If you have just been told you have an ovarian cyst, it is completely normal to feel uncertain about what that means.
For many women, the finding comes as a surprise. It shows up on a routine ultrasound, with no symptoms and no warning. For others, it explains something that has been causing discomfort for a while. Either way, the question is usually the same: what happens now?
The answer depends on what type of cyst it is. And that is what we want to help you understand.
What Is an Ovarian Cyst?
An ovarian cyst is a sac filled with often fluid or sometimes other components that develops on or inside an ovary. They are extremely common. Most women will have at least one during their lifetime, often without ever knowing it.
What matters most is not whether you have a cyst, but what kind it is. Some types resolve on their own within a cycle or two. Others need monitoring or treatment. Understanding which category you are in is the starting point for everything else.
Types of Ovarian Cysts
Functional Cysts
These are by far the most common type, and in most cases they are nothing to worry about.
Functional cysts form as a normal part of the menstrual cycle. Each month, a follicle in the ovary grows to release an egg. If the follicle does not open as expected, it can fill with fluid and become a follicular cyst. If it releases the egg but then seals up instead of dissolving, it becomes a corpus luteum cyst.
Both types are usually small, often cause no symptoms at all, and typically disappear on their own within one to three cycles without any treatment.
Endometriomas
Endometriomas, sometimes called chocolate cysts, form when endometriosis affects the ovary. Endometriotic deposit grows onto the surface of ovarian tissue, bleeds during each menstrual cycle and eventually sealing itself creating a cyst filled with old dark blood.
Unlike functional cysts, endometriomas do not go away on their own. They can cause pelvic pain, affect ovarian reserve, and are often a sign that endometriosis is present elsewhere in the pelvis. If you have been told you have an endometrioma and you are thinking about your fertility, a specialist conversation sooner rather than later is worthwhile.
Dermoid Cysts
Dermoid cysts are the most common solid ovarian cysts which can contain tissue such as hair or skin cells. They sound more alarming than they are but are almost always benign (cancerous in very rare circumstances). However they do persist and grow slowly over time. This increases the risk of ovarian torsion – a medical emergency – where the ovary is twisted on its stalk, cutting off its own blood supply, necessitating an emergency surgery to resolve it. This is why surgical removal is generally recommended, particularly as they get larger.
Cystadenomas
Cystadenomas form on the surface of the ovary and can sometimes grow quite large. They are usually benign, but they are watched carefully because a small number can develop into something more complex over time, such as borderline ovarian tumour. Size, ultrasound features, and your individual history all inform how they are managed.
PMOS and Ovarian Cysts: An Important Distinction
If you have been diagnosed with polyendocrine metabolic ovary syndrome (PMOS), you may have been told you have cysts on your ovaries. This understandably causes confusion.
What is seen on ultrasound in PMOS is not the same as a true ovarian cyst. It is a collection of small, undeveloped follicles that have not completed their growth cycle. PMOS is a hormonal condition, and what shows up on the scan is a result of that hormonal picture, not independent growths sitting in the ovary.
Managing PMOS is about addressing hormones and cycle regularity, not removing anything surgically. That said, women with PMOS can also develop separate ovarian cysts just like anyone else. If you have a PMOS diagnosis and a cyst has been found, it is worth understanding which you are dealing with.
Symptoms
Many ovarian cysts cause no symptoms at all. They are found by chance during an ultrasound done for an entirely different reason.
When symptoms are present, they can include a dull ache or pressure in the lower abdomen, usually on one side. Some women notice bloating, pain during or after sex, changes to their cycle, or discomfort when passing urine or having a bowel movement.
When to Seek Urgent Help
If you experience sudden, severe pelvic pain, please seek medical attention promptly. This can indicate a cyst has ruptured, or more urgently, that ovarian torsion has occurred.
Ovarian torsion is when the ovary twists around its own blood supply. It is a medical emergency. If the pain comes on sharply and is accompanied by nausea, vomiting, or feeling faint, do not wait for a routine appointment. Instead, present immediately to an emergency department.
How Ovarian Cysts Are Diagnosed
The main tool is a pelvic ultrasound, which can identify the presence, size, location, and features of a cyst. It is worth knowing that ultrasound is an operator-dependent investigation, and what gets detected depends significantly on the examiner’s experience and what they are trained to look for. For assessing complex ovarian cysts such as endometriomas, a specialist gynaecological ultrasound provides considerably more details than a general scan.
Blood tests may also be arranged depending on what the ultrasound shows. Ovarian tumour markers are used in specific clinical situations but are not a routine test for simple cysts. Hormone testing is helpful where PMOS or other hormonal conditions are part of the picture.
Treatment Options
Treatment depends on the type of cyst, its size, your symptoms, and what matters to you, including your reproductive goals.
Monitoring is the right first step for most functional and simple cysts. A repeat ultrasound after one to three cycles to see whether the cyst has resolved is often all that is needed. Watchful waiting is a valid clinical approach, not a delay. Many cysts resolve completely on their own.
Hormonal management such as the combined oral contraceptive pill does not reliably shrink an existing cyst, but it can reduce the likelihood of new functional cysts forming. For women with PMOS-related follicles, the goal is addressing the hormonal environment.
Surgery comes into the conversation when a cyst is causing significant pain, is large enough to raise concern about torsion, has features on imaging that need closer investigation, or is a type that will not resolve without treatment. At Create Health, ovarian cyst surgery is performed laparoscopically in the vast majority of cases, with the goal of removing the cyst while preserving as much healthy ovarian tissue as possible. You can read more about when surgery is needed and what it involves.
Ovarian Cysts and Fertility
Finding a cyst when you are trying to conceive, or starting to think about it, naturally raises questions.
For most functional cysts, there is no meaningful impact on your ability to conceive and no reason to delay.
For endometriomas, the picture is more individual. The right path depends on the size of the cyst, your ovarian reserve, whether other signs of endometriosis are present, and your timeline. This is a conversation best had with a gynaecologist or fertility specialist who can look at the whole picture with you.
For PMOS-related follicles, the focus is on whether ovulation is occurring regularly and how best to support that.
When to See a Specialist
You do not need to have all the answers before making an appointment. Coming in is how the picture becomes clearer.
It is worth seeking a specialist opinion if you have been told you have a cyst and are not sure what type it is or what happens next, if you have persistent pelvic pain that is affecting your daily life, if your symptoms could suggest endometriosis, if you are trying to conceive or planning a family, or if you experience sudden severe pelvic pain at any point.
Frequently Asked Questions
Are ovarian cysts dangerous?
Most are benign and resolve without treatment. The type, size, and features of the cyst determine how it is managed. Finding one is not a reason to panic.
Do ovarian cysts need to be removed?
Not always. Most functional cysts resolve on their own. Dermoid cysts and endometriomas generally require treatment at some point. You can read more about when surgery is recommended.
Can an ovarian cyst affect my ability to conceive?
For most simple cysts, there is no impact. Endometriomas can affect ovarian reserve and may have fertility implications depending on their size and location. A specialist assessment is a good starting point if you have a cyst and are planning a family.
Is PMOS the same as having ovarian cysts?
No. PMOS is a hormonal condition and the follicles seen on ultrasound are not structural cysts. They are managed very differently. You can find out more on our PMOS page.
What does ovarian cyst pain feel like?
Usually a dull ache or feeling of pressure on one side of the lower abdomen. Some women notice pain during sex or around their period. Sudden, severe pain is different and needs urgent attention.
Ovarian Cyst Care at Create Health
At Create Health, our gynaecologists in Melbourne provide assessment, diagnosis, and management of ovarian cysts across our clinics in Mount Waverley, East Melbourne, and Berwick.
Whether you have been referred after a scan, are experiencing symptoms, or simply want to understand what a finding means for your health, our team will take the time to give you a clear picture of where things stand and what your options are.
We offer specialist gynaecological ultrasound, laparoscopic surgery where needed, integrated fertility support, and coordinated care across gynaecology, fertility, and obstetrics.
To make an enquiry or book an appointment, contact our team at any of our Melbourne locations.
