An ovarian cyst is a fluid-filled sac that forms on or within an ovary. These cysts are common, with many individuals developing them. Most are harmless and frequently resolve on their own without intervention.
Understanding Ovarian Cyst Size and Risk
The size of an ovarian cyst is a factor in assessing its risk, though not the only one. Cysts under 50 millimeters (5 cm) are often benign and disappear naturally. Functional cysts, the most common type, measure larger than 25 mm (2.5 cm) and resolve within a few menstrual cycles.
Cysts exceeding 50 mm (5 cm) may warrant closer observation. Those over 60 mm (6 cm) are considered large and might lead to symptoms or complications. Cysts exceeding 100 mm (10 cm) are large, increasing the chance of issues like ovarian torsion, where the ovary twists and cuts off its blood supply, or rupture. While larger cysts increase complication risk, most ovarian cysts, even large ones, are non-cancerous.
Other Factors Determining Risk
Beyond size, medical professionals consider other characteristics and patient factors when assessing ovarian cyst risk. The cyst’s appearance on imaging, particularly ultrasound, provides important clues. Simple cysts, fluid-filled with smooth, thin walls and no solid components, are benign. Complex cysts, with solid areas, internal septations, or abnormal blood flow, raise more concern regardless of size and require further investigation.
Symptoms also play a role in risk assessment. Pelvic pain, bloating, or changes in bowel or bladder habits can indicate a problematic cyst.
A patient’s age is another consideration, as the risk profile changes between pre-menopausal and post-menopausal individuals. Post-menopausal women with ovarian cysts face a slightly higher malignancy risk, necessitating thorough evaluation.
The rate a cyst grows is also monitored, as rapid growth can be a concerning sign. Blood tests, such as the CA-125 tumor marker, may be used, though elevated levels can occur due to benign conditions like endometriosis or menstruation, not just cancer.
When to Seek Medical Evaluation
Prompt medical evaluation is important if an individual experiences symptoms suggesting a complication with an ovarian cyst. Sudden, severe abdominal or pelvic pain, especially if accompanied by fever, vomiting, dizziness, lightheadedness, or rapid breathing, signals an emergency like a ruptured cyst or ovarian torsion. These symptoms require immediate medical attention.
It is also important to seek medical advice for persistent or worsening symptoms like ongoing pelvic pain, abdominal fullness, or changes in menstrual patterns. A healthcare provider can conduct a pelvic exam and order imaging tests, such as a pelvic ultrasound, to evaluate the cyst. Ultrasound is the initial imaging choice to determine the cyst’s size, location, and characteristics, guiding further management decisions.
Management and Monitoring
Many ovarian cysts, particularly functional ones, resolve on their own without specific medical intervention. For such cysts, a healthcare provider may recommend watchful waiting, involving repeat imaging, often ultrasound, over several weeks or months to monitor for changes. This approach is common for small, fluid-filled, asymptomatic cysts.
Medical intervention might be considered if a cyst is large, causes persistent symptoms, or shows concerning characteristics. Oral contraceptives may be prescribed to prevent new functional cysts, though they do not shrink existing ones. Surgical removal, through procedures like laparoscopy or laparotomy, is an option for cysts that are large, symptomatic, or suspicious for malignancy. The decision for surgery is individualized, taking into account the cyst’s features, symptoms, age, and overall health.