-125 with HE4 improves specificity to 93 % in pre-menopausal women.
  • Combined hormonal contraception prevents new cystsOral contraceptives reduce functional cyst recurrence by about 50 % after six months of consistent use.
  • Laparoscopic cystectomy preserves fertilityMinimally invasive surgery removes the cyst wall while keeping healthy ovarian tissue; recovery averages 10 days.
  • GnRH agonists shrink endometriomasSix months of therapy can cut cyst size by 45 %, but bone density monitoring is required.
  • Watchful waiting with repeat ultrasound confirms spontaneous resolutionMayo Clinic advises monitoring simple cysts with a follow-up scan in about 6–12 weeks because many disappear without treatment. (Mayo)
  • Pregnancy testing distinguishes corpus luteum cysts from ectopic riskA routine serum hCG test is recommended; a positive result suggests a pregnancy-related cyst or warrants evaluation for ectopic pregnancy before further imaging or surgery. (Mayo)

References

How Eureka’s AI doctor guides you through ovarian cyst concerns

Eureka’s AI doctor asks targeted questions about pain pattern, cycle timing, and family history, then offers evidence-based next steps. "Our model follows the American College of Obstetricians and Gynecologists (ACOG) cyst management algorithm before suggesting any action," explains Sina Hartung, MMSC-BMI.

  • Symptom triage within two minutesThe chat assesses red flags like torsion risk and advises immediate ER care when indicated.
  • Personalized imaging remindersIf your cyst is under 4 cm and simple, the AI schedules a six-week check-in and sends a repeat-ultrasound reminder.
  • Education on hormonal optionsIt outlines pros and cons of combined pills, vaginal rings, or progestin-only methods in plain language.

Why women with ovarian cysts rate Eureka 4.8/5 stars

Users appreciate that the AI stays private, non-judgmental, and thorough. The team at Eureka Health notes, "Every medication or lab order the AI suggests is reviewed by a licensed physician before it reaches the pharmacy or lab."

  • One-stop ordering for ultrasound and labsEureka can send electronic orders to any imaging center in 44 states, streamlining care.
  • Secure symptom tracking with graphsDaily pain logs create a visual trend that you can export to your OB-GYN.
  • After-hours reassurance47 % of cyst-related chats occur between 7 pm and 7 am, when clinics are closed—Eureka is always on.
  • Confidential space for sensitive questionsAll chats are end-to-end encrypted and automatically anonymized after 30 days.

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Frequently Asked Questions

Can a cyst prevent me from getting pregnant?

Most functional cysts do not affect fertility, but large endometriomas or multiple surgeries can reduce ovarian reserve. An AMH blood test can give a clearer picture.

Is it safe to exercise with an ovarian cyst?

Moderate, low-impact activities like walking or Pilates are fine; avoid heavy lifting or high-intensity workouts if your cyst is over 5 cm to lower rupture risk.

Will a cyst make my periods irregular?

A corpus luteum cyst can delay a period by a week or cause heavier bleeding once it resolves, but the effect is usually temporary.

Do I need surgery if the cyst is 6 cm?

Not always. A thin-walled 6 cm follicular cyst in a pre-menopausal woman can be watched; complex or symptomatic cysts of that size often require removal.

Can diet shrink ovarian cysts?

No food directly shrinks a cyst, but maintaining a healthy weight and stabilizing insulin with balanced meals may reduce new cyst formation in PCOS.

What pain reliever is safest?

Acetaminophen is usually preferred for mild pain; NSAIDs like ibuprofen help if inflammation is suspected. Check with your clinician if you have kidney or stomach issues.

How often should I repeat an ultrasound?

For a simple cyst under 5 cm, most guidelines suggest a repeat scan in 6–12 weeks, then annually if it remains stable.

Is a dermoid cyst cancer?

Dermoid (teratoma) cysts are almost always benign; malignant transformation occurs in less than 2 % of cases.

Do birth control pills cure cysts?

They do not cure an existing cyst but can prevent new functional cysts from forming by suppressing ovulation.

This content is for informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare provider for diagnosis, treatment, and personalized medical recommendations.

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