Ovarian cysts

Ovarian cysts.

Most resolve on their own within two or three cycles. The visit exists to identify the ones that will not, and to say which of those actually need an operation.

How this is approached here

What happens, in order

  1. 01

    Transvaginal ultrasound at the first visit

    In the office. Size, wall thickness, septations and blood flow are what matter — not the diameter alone.

  2. 02

    A simple cyst under 5 cm

    In someone still having periods is re-scanned in six to eight weeks rather than treated. Most are gone by then.

  3. 03

    Where features are not simple

    CA-125 and, depending on age, AFP, hCG and LDH are drawn, and the risk-of-malignancy index is calculated rather than eyeballed.

  4. 04

    Endometriomas and dermoids do not resolve

    They are followed if small and asymptomatic, and removed laparoscopically if not.

  5. 05

    Anything with concerning features on imaging

    Goes to gynecologic oncology before an operation, not after one.

When it is urgent

Reasons to be seen the same day

Sudden

Severe one-sided pelvic pain, particularly with nausea or vomiting — ovarian torsion is a surgical emergency and the ovary is salvageable only for a short window.

Pain with fainting, or a racing pulse

A ruptured cyst can bleed.

Fever with pelvic pain

Which points at an abscess rather than a cyst.

A positive pregnancy test with one-sided pain

Ectopic pregnancy has to be excluded first, regardless of a known cyst.

Ovarian cysts: common questions

Does a cyst mean I have cancer?
Almost always no. In women who are still having periods, the great majority of cysts are functional — part of ovulation — and resolve without treatment. Risk rises after menopause, which is why the approach to a post-menopausal cyst is different from the start.
Will I lose the ovary?
The aim of a cystectomy is to take the cyst and leave the ovary, and in most planned operations that is what happens. Where the ovary has already been damaged by torsion or the cyst has replaced it, it may not be possible, and that possibility is discussed before you consent rather than afterwards.
Will birth control shrink it?
Hormonal contraception does not shrink an existing cyst. It reduces how often new functional cysts form, which is useful if you keep getting them, and that is the honest reason to take it.
Can a cyst stop me getting pregnant?
A simple cyst generally does not. Endometriomas can reduce ovarian reserve, and removing them can too, so the order of treatment changes if you are trying to conceive — say so at the first visit.

Know before you book.

Vireo opens in 2027. Until then the plan list, panel status and first-available wait for every office are published on this site and kept current. Questions can go to the practice office on (305) 555-0180.

See the locations