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.
- 1: Functional (follicular) cyst: thin wall, clear fluid
- 2: Corpus luteum cyst: thick wall, lacy content
- 3: Endometrioma (chocolate cyst): thick, dark fluid
- 4: Dermoid cyst: may contain fat, hair and a solid part
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?
Do cysts prevent pregnancy?
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.
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