Cysts

What the finding means and what happens next

The word “cyst” can be unsettling to hear during an examination. A cyst is a sac containing fluid or other contents in the ovary or on its surface. Cysts are common and most are benign. Some form in connection with the menstrual cycle and go away on their own.

So the finding alone does not mean that you need surgery. What matters is what the cyst looks like, whether it changes and whether it is causing you problems.

You may notice it — or you may not

We find many cysts on ultrasound without you feeling anything at all. In other cases, there may be pressure or pain in the lower abdomen, discomfort during intercourse, a bloated feeling or a change in your periods. However, these symptoms can also have other causes.

Ultrasound helps us assess the size and appearance of the cyst. Depending on the finding, your age and your symptoms, we will recommend a follow-up or further tests. If we add blood tests, we will explain what they mean. Even an elevated level of a tumor marker does not by itself confirm cancer.

When a follow-up is enough

For a cyst with a typical appearance that is not causing problems, monitoring is often enough. We will schedule your next ultrasound and check whether the cyst is disappearing, staying the same or growing.

Not all cysts are the same. Some are related to endometriosis, for example, and require a different approach. Hormonal contraception does not make an existing functional cyst go away any faster.

If surgery is advisable

We consider surgery when symptoms are significant, the cyst is growing, or the finding needs to be clarified in more detail. For cysts that are probably benign, laparoscopy — surgery through small incisions in the abdomen — can often be used.

If the finding allows, we try to preserve the healthy part of the ovary. Sometimes, however, it is necessary to remove the entire ovary. We will discuss the possible extent of the procedure and its effect on fertility with you beforehand. Please also let us know if you are planning a pregnancy.

When not to wait for your scheduled follow-up

Sudden severe pain in the lower abdomen, especially with vomiting, weakness, dizziness or fainting, requires urgent examination. It may be a ruptured cyst or ovarian torsion, a twisting of the ovary that restricts its blood supply. In such a situation, seek emergency medical care.

At a routine follow-up, we will explain what we found and why we recommend the chosen approach. We want you to understand when monitoring is a safe and appropriate choice, too.