Chronic ovarian cysts: what to know

Many ovarian cysts are fluid-filled and related to the menstrual cycle, while others arise from different ovarian tissues. The cyst's appearance, size, persistence, symptoms and your stage of life guide the next step.

A cyst may be described as chronic when it remains on repeat imaging, returns over time or causes ongoing pelvic pressure, bloating, pain during sex or changes in bladder or bowel comfort. Those symptoms can have other causes, so imaging and clinical assessment matter.

A transvaginal ultrasound can show whether a cyst is simple or has more complex features. Your clinician may also consider pregnancy possibility, menstrual pattern, previous cysts, menopause status and whether symptoms occur suddenly or gradually.

Arrange a gynaecology review if pain or pressure continues, the cyst has persisted on imaging, or symptoms interfere with daily activities. Keep a brief record of pain timing, menstrual bleeding, fullness, nausea and medicines used; this can reveal patterns and support treatment decisions.

Management may involve monitoring with repeat ultrasound, symptom relief, hormonal contraception for selected people, or surgery. Hormonal contraception may reduce formation of some new cycle-related cysts but does not remove every existing cyst. A laparoscopic ovarian cystectomy may be considered when removal is appropriate, with preservation of healthy ovarian tissue where feasible.

Seek urgent medical care for sudden severe pelvic or lower abdominal pain, especially with vomiting, faintness, weakness, fever or heavy bleeding. These features can occur if a cyst ruptures, bleeds or contributes to twisting of the ovary, and prompt examination is needed.

Ask what type of cyst the scan suggests, whether repeat imaging is needed, which symptom changes should trigger urgent care, and how each option could affect fertility or ovarian function. If surgery is proposed, ask why removal is recommended and whether the ovary is expected to be preserved.