Could your pelvic pain be an ovarian cyst?

Ovarian cysts are common, and most are small, harmless and go away on their own. In fact, you may have one without ever knowing it.

But some ovarian cysts can cause pelvic pain, pressure or bloating. Knowing what those symptoms can feel like — and when they may need medical attention — can help you decide what to do next.

“Ovarian cysts are quite common, as the body makes cysts all the time,” says Deepti Nahar, M.D., an OB/Gyn with Sutter. “Sometimes we feel them, and sometimes we don’t. So it’s not necessarily a bad thing to have a cyst. The trouble happens when they’re a concerning type of cyst or when they cause pain that interrupts your life.”

What causes ovarian cysts?

An ovarian cyst is a sac, usually filled with fluid, that develops in or on an ovary. Most are benign.

The most common ovarian cysts are functional cysts, which develop as part of the menstrual cycle. They include:

• Corpus luteum cysts: These form after an egg is released, when fluid collects in the follicle that remains behind.
• Follicular cysts: These develop as part of the normal process of the ovary maturing eggs.

Functional cysts often go away on their own within a few menstrual cycles. Other types of ovarian cysts can develop for different reasons. For example, endometriosis can cause an endometrioma, a cyst that forms when tissue similar to the uterine lining grows on an ovary. Less commonly, ovarian cysts may be associated with other conditions and may require further evaluation.

What ovarian cyst pain feels like

Many ovarian cysts don’t cause symptoms. When they do, you may feel a dull ache or sharper pain in your lower abdomen or pelvis, often on the side where the cyst is located. You may also notice bloating, pressure or a feeling of fullness.

“The pain can be mild or moderate,” Nahar says. “And you may feel it on either side of your body.”

Sometimes an ovarian cyst can rupture, or an ovary can twist around the tissues that support it, a condition called ovarian torsion. Both can cause sudden, severe pelvic or abdominal pain which can lead patients to go to the emergency room and cause them to possibly need surgery. Torsion may also cause nausea and vomiting.

How to manage ovarian cyst pain

If you have pelvic pain that may be related to an ovarian cyst, getting the right diagnosis is the first step. Your doctor may perform a pelvic exam and recommend an ultrasound to look at the cyst’s size, shape and location. Other tests may be needed depending on your symptoms and what the ultrasound shows.

“Treatment depends on what type of cyst it is,” Nahar says. “Some cysts just resolve on their own. If it’s painful, taking an over-the-counter medication like ibuprofen or acetaminophen, along with using a heating pad, can help.”

Depending on the type of cyst, hormonal birth control may also be an option. It can help reduce the chance of developing some new functional cysts, although it doesn’t make an existing cyst disappear.

If a cyst continues to grow, causes significant pain or has concerning features, surgery may be recommended. In many cases, a cyst can be removed with minimally invasive laparoscopic surgery, which usually allows you to recover faster and go home the same day.

When ovarian cyst pain is urgent

Sudden, severe pelvic or abdominal pain needs prompt medical attention, particularly if it occurs with nausea, vomiting, fever, dizziness, weakness or fainting. These can be signs of a ruptured cyst, internal bleeding or ovarian torsion.

You should also contact your doctor if pelvic pain is new for you, keeps coming back, interferes with your normal activities or doesn’t improve with over-the-counter pain medicine.

“If you’re concerned about it, it’s always worth checking in with your OB/Gyn or your primary care doctor,” Nahar says.