Ovarian Masses

An ovarian cyst is a closed sac within the ovary that contains fluid or solid material. The majority of ovarian cysts in pre-menopausal women will be “normal” cysts, related to development of the egg in the ovary and ovulation. These cysts will almost always go away over time.

Many women at some time in their lives will be diagnosed with an ovarian mass or cyst. Ovarian cysts affect women of all ages, however they occur most often during a woman’s childbearing years.

Sometimes cysts are found because a woman is having pain or discomfort, and sometimes they are felt on a routine pelvic examination.

When a cyst or mass is found in a woman who is still having normal periods, it is important to monitor it to see if it gets smaller or resolves over the course of four to six weeks. An ultrasound, an imaging test that uses sound waves to create a picture of the inside of the body, is an accurate and painless way to monitor an ovarian cyst. Cysts that get smaller between two different ultrasounds usually require no further treatment.

Pain caused by ovarian cysts may be treated with:

  • Pain relievers
  • A warm bath
  • A heating pad or hot water bottle applied to the lower abdomen near the ovaries can relax tense muscles and relieve cramping, lessen discomfort, and stimulate circulation and healing in the ovaries
  • Bags of ice covered with towels can be used alternatively to the heading pad to increase local circulation
  • Combined oral contraceptive pill to regulate the menstrual cycle, prevent the formation of follicles that can turn into cysts, and possibly shrink an existing cyst
  • Limiting strenuous activity may reduce the risk of cyst rupture or torsion

Ovarian cysts that don’t get significantly smaller or disappear over the course of a month or two are more likely to be tumors. These tumors are generally benign, or non-cancerous, especially in younger women. Sometimes ultrasound or other imaging tests, such as an MRI, can determine that the cysts are non-cancerous. If they are also small and don’t cause any symptoms, they can often just be monitored periodically. If a cyst is larger, or if it is difficult to accurately determine the kind of cyst, it will most likely need to be removed surgically.

Ovarian cysts or masses can often be removed via laparoscopy, a surgical technique that uses several tiny incisions in the abdomen. Sometimes, if the cyst is quite large or if a woman is older, it is better to do the operation through a larger abdominal incision.

Often just the cyst or mass can be removed, leaving the ovary in place, but sometimes it is necessary to remove the entire ovary. If an ovary is removed, the other remaining ovary will take over the function for both ovaries, so menstrual periods and fertility generally aren’t affected.