Ovarian Cyst

An ovarian cyst is a fluid-filled sac that develops on or within an ovary. Most are harmless and resolve on their own, particularly those related to the normal menstrual cycle, but some can cause pain or, rarely, complications requiring treatment.

• Many ovarian cysts cause no symptoms and are found incidentally on examination or imaging
• Pelvic pain or a dull ache, which may worsen around ovulation or menstruation
• Bloating or a feeling of fullness in the lower abdomen
• Sudden, severe pelvic pain, possibly with nausea and vomiting, can indicate a cyst has ruptured or caused the ovary to twist (torsion) — this requires urgent assessment

• Most commonly form as part of the normal menstrual cycle (functional cysts), related to the process of ovulation, and typically resolve on their own within a few menstrual cycles.
• Less commonly, cysts can result from other underlying conditions, such as endometriosis or, rarely, an ovarian tumour.
• Risk of complications such as rupture or torsion is influenced by the size of the cyst.

• Often diagnosed incidentally on pelvic examination or ultrasound.
• Pelvic ultrasound is the standard test to characterise the cyst's size and appearance, which helps guide whether monitoring or further evaluation is needed.
• Sudden severe pain requires urgent assessment to exclude ovarian torsion or a ruptured cyst with bleeding, both of which can be emergencies.

Most simple, functional ovarian cysts require no treatment and are monitored with a repeat ultrasound after a few months to confirm they have resolved on their own.

Pain relief with an NSAID can help manage mild to moderate discomfort while a cyst resolves.

Larger cysts, those with concerning features on ultrasound, or those causing persistent symptoms may be referred for further specialist assessment, which could include a procedure to remove the cyst.

Sudden severe pelvic pain suggestive of cyst rupture with bleeding, or ovarian torsion, is a medical emergency requiring urgent hospital assessment and, for torsion, emergency surgery to try to save the ovary.

• Attend routine gynaecological check-ups, which can help detect cysts before they cause complications.
• Seek prompt medical assessment for persistent pelvic pain or bloating.
• Seek immediate emergency care for sudden, severe pelvic pain, particularly with nausea and vomiting.
• There is no specific way to prevent functional ovarian cysts, since they relate to the normal menstrual cycle.