Most ovarian cysts are harmless, require no treatment, and disappear on their own within one or two menstrual cycles. If you’ve been told you have one, the most likely next step is simply monitoring it with a follow-up ultrasound. But knowing which type you have, what symptoms to watch for, and when a cyst needs more attention can make a stressful diagnosis feel far more manageable.
Understand What Type of Cyst You Have
The single most important thing you can do is find out what kind of cyst your doctor identified, because the type determines everything that follows.
Functional cysts are by far the most common. They form as a normal byproduct of your menstrual cycle. A follicular cyst develops when the follicle that usually releases an egg doesn’t rupture and keeps growing instead. A corpus luteum cyst forms after an egg is released, when fluid builds up in the empty follicle. Both types rarely cause pain and typically resolve within six to eight weeks without any intervention.
Dermoid cysts (teratomas) grow from reproductive germ cells and can contain unexpected tissue like hair, skin, or teeth. They’re almost never cancerous but can grow large. Endometriomas develop when endometrial-like tissue attaches to the ovary and forms a cyst, often called a “chocolate cyst” because of the dark fluid inside. Cystadenomas grow from cells on the ovary’s surface and can also become quite large. Unlike functional cysts, none of these will resolve on their own with time.
What Monitoring Looks Like
For a small, simple-looking functional cyst, your doctor will likely recommend watchful waiting. This means doing nothing for now and scheduling a repeat ultrasound after one or two menstrual cycles to see if the cyst has shrunk or disappeared. Functional cysts go away without treatment within six to eight weeks in most cases.
The initial imaging is almost always a transvaginal ultrasound, which gives a close, detailed view of the ovaries. The ultrasound report will note the cyst’s size, whether it’s filled with fluid or has solid areas, whether there are internal walls (called septations), and how blood flows around it. A cyst that has thin, smooth walls, no solid components, and no internal blood flow on color Doppler is consistent with a benign, harmless cyst in any age group.
Your doctor may also order blood work. For premenopausal patients, a pregnancy test is standard to rule out an ectopic pregnancy, which can look like a cyst on imaging. A blood count checks for anemia from any internal bleeding. In postmenopausal patients especially, a blood test called CA-125 helps assess cancer risk. A CA-125 level below 35 U/ml is considered normal, though this marker is most useful when interpreted alongside the ultrasound findings rather than on its own.
Managing Pain at Home
Many cysts cause no symptoms at all, but if yours is producing a dull ache or pressure in your lower abdomen, several simple strategies can help while you wait for it to resolve.
Over-the-counter pain relievers like ibuprofen, naproxen, or acetaminophen are the first line for temporary relief. Heat therapy works well too. Placing a heating pad or hot water bottle on your lower abdomen can be as effective as OTC pain medication for some people. If you don’t have a heating pad, you can soak a hand towel in water, place it in an open zip-close bag, microwave it for two minutes, then seal the bag and wrap it in another damp towel for about 20 minutes of steady heat. A warm bath with two cups of Epsom salts dissolved in the water, soaking for around 20 minutes, is another option that may ease discomfort.
Birth Control Pills Don’t Shrink Existing Cysts
This is one of the most widely held misconceptions. Because early oral contraceptives were associated with fewer functional cysts forming in the first place, many clinicians assumed the pills could also treat cysts that were already there. A Cochrane review of the available trials found this isn’t the case. In none of the trials studied did combined oral contraceptives help existing cysts resolve any faster than doing nothing.
That said, hormonal birth control can help prevent new functional cysts from forming by suppressing ovulation. So if you tend to develop cysts repeatedly, your doctor may suggest it as a preventive measure. Just know it won’t speed up the disappearance of a cyst you already have.
When a Cyst Becomes an Emergency
Two complications require immediate medical attention: rupture and torsion.
A ruptured cyst typically causes sudden, sharp pain, often during physical activity or sexual intercourse. The pain may be intense but is usually self-limiting as the fluid is reabsorbed by the body. In some cases, though, a rupture can cause significant internal bleeding that needs emergency treatment.
Ovarian torsion happens when a cyst (particularly a large dermoid or cystadenoma) shifts the ovary out of position, causing it to twist on its blood supply. This can cut off circulation to the ovary entirely. Torsion pain can be sharp or dull, constant or intermittent, and often radiates to the back or flank. Nausea and vomiting are common. Fever suggests the ovary may already be losing blood flow. Abnormal vaginal bleeding or discharge can also occur.
If you experience sudden, severe pelvic pain with nausea or vomiting, or if you develop a fever alongside worsening abdominal pain, treat it as an emergency. Torsion is time-sensitive because the ovary can be saved if blood flow is restored quickly.
When Surgery Is Recommended
Most cysts never need surgery. But your doctor may recommend it if a cyst is large (generally over 10 cm), persists through multiple cycles, has concerning features on ultrasound like thick walls, solid areas, or irregular internal structures, or is causing significant symptoms.
The standard surgical approach is laparoscopic cystectomy, a minimally invasive procedure that removes the cyst while preserving the ovary. For very large cysts, typically over 12 cm, a traditional open incision (laparotomy) may be necessary instead. Ultrasound features that raise suspicion for malignancy, such as solid components, thick septations, or increased blood flow on Doppler, will also prompt surgical removal for further testing.
How Cysts Affect Fertility
Simple functional cysts do not impair your ability to get pregnant. They’re a sign that your ovaries are cycling normally, and they resolve on their own.
Two conditions involving ovarian cysts can affect fertility. Endometriomas are linked with difficulty conceiving, likely because the endometrial tissue surrounding the ovary can interfere with egg release and fallopian tube function. Polycystic ovary syndrome (PCOS), which involves many small cysts along with irregular periods and hormonal imbalances, can lead to less frequent ovulation. If you’re not ovulating regularly, the window for conception narrows significantly.
It’s worth noting that PCOS and a single ovarian cyst are not the same thing, even though they both show up on ultrasound. PCOS is diagnosed based on a combination of menstrual history, hormone levels, and imaging patterns, not the presence of one cyst alone. Some people with PCOS don’t even show the classic ovarian changes on ultrasound.
What to Ask Your Doctor
If you’ve just been told you have an ovarian cyst, a few targeted questions will help you understand your specific situation. Ask what type of cyst it appears to be, how large it is, and whether it has any features that need closer monitoring. Find out when your follow-up ultrasound should be scheduled and what symptoms should prompt you to come in sooner. If you’re trying to conceive or planning to in the future, ask whether your particular cyst type has any implications for fertility. These answers will give you a clear picture of what to expect and what, if anything, you need to do next.