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# Ovarian cyst

An ovarian cyst is a fluid-filled sac in or on the ovary; most are linked to the menstrual cycle and go away on their own, and few are cancer.

Updated 2026-10-29

## Structures involved

Tap one to see what it is and open it in 3D.

- [Ovaries](https://durgical.com/en/anatomy/ovary/)
- [Mesovarium](https://durgical.com/en/anatomy/mesovarium/)
- [Rectouterine pouch](https://durgical.com/en/anatomy/rectouterine-pouch/)
- [Ovarian artery](https://durgical.com/en/anatomy/ovarian-artery/)
- [Uterine tubes](https://durgical.com/en/anatomy/uterine-tube/)

## In histology

- [Ovary: follicles, ovulation and corpus luteum](https://durgical.com/en/histology/ovary-follicles-ovulation-and-corpus-luteum/)

## In embryology

- [Ovarian cycle, ovulation and the corpus luteum](https://durgical.com/en/embryology/ovarian-cycle-ovulation-and-the-corpus-luteum/)

## In the clinical exam

- [Gynecologic examination: speculum and bimanual exam](https://durgical.com/en/clinical-exam/gynecologic-examination-speculum-and-bimanual-exam/)

## In physiology

- [Oogenesis, follicles and ovulation](https://durgical.com/en/physiology/oogenesis-follicles-and-ovulation/)

## What it is

A fluid-filled sac in or on the ovary. Most are functional cysts linked to the menstrual cycle that resolve on their own; a smaller share are benign or, rarely, malignant tumours.

## Who gets it

Very common in women of reproductive age and often found incidentally on ultrasound. After menopause, cysts are less common and need more careful assessment for malignancy.

## Causes

- Follicular cyst: a follicle that fails to rupture at ovulation
- Corpus luteum cyst, which may bleed (haemorrhagic cyst)
- Endometrioma (endometriosis of the ovary)
- Mature cystic teratoma (dermoid cyst)
- Serous or mucinous cystadenoma; rarely a borderline or malignant tumour

## Risk factors

- Reproductive age with ovulatory cycles
- Ovulation-inducing fertility treatment
- Endometriosis
- Early pregnancy (corpus luteum cyst)
- Smoking, linked to functional cysts in some studies

## Pathophysiology

Functional cysts form when a follicle keeps growing instead of rupturing, or when the corpus luteum fills with fluid or blood. Most regress within a few cycles. Neoplastic cysts arise from the surface epithelium or germ cells and do not regress.

## Classification

- Functional: follicular, corpus luteum, haemorrhagic
- Benign neoplastic: dermoid cyst, cystadenoma
- Endometrioma
- Ultrasound risk systems (for example IOTA rules or O-RADS) sort cysts by likely risk of malignancy

## Symptoms and signs

- Often no symptoms; found incidentally
- Dull one-sided pelvic pain or pressure
- Bloating or a feeling of fullness
- Menstrual irregularity with some functional cysts
- Sudden severe pain with rupture, bleeding or torsion

## Red flags

- Sudden severe pain with vomiting (possible torsion)
- Signs of internal bleeding: fainting, low blood pressure, rising heart rate
- Solid areas, thick septa, ascites or a new cyst after menopause (possible malignancy)

## Diagnosis

**Clinical**
History, timing in the cycle and pelvic examination; many are found on imaging done for another reason.

**Tests**
Pregnancy test (hCG); complete blood count if bleeding is suspected; CA-125 mainly after menopause or when a mass looks complex, knowing it also rises in benign conditions.

**Imaging**
Transvaginal ultrasound is the main test: a simple thin-walled cyst is almost always benign; solid parts, papillae or blood flow raise concern. MRI helps with indeterminate masses.

## Differential diagnosis

- Ectopic pregnancy
- Hydrosalpinx or tubo-ovarian abscess
- Paraovarian cyst
- Pedunculated uterine fibroid
- Ovarian cancer

## Goal of treatment

Tell benign from suspicious cysts, relieve symptoms, prevent complications such as torsion, and preserve ovarian tissue.

## Treatment

**Follow-up**
Watchful waiting with repeat ultrasound for simple cysts, which usually resolve within a few cycles.

**Medical**
Analgesics for pain; combined hormonal contraceptives may reduce new functional cysts but do not shrink existing ones.

**Surgical**
Laparoscopic cystectomy for persistent, large, symptomatic or complex cysts, preserving the [ovary](https://durgical.com/en/anatomy/ovary/) where possible.

**Acute**
Emergency surgery for torsion or rupture with ongoing bleeding.

## Complications

- Ovarian torsion
- Rupture with haemoperitoneum
- Chemical peritonitis from a ruptured dermoid cyst
- Reduced ovarian reserve after repeated surgery

## Prognosis

Functional cysts usually resolve without treatment. Benign neoplastic cysts are cured by removal, though endometriomas and dermoid cysts can recur.

## Test yourself

Think of the answer, then tap the question to see it.

## What is the most common type of ovarian cyst in women of reproductive age?

A functional follicular cyst, which usually resolves on its own within a few cycles.

## Which ultrasound features suggest an ovarian mass may be malignant?

Solid components, papillary projections, thick septa, strong internal blood flow and ascites.

## Do combined hormonal contraceptives make an existing functional cyst disappear faster?

No. They may prevent new functional cysts but do not speed the resolution of existing ones.

## Which ovarian cyst may contain hair, fat and teeth?

The mature cystic teratoma (dermoid cyst).

## Why is CA-125 less useful before menopause?

It also rises in benign conditions such as endometriosis, fibroids, menstruation and pelvic infection.

[Add to my cards (5)](https://durgical.app/estudiar/?add=/en/conditions/ovarian-cyst/)

## Related conditions

- [Ovarian torsion](https://durgical.com/en/conditions/ovarian-torsion/)
- [Polycystic ovary syndrome](https://durgical.com/en/conditions/polycystic-ovary-syndrome/)
- [Endometriosis](https://durgical.com/en/conditions/endometriosis/)
- [Ovarian cancer](https://durgical.com/en/conditions/ovarian-cancer/)
- [Ectopic pregnancy](https://durgical.com/en/conditions/ectopic-pregnancy/)
- [Dysmenorrhoea](https://durgical.com/en/conditions/dysmenorrhoea/)
- [Molar pregnancy (hydatidiform mole)](https://durgical.com/en/conditions/molar-pregnancy/)

Educational information, not medical advice. For any symptom, see a health professional.

Sources: [Ovarian Cyst](https://www.ncbi.nlm.nih.gov/books/NBK560541/) (StatPearls (NCBI Bookshelf), 2023).

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Source: https://durgical.com/en/conditions/ovarian-cyst/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/ovarian-cyst/