Specialist diagnosis and management of ovarian cysts, with personalised treatment plans tailored to your symptoms and circumstances.
Ovarian cysts are fluid-filled sacs that develop on or within the ovaries. They are very common and most form naturally as part of the menstrual cycle, causing no symptoms and resolving on their own within a few weeks. However, some cysts grow large, rupture, or affect blood supply to the ovary, causing symptoms that require treatment. While the majority of ovarian cysts are benign, specialist assessment is important to confirm the nature of any cyst and determine the most appropriate course of management.
Pelvic pain, which may be dull or sharp, or occur during intercourse
Heavier, lighter, or irregular periods
Bloating or feeling full quickly
Constipation
Frequent urination
Fatigue
Ovarian cysts are diagnosed using pelvic ultrasound scan, which confirms the presence, size, and characteristics of the cyst. A blood test measuring CA-125 protein levels may also be recommended where there is any concern about the nature of the cyst.
Treatment depends on the size and type of cyst, the presence of symptoms, and whether you are pre- or post-menopausal:
Watchful waiting with follow-up ultrasound scan (for small, asymptomatic cysts)
Laparoscopic (keyhole) surgery to remove the cyst
Laparotomy where a cancerous cyst cannot be excluded
At London Pregnancy Care and Gynaecology, care is delivered by experienced consultant specialists with a focus on personalised treamtent, continuity of care, and clear, supportive guidance.
Most ovarian cysts form as part of the menstrual cycle. Follicular cysts develop when a follicle fails to release its egg or does not shrink afterwards. Luteal cysts form when the remaining tissue after egg release fills with blood. Other types include dermoid cysts, which can develop in younger women and occasionally grow quite large, and cystadenomas, which are more common in women over 40. The vast majority of ovarian cysts are benign.
Many ovarian cysts produce no symptoms at all and are only discovered incidentally. When symptoms do occur, they can include pelvic pain — either dull or sharp — particularly during sex, changes to your periods, bloating, constipation, frequent urination, and fatigue. A cyst that ruptures or twists can cause sudden, severe pain requiring prompt medical attention.
An ultrasound scan is the primary diagnostic tool, using sound waves to produce an image of the ovaries and assess the size and nature of any cyst. A transvaginal probe may be used alongside an abdominal scan for a clearer picture. If the scan suggests the cyst may contain solid material, a CA-125 blood test may be recommended to help assess the likelihood of malignancy, though further investigation is always needed to confirm this.
Not always. In pre-menopausal women, most cysts resolve on their own within a few weeks and a follow-up scan is arranged to confirm this. The decision to treat depends on the size and characteristics of the cyst, whether symptoms are present, and menopausal status. Post-menopausal women are monitored more closely due to a slightly higher risk of malignant change.
Most ovarian cysts can be removed by laparoscopy — keyhole surgery performed under general anaesthetic through small incisions in the abdomen. The procedure typically takes around an hour and most patients return home the following day. Where there is a possibility of a cancerous cyst, a laparotomy may be necessary, involving a larger incision to allow the cyst and ovary to be removed and sent for laboratory analysis. A short hospital stay may be required after this procedure.
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