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A functional ovarian cyst is a sac that forms on the surface of a woman's ovary during or after ovulation. It holds a maturing egg. Usually the sac goes away after the egg is released. If an egg is not released, or if the sac closes up after the egg is released, the sac can swell up with fluid.
Functional ovarian cysts are different from ovarian growths caused by other problems, such as cancer. Most of these cysts are harmless. They do not cause symptoms, and they go away without treatment. But if a cyst becomes large, it can twist, rupture, or bleed and can be very painful.
A functional ovarian cyst forms because of slight changes in the way the ovary makes or releases an egg. There are two types of these cysts:
Most functional ovarian cysts do not cause symptoms. The larger the cyst is, the more likely it is to cause symptoms. Symptoms can include:
Some functional ovarian cysts can twist or break open (rupture) and bleed. Symptoms include:
If you have these symptoms, call your doctor right away. Some ruptured cysts bleed enough that treatment is needed to prevent heavy blood loss.
Your doctor may find an ovarian cyst during a pelvic exam. He or she may then use a pelvic ultrasound to make sure that the cyst is filled with fluid.
If you see your doctor for pelvic pain or bleeding, you'll be checked for problems that may be causing your symptoms. Your doctor will ask you about your symptoms and menstrual periods. He or she will do a pelvic exam and may do a pelvic ultrasound.
Most functional ovarian cysts go away without treatment. Your doctor may suggest using heat and medicine to relieve minor pain.
If a large cyst bleeds or causes severe pain, you can have surgery to remove it.
Your doctor may suggest that you take birth control pills, which stop ovulation. This may prevent new cysts from forming.
A functional ovarian cyst is caused by one or more slight changes in the way the ovary produces or releases an egg. During the normal monthly menstrual cycle, one of two types of functional cysts may develop:
The development of functional cysts is also common during treatment with clomiphene (such as Clomid or Serophene) for infertility. These cysts go away after treatment is completed, though this can take several months. They do not appear to endanger pregnancy.
There are other types of ovarian cysts and growths caused by other conditions. An ovarian growth can be a noncancerous (benign) cystic tumor or related to endometriosis or cancer. In some cases, what seems to be an ovarian mass is actually growing on nearby pelvic tissue. This is why it's important for you to have pelvic exams and for your doctor to carefully diagnose any cysts or growths felt on your ovaries.
Functional ovarian cysts usually are harmless, do not cause symptoms, and go away without treatment. Ovarian cysts are often discovered during a pelvic exam.
The larger the ovarian cyst is, the more likely it is to cause symptoms. When symptoms occur, they may include:
More severe symptoms may develop if the cyst has twisted (torsion), is bleeding, or has ruptured. See your doctor immediately if you have any of the following pain, shock, or bleeding symptoms:
There are many other conditions that cause signs or symptoms of a functional ovarian cyst. This is why it's important to have any unusual pelvic symptoms checked and to have a pelvic exam.
Most functional ovarian cysts cause no symptoms and go away without treatment in 1 to 2 months or after 1 to 2 menstrual periods. Some cysts grow as large as 4 in. (10.2 cm) in diameter before they shrink or rupture. A rupturing functional cyst can cause some temporary discomfort or pain.
Functional ovarian cysts do not cause ovarian cancer. But your doctor must rule out other possible types of ovarian cysts or growths before diagnosing a functional cyst. This may involve another pelvic exam, a pelvic ultrasound, or possibly a laparoscopy procedure to closely examine the cyst and its ovary.
Cysts after menopause. After menopause, ovarian cancer risk increases. This is why all postmenopausal ovarian growths are carefully checked for signs of cancer. Some doctors will recommend removing the ovaries (oophorectomy) when any kind of cyst develops on an ovary after menopause. But the trend in medicine seems to be moving away from surgery for small and simple cysts in postmenopausal women. In the 5 years after menopause, some women will still have functional ovarian cysts now and then. Some postmenopausal ovarian cysts, called unilocular cysts, which have thin walls and one compartment, are rarely linked to cancer.
A functional ovarian cyst sometimes develops near the end of the menstrual cycle, when an egg follicle fills up with fluid. Factors that may increase your risk for developing a functional ovarian cyst include:
Call your doctor immediately if you have:
Call your doctor for an appointment if:
For more information about other symptoms that concern you, see:
Most functional ovarian cysts are harmless, do not cause symptoms, and go away without treatment. Watchful waiting is usually an appropriate option if you are diagnosed with a functional ovarian cyst.
Ovarian cysts can be diagnosed and treated by any of the following health professionals:
You may need to see a gynecologist for further testing or treatment.
If you see your doctor for pelvic pain or bleeding, you'll be checked for a number of conditions, including an ovarian cyst, that may be causing your symptoms. Your evaluation will include a pelvic exam, a history of your symptoms and menstrual periods, a family history, and a transvaginal ultrasound (which uses a narrow wand placed in the vagina). See an image of ovarian cysts.
If your doctor discovers an ovarian cyst during a pelvic exam, a transvaginal or abdominal ultrasound can help show what kind of cyst it is.
If an ultrasound shows that you have a fluid-filled functional ovarian cyst, and it isn't causing you severe pain, your doctor will probably suggest a watchful waiting period. You can then have the cyst checked 1 to 2 months later to see whether it is changing in size. Most cysts go away in 1 to 2 months without treatment or after 1 or 2 menstrual periods.
Your doctor will recommend further testing or treatment if:
Most functional ovarian cysts are harmless, do not cause symptoms, and go away without treatment. When treatment is needed, treatment goals include:
Because functional ovarian cysts typically go away without treatment, your doctor may recommend a period of observation without treatment (watchful waiting) to see whether your ovarian cyst gets better or goes away on its own. Your doctor will do another pelvic exam in 1 to 2 months to see whether the cyst has changed in size.
If an ovarian cyst doesn't go away, your doctor may want to do more tests to be sure that your symptoms are not caused by another type of ovarian growth. Home treatment with heat and pain-relieving medicine can often provide relief of bothersome symptoms during this time.
A functional ovarian cyst that doesn't go away, has an unusual appearance on ultrasound, or causes symptoms may require treatment with either medicines or surgery.
Functional ovarian cysts cannot be prevented if you are ovulating. Anything that makes ovulation less frequent reduces your chance of developing an ovarian cyst. Birth control pills, pregnancy, and breastfeeding in the first 6 months following birth prevent ovulation. Ovulation ceases when menopause is complete.
Home treatment can help relieve the discomfort of functional ovarian cysts.
Treatment with medicine may be useful if you have recurrent, painful functional ovarian cysts.
Birth control pills (oral contraceptives) are used to prevent ovulation. Without ovulation, the chance that ovarian cysts will form is reduced and your symptoms may be relieved. Although birth control pills do not make ovarian cysts go away any faster, their use may prevent new cysts from forming.
Birth control pills have not been shown to get rid of or shrink ovarian cysts that have already formed. Some studies show that the cysts shrink at the same rate with or without birth control pill use.footnote 1
Surgery may be needed to confirm the diagnosis of an ovarian cyst or to evaluate ovarian growths when ovarian cancer is possible. Surgery does not prevent ovarian cysts from coming back unless the ovaries are removed (oophorectomy).
Surgery may be needed in the following situations:
Goals of surgical treatment for an ovarian cyst are to:
Surgery for an ovarian cyst or growth can be done through a small incision using laparoscopy or through a larger incision (laparotomy). The cut is made in your stomach area.
Laparoscopy may be used to confirm the diagnosis of an ovarian cyst in a woman of childbearing age. Persistent, large, or painful ovarian cysts that have no signs of cancer risk can be removed during laparoscopy, leaving the ovary intact.
Laparotomy is used when an ovarian cyst is very large, ovarian cancer is suspected, or other problems with the abdominal or pelvic organs are present. If cancer is found, the larger incision lets the surgeon closely examine the entire area and more safely remove all cancerous growth.
For the most part, functional ovarian cysts stop forming when menopause occurs (in rare cases, a functional ovarian cyst will occur or persist within 5 years of menopause). Relieving symptoms with medicine until menopause is complete may be an option.
Some women prefer the risks of surgery to symptoms that reduce their quality of life. If your doctor recommends surgery, ask whether laparoscopic surgery or laparotomy would be the best choice for you.
Unless the ovaries are removed, surgery does not prevent the formation of new functional ovarian cysts.
No other treatment for functional ovarian cysts is available at this time.
CitationsGrimes DA, et al. (2011). Oral contraceptives for functional ovarian cysts. Cochrane Database of Systematic Reviews (9).
Current as of: July 17, 2020
Author: Healthwise StaffMedical Review: Sarah Marshall MD - Family MedicineKathleen Romito MD - Family MedicineMartin J. Gabica MD - Family MedicineKirtly Jones MD - Obstetrics and Gynecology
Current as of: July 17, 2020
Author: Healthwise Staff
Medical Review:Sarah Marshall MD - Family Medicine & Kathleen Romito MD - Family Medicine & Martin J. Gabica MD - Family Medicine & Kirtly Jones MD - Obstetrics and Gynecology
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