Ovarian Cysts: Types and Treatment | Prof. Dr. İkbal Kaygusuz

Ovarian Cysts: Types, Monitoring and When Surgery Is Needed

Prof. Dr. İkbal Kaygusuz Last reviewed: 25 September 2026 2 min read

In short: Most ovarian cysts are functional cysts related to the menstrual cycle that disappear on their own within a few cycles. Persistent cysts such as endometriomas, dermoid cysts and cystadenomas are monitored or treated laparoscopically depending on size, ultrasound appearance and symptoms. Sudden severe pelvic pain needs urgent assessment for torsion or rupture.

Types of cysts

Functional cysts (follicular and corpus luteum): related to ovulation; usually resolve in 1-3 months.
Endometrioma ("chocolate cyst"): caused by endometriosis; may cause pain and reduce ovarian reserve.
Dermoid cyst (mature cystic teratoma): contains tissues such as fat and hair; common in young women.
Cystadenomas: benign cysts containing fluid or mucus that can grow.
Polycystic ovaries: not true cysts but many small follicles.

Symptoms

Most cysts cause no symptoms and are found on routine ultrasound. Large cysts can cause fullness, pain, pain during sex or irregular periods. Sudden severe pain with nausea or vomiting suggests torsion or rupture and needs urgent assessment.

Assessment

Transvaginal ultrasound shows size, content and internal structure. International classification systems (IOTA, O-RADS) help estimate the likelihood that a cyst is benign. Tumour markers such as CA-125 and MRI are used when needed.

Treatment

Observation: small simple cysts are rescanned after 6-12 weeks.
Laparoscopic cystectomy: for persistent, growing, symptomatic or suspicious cysts.
Preserving ovarian tissue: especially in women planning pregnancy, healthy tissue and ovarian reserve are protected as far as possible.

Cysts and fertility

Surgery for endometriomas can reduce ovarian reserve, so decisions are made carefully in women planning IVF. Freezing eggs or embryos before surgery may be discussed.

Frequently Asked Questions

Does every ovarian cyst need surgery?

No. Most are functional and resolve. Surgery is considered for persistent, growing, symptomatic or suspicious cysts.

Do cysts prevent pregnancy?

Functional cysts usually do not. Some, such as endometriomas, can affect fertility and are assessed individually.

Sources

ACOG Practice Bulletin No. 174: Evaluation and Management of Adnexal Masses, 2016.
Andreotti RF, et al. O-RADS US Risk Stratification and Management System. Radiology, 2020.

The information on this website is for general information only and does not replace a medical consultation.