Are Ovarian Cysts Serious? 5 Things an OBGYN Wants You to Know

The diagnosis isn’t as scary as you think.

By Madeline Merinuk
ovarian cyst

A few years ago, I was driving home from my friend’s house when I felt an extremely sharp, stabbing pain on the lower right side of my abdomen. I assumed it was just cramps, so I kept driving, hoping it would subside. Several hours went by, I took some aspirin, but the pain still didn’t pass. Eventually, I knew I had to go to the ER. After several (dreadful) hours of blood tests and waiting around, the nurse arrived with a diagnosis: I had an ovarian cyst. I went into panic mode when I got the news. Are ovarian cysts serious? Would I need surgery? Would it rupture inside of me? And more importantly, was I doing something that could have caused it?

Frustratingly, the doctors and nurses in the ER didn’t give me much besides the fact that ovarian cysts are common, and it was not a life or death situation. They told me all I had to do was get one or two follow-up ultrasounds in the coming months, and the cyst would just disappear on its own, and I went home feeling relieved, but confused.

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After I got home, I couldn’t help but feel freaked out. I needed to know more about ovarian cysts and to see if there was anything I could do to prevent them in the future. To do so, I spoke with  medical professional, licensed OBGYN Dr. Leah Millheiser, to get down to the nitty gritty of why I, and many other women, develop cysts and what that indicates about our overall ovarian health. 

What is an ovarian cyst and how does it form?

According to Dr. Millheiser, “ovarian cysts are fluid-filled sacs or pockets either in an ovary or on its surface.” There are several different types of ovarian cysts, but she says that most types are benign, meaning they are not harmful or malignant. The most common type of ovarian cyst is a corpus luteum cyst, otherwise known as a functional cyst, which Dr. Millhesier says is formed during ovulation. When women ovulate, the eggs are released from the follicles (according to Rogel Cancer Center, follicles are fluid-filled sacs in your ovaries in which your eggs grow.) Sometimes, though, when the egg is released, the follicle can get filled with too much fluid because of the extra space, which is what causes it to become a cyst. 

Another common type of cyst that can be unrelated to your menstrual cycle are dermoid cysts, which Dr. Millheiser says contain tissue, such as hair, skin or teeth (yes, this is real). These form from embryonic cells (cells developed from human embryos, according to Dr. Millheiser.) According to the National Cancer Institute, dermoid cysts develop at birth and can form anywhere in the body, but are most common in the ovaries, whereas corpus luteum cysts can develop at any age after menstruation begins.

Basically, if you have ovaries and hormones, you are susceptible to developing an ovarian cyst. “People who have medical conditions, like endometriosis or polycystic ovarian syndrome, are more likely to get one because those certain medical conditions directly affect your ovaries,” says Dr. Millheiser. Otherwise, you have just as good a chance as anyone else. In fact, according MedScape, "Ovarian cysts are found on transvaginal sonograms in nearly all premenopausal women and in up to 18 percent of postmenopausal women."

How do I know if I have an ovarian cyst?

Not to scare you, but chances are, you could have an ovarian cyst right now and you wouldn’t even know it. Speaking from experience, I didn’t know I had one until I got checked. According to Women’s Health, most women make at least one corpus luteum cyst every month, but they go away with each cycle. Dr. Millheiser says that most ovarian cysts are found incidentally, and it’s really rare that someone comes into their gynecologist’s office with concerns about a potential cyst. 

Dr. Millheiser says that a lot of women who have ovarian cysts experience little to no symptoms because the cyst doesn’t grow to a size that is of concern (the normal size of a cyst is about 2 cm. according to Dr. Millheiser.) However, for women who do experience symptoms or warning signs (like myself), these can include sharp, cramping pain or spotting. Dr. Millheiser notes symptoms usually come up randomly, and that not all women experience them because it varies from woman to woman, depending on the characteristics of their specific cyst. Other symptoms include experiencing a growth in their abdomen, depending on the size of the cyst, and some women will become nauseous or even lose their appetite. According to Dr. Millheiser, if the cyst is big enough (6cm-10cm), you actually can feel it if you press down on the area in which you are experiencing pain, but these bigger cysts are subject to surgical removal because those are the cysts that become dangerous or potentially cancerous. Ovarian cysts also can affect your sex life because, if the cyst is big enough, you’ll feel pain during penetration — which Dr. Millheiser says is another way women can detect signs of a cyst. 

What happens after I’m diagnosed?

Most cysts are found circumstantially during a routine ultrasound, or other medical screening — or, you could have a situation like mine where you are unknowingly experiencing typical symptoms, go to a doctor, and come to find out that you have a cyst. Like Dr. Millheiser said, most women aren’t aware that they have one until the doctor finds it by chance, but once you are diagnosed with an ovarian cyst, the first thing a doctor will do is check the size of it. 

If the cyst is small and benign, Dr. Millheiser says that your doctor will most likely do a check-up every few months to make sure the cyst is at a stable size and not growing, and the cyst will disappear on its own with each passing cycle. When I was first diagnosed and heard the doctor say this, I had to do a mental double take. I couldn’t believe a cyst could just disappear on its own — no medication or surgery required. In my case, I had to do two ultrasounds in the following months to make sure the cyst didn’t grow, and Dr. Millheiser says this is common for most patients with a diagnosed benign cyst. If your cyst remains at a stable size, which is about 2 cm, according to Dr. Millheiser, or decreases, then there’s nothing to worry about. Since benign cysts go away on their own, the symptoms will subside as the cyst naturally decreases in size. However, if you start experiencing extreme symptoms, you should go visit your doctor just to make sure everything is okay.

If the doctors see worrisome features, which Dr. Millheiser says includes nodularity (having small nodules on the wall of the cyst) or a strange appearance, or if the cyst is continuing to grow, then you may need additional medical screening, like a blood test, to make sure the cyst is not malignant. If the cyst has these worrisome characteristics, you may be at risk for a greater medical problem.

Can I prevent ovarian cysts?

Dr. Millheiser says the easiest way to prevent ovarian cysts is by going on birth control pills. Taking birth control pills will stop ovulation, which is how pregnancy is prevented. Since most functional cysts are developed during ovulation, there’s only a small chance you could develop one if you’re on the pill. “Birth control won’t help pre-existing cysts go away, but it will help prevent new ones from developing,” says Dr. Millheiser. Additionally, Healthline says there is no way to prevent ovarian cysts.

According to the Women’s Center at Southwest Health, a women’s health medical center in Wisconsin, pregnant women are also susceptible to cysts, but like any other cyst, it will go away on its own unless a doctor thinks otherwise. However, if the cyst has to be removed at minimum 11 weeks before birth, there’s a chance the pregnancy could end in a miscarraige, so cysts found in pregnant women need to be monitored even closer.

It’s odd to think that women can have one, or even multiple ovarian cysts throughout their life and not even know it. Most medical complications require some sort of maintenance: medicine, surgery, etc… I didn’t have to do anything to make my cyst go away. The only thing I had to do was get a follow-up ultrasound to make sure it didn’t increase in size. I have also gone on birth control since, and (to my knowledge) no new ones have developed. If you start to feel a mysterious, unfamiliar abdomen pain, like I did, check with a doctor just to ensure everything’s fine. Chances are, it’s probably nothing to worry about.

Related:

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Detecting & Treating Ovarian Cysts

Article written by Madeline Merinuk