Understanding Ovarian Cysts

July 16, 2023
Lisa P. Otey, MD

Ovarian Cysts

A cyst is a pouch or sac that is filled with fluid or other tissue. It is called an ovarian cyst when such cysts grow on the ovary. A woman has two ovaries. These are located on the either side of the uterus.

Not all cysts are harmful. In fact, it is normal for cysts to grow on the ovaries. The majority of the cysts are harmless and often will just go away naturally. Most ovarian cysts are small – so tiny that they often do not cause symptoms. In some cases such as ovarian cyst rupture, these cause discomfort and problems and therefore require treatment by a Houston Gynecologist.

Kinds of Ovarian Cysts

The following are the specific kinds of ovarian cysts:

Functional Cysts

This is the most common kind of ovarian cyst because this cyst develops as a consequence of ovulation – a normal bodily function. Functional cysts do not cause symptoms or only cause mild ones. These cysts normally go away after 6-8 weeks.

Dermoid Cysts

This particular cyst evolves from a cell type that has the capacity to develop into different forms of tissue such as hair, fat, teeth and skin. This cyst may exist from birth and grow during the reproductive years. Dermoid cysts can be found in one or both ovaries. Most of these cysts are so tiny that they cause no symptoms at all. In situations when these cysts become large, they may cause discomfort and pain.


Cystadenomas are cysts that grow from the cells on the external part of the ovary. In some cases, these cysts are filled with thick, sticky gel or watery substance. For the most part, they are benign or not cancerous. If they grow in size they can cause pain.


These are ovarian cysts that develop as a result of endometriosis. In this situation, the endometrial tissue or the tissue found on the lining of the uterus grows outside the uterus such as in the ovaries. An endometrioma may develop as the endometrial tissue continues to bleed with each menstrual cycle. These cysts are also called chocolate cysts because they are filled with dark, reddish-brown blood.


Some ovarian cysts are very small and cause no symptoms at all. Some may cause sharp or dull pain in the abdomen and pain during particular activities. Big cysts may cause torsion or twisting of the ovary, resulting in pain and discomfort.  Ovarian cyst rupture or bleed may cause more urgent problems requiring immediate treatment.

In exceptional cases, cysts may become malignant or cancerous. Ovarian cancer is unusual in younger women. The risk of ovarian cancer increases as a woman ages.

Early Signs of Ovarian Cancer

  • Feeling tired
  • Bloating
  • Constipation
  • Indigestion
  • Inability to eat normally
  • Unexplained weight loss
  • Back pain
  • Enlargement or swelling of the abdomen
  • Urinary frequency or incontinence
  • Pelvic or abdominal pain


There are several options to treat ovarian cysts. Your choice of treatment is dependent on a number of factors which include your age, kind of cyst, size and shape of the cyst, your family history and whether or not you have symptoms.

“Watchful” Waiting

If you are not having any symptoms from a cyst, your physician may observe it determine whether it has increased its size or not over the following month or two. If you have functional cysts, there is no need to worry as these easily go away even without our intervention in just a month or two. If you have a cyst rupture, most spontaneously resolve but some require surgery because of extensive bleeding.  If you are past menopause and you are concerned about the possibility of cancer, your health care provider may propose for you to have regular ultrasound examinations as well as a blood test called CA-125. And if there are changes or if the cyst becomes bigger, there may be a need for a treatment.

Birth Control Pills

If you are constantly having functional cysts, your health care provider may recommend birth control pills to prevent you from ovulating. If you do not ovulate, it will be unlikely for you to develop new cysts. However, the pills will not make the existing cysts go away. These pills are more of a preventive measure.


Surgery may be recommended by your health care provider when your cyst is causing symptoms and when the cyst is large. The need for surgery is also dependent on the following factors:

  • Size of cyst
  • Type of cyst
  • Your age
  • Your symptoms
  • Your desire to have children

There are instances when the cysts can be removed without necessarily removing the ovary. This type of surgery is called cystectomy. Sometimes, one or two of the ovaries may be removed – this situation cannot be decided prior to surgery as your Houston Gynecologist can only decide on this during the surgery.

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