By Natasha L. Spencer, MD 

OB-GYN with Orlando Health Physician Associates

Ovarian cysts might sound scary, but they are common, appearing and disappearing during ovulation. Cysts cause anxiety because they can be benign — meaning they are harmless — or malignant, with cancerous cells. 

Can I Tell If I Have Ovarian Cysts?

Most women don’t know they have ovarian cysts. For others, cysts can cause bloating, pressure or pain in the pelvic area. Cysts can feel like menstrual cramps, so see a doctor if the pain or pressure feels more significant or lasts longer than usual.

Cysts are more likely to show up if you’re perimenopausal, but menopausal women still get them, and there’s a higher chance the cysts could be cancerous. If you’re feeling pressure and pain even though you’ve stopped menstruating, visit your doctor.

What Doctor Will Check

To determine the size, location and characteristics of your ovarian cysts, your doctor may do a speculum exam, bimanual internal exam, lab work and/or vaginal ultrasound. Depending on several indicators, your doctor might consider surgical removal. These include:

• Size: Ovarian cysts that are larger than 6 to 10 centimeters come with the possibility of torsion, when the cyst ruptures and the ovary can twist around itself. Enlarged cysts can also indicate polycystic ovarian syndrome.
• Appearance: A vaginal ultrasound can tell whether the cyst is singular with thin walls, or if it’s multilocular, consisting of smaller offshoots.
• Bloodwork: Your doctor also can check genetic and tumor markers that point to the likelihood of your cyst being malignant. 

Many cysts resolve by themselves within two to three months, so your doctor may take a wait-and-see approach. If there are no red flags and you’re not in pain, your cyst can be monitored through regular imaging.

What To Expect from Surgery

Surgery to remove a cyst is typically an outpatient procedure. The location and angle of the cyst determine whether you will have minimally invasive laparoscopy through the navel or a more involved surgical procedure. It’s crucial the cyst remains intact throughout the procedure. Rupturing within the pelvis can cause problems, especially if it is malignant.

Your doctor may discuss ways to prevent ovarian cysts from recurring, such as hormonal birth control. If you’re past your childbearing years and lab work has shown you may have a higher cancer risk, you could also opt for a hysterectomy.