A Cyst or Not a Cyst? That is the Question.

We are often asked by patients if their symptoms could be due to an ovarian cyst. Many women tell us they have a history of problematic cysts and are concerned that another may be present. This certainly could be the case, as ovarian cysts are a very common occurrence, particularly in women of childbearing age. In fact, for women who are not using hormonal contraception, a small ovarian cyst forms every month and ultimately resolves with ovulation.

Cysts that come and go with a woman’s normal menstrual cycle or within 6-8 weeks are termed functional cysts. Others cysts may not resolve over time and may require eventual surgical management. This includes cysts known as a teratoma, cystadenoma, or endometrioma. These cysts are all benign and innocent, but can result in pain or pelvic discomfort. They may be identified on a pelvic examination. If your provider suspects you have a cyst, it is very common to have a pelvic ultrasound. When ovarian cysts occur in postmenopausal women, your provider may order a laboratory test known as a CA–125.

If an ovarian cyst is causing significant symptoms, if the cyst has reached a critical size or if there is a concern regarding the exact nature of the cyst, surgery may be recommended. Typically this can be done with minimally invasive surgery, using a laporascope, which is associated with a very rapid recovery. Occasionally an ovarian cyst may cause twisting of the ovarian pedicles and result in severe, acute pain that requires prompt evaluation. Many patients are concerned that an ovarian cyst may be malignant. This is a very uncommon occurrence, but underscores the need for regular and comprehensive examinations to identify any ovarian lesion that may require medical attention.

Even if you don’t require an annual Pap smear, we recommend coming for a visit with us annually to assess general health, screen for breast cancer and discuss any concerns. A cyst or not a cyst? Ask your provider.

Written by: David L. Curran, MD.