Most ovarian cysts are small and do not cause symptoms. Some cysts may cause a dull or sharp ache in the abdomen and pain during certain activities. Larger cysts may cause torsion (twisting) of the ovary that causes pain. Cysts that bleed or rupture (burst) may lead to serious problems requiring prompt treatment.

An ovarian cyst may be found during a routine pelvic exam. If your health care provider finds an enlarged ovary, tests may be recommended to provide more information:

• Vaginal ultrasound - This procedure uses sound waves to create pictures of the internal organs that can be viewed on a screen. For this test, a slender instrument called a transducer is placed in the vagina. The views created by the sound waves show the shape, size, location, and makeup of the cyst.
• Laparoscopy - In this type of surgery, a laparoscope—a thin tube with a camera—is inserted into the abdomen to view the pelvic organs. Laparoscopy also can be used to treat cysts.
• Blood tests - If you are past menopause, in addition to an ultrasound exam, you may be given a test that measures the amount of a substance called CA 125in your blood. An increased CA 125 level may be a sign of ovarian cancer in women past menopause. In premenopausal women, an increased CA 125 level can be caused by many other conditions besides cancer. Therefore, this test is not a good indicator of ovarian cancer in premenopausal women.

Combined hormonal birth control pills may be prescribed to treat some types of ovarian cysts. This treatment will not make cysts you already have go away. But it may reduce the risk that new cysts will form.

If your cyst is large or causing symptoms, your health care provider may suggest surgery. The extent and type of surgery that is needed depends on several factors:

• Size and type of cyst
• Your age
• Your desire to have children

Sometimes, a cyst can be removed without having to remove the ovary. This surgery is called cystectomy. In other cases, one or both of the ovaries may have to be removed. Your doctor may not know which procedure is needed until after the surgery begins.