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Home > Wellness > Health Library > Functional Ovarian Cysts
ovarian cyst is a sac that forms on the surface of a woman's
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.
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
doctor may find an ovarian cyst during a routine
pelvic exam. He or she may then use a pelvic
ultrasound to make sure that the cyst is filled with
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.
Learning about ovarian cysts:
Living with ovarian cysts:
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
The development of functional cysts is also common during
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
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 regular 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
routine 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 regular annual pelvic exams.
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
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
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.
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,
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
To prepare for your appointment, see the topic Making the Most of Your Appointment.
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
If your doctor discovers an ovarian cyst during a
routine pelvic exam, a transvaginal or abdominal ultrasound can help show what
kind of cyst it is.
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:
functional ovarian cysts are harmless, do not cause
symptoms, and go away without treatment. When treatment is needed, treatment
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
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
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
ovulating. Anything that makes ovulation less frequent
reduces your chance of developing an ovarian cyst.
Birth control pills, pregnancy, and
breast-feeding in the first 6 months following birth
prevent ovulation. Ovulation ceases when
menopause is complete.
Home treatment can help relieve the
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.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
Surgery may be needed in the following
Goals of surgical treatment for an ovarian cyst are
Surgery for an ovarian cyst or growth
can be done through a small incision using
or through a larger incision (laparotomy). The cut is made in your
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.
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
Grimes DA, et al. (2011). Oral contraceptives for functional ovarian cysts. Cochrane Database of Systematic Reviews (9).
Other Works Consulted
Tzadik M, et al. (2007). Benign disorders of the ovaries and oviducts. In AH DeCherney et al., eds.,
Current Diagnosis and Treatment Obstetrics and Gynecology, 10th ed., pp. 654–661. New York: McGraw-Hill.
February 1, 2013
Sarah Marshall, MD - Family Medicine & Kirtly Jones, MD - Obstetrics and Gynecology
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