Ovarian cysts are common fluid-filled sacs that develop on the ovaries. Simple ovarian cysts are overwhelmingly benign and rarely cancerous. These harmless growths often resolve on their own, but medical evaluation is important for accurate diagnosis and peace of mind.
Understanding Simple Ovarian Cysts
Simple ovarian cysts are fluid-filled sacs that commonly form on the ovaries as part of the regular menstrual cycle. These are often called functional cysts, meaning they arise from the normal functioning of the ovaries. Functional cysts include follicular cysts, which develop when a follicle fails to release an egg, and corpus luteum cysts, which form after an egg is released.
These cysts are very common, particularly in individuals who are still menstruating, and frequently cause no symptoms. They generally shrink and disappear within a few months without treatment. Their prevalence decreases after menopause because ovulation, the process central to their formation, ceases.
Differentiating Cyst Types and Cancer Risk
Distinguishing between simple and complex ovarian cysts is important for assessing cancer risk. On imaging, a simple cyst appears as a smooth-walled, purely fluid-filled sac with no internal structures. This appearance helps medical professionals determine its likely benign nature. In contrast, complex cysts may contain internal walls (septations), solid components, or evidence of blood flow, which can indicate a slightly higher, though still often benign, risk.
The risk associated with ovarian cysts is also influenced by age. For instance, in individuals under 50, less than 1% of ovarian cysts are cancerous. The likelihood of a cyst being cancerous increases slightly after menopause. Doctors may consider a blood test for Cancer Antigen 125 (CA-125), a protein that can be elevated in ovarian cancer. However, CA-125 levels can also be elevated by many non-cancerous conditions, such as menstruation, pregnancy, endometriosis, uterine fibroids, and pelvic inflammatory disease, making it an unreliable sole indicator for ovarian cancer screening.
Medical Evaluation and Monitoring
When an ovarian cyst is suspected, a transvaginal ultrasound is typically the primary diagnostic tool. This imaging technique allows healthcare providers to visualize the cyst’s size, shape, and internal characteristics, helping to determine if it is simple or complex. For most simple cysts, a “watchful waiting” approach is common, involving repeat ultrasounds over a few months to observe if the cyst resolves on its own.
If a simple cyst is larger than 7 centimeters or has complex features, additional imaging such as an MRI or CT scan may be considered to further evaluate its nature. Even large simple cysts often do not require intervention and may still resolve. The goal of monitoring is to confirm the cyst’s benign nature and ensure it does not grow or change in a concerning way.
When to Seek Medical Attention
While most ovarian cysts are harmless, certain symptoms warrant prompt medical consultation. Sudden, severe abdominal or pelvic pain, especially if accompanied by nausea, vomiting, fever, or rapid heart rate, could indicate a ruptured cyst or ovarian torsion, where the ovary twists, cutting off its blood supply. These situations require immediate medical attention to prevent serious complications.
Other concerning symptoms that should prompt a doctor’s visit include unexplained weight loss, persistent abdominal bloating or distension, and significant changes in bowel or bladder habits. Although these symptoms can be associated with various conditions, their presence should always be evaluated by a healthcare professional to rule out any underlying issues.