The Simple Ovarian Cyst

One night I answered my phone to hear the frantic voice of a friend's husband. He was rapidly explaining that my friend was in sudden, agonizing, abdominal pain. I could hear her in the background actively vomiting. I told him to take her straight to the Emergency Department. While waiting to hear news of her, I pondered the variety of problems that could have led to such awful symptoms. Hours later, he called back to report that she was much better and had been diagnosed with a ruptured ovarian cyst. I've never taken the diagnosis of ovarian cyst lightly since that night.

What is an ovarian cyst?

When a woman ovulates, the egg releases from the surface of the ovary. On occasion, the site from which the egg releases will form a cyst that is fluid filled. Often, that fluid is simply clear body fluid and the cyst is referred to as a "simple" cyst. If the cyst remains intact, it generally is reabsorbed into the body and goes away, usually occurs over a 2- to 4-week period. The hormones in the latter part of your monthly cycle tend to support the cyst, but when they decline during the cycle, the cyst will resolve and not cause a problem.

On occasion, however, one of these cysts will rupture. This may happen spontaneously or with the type of movement that comes with some types of activity, such as sexual intercourse. Oddly, a cyst might be very painful or not painful at all, and the size of the cyst doesn't seem to match up with the level of pain. In any case, the rupture of a cyst tends to be a very painful process. Once the cyst does rupture, the fluid spills out into the pelvis and gets reabsorbed into the body. Once this happens, the pain tends to go away rapidly and nothing else need be done.

How is the cyst treated?

If you're diagnosed with a cyst, the primary concern is that the weight of the cyst doesn't cause the ovary to twist over on its blood supply--a dangerous condition known as ovarian torsion. As long as torsion is not present, the cyst usually can be left alone to resolve on its own. Pain can generally be managed with appropriate pain medications prescribed by your health care provider and will gradually improve.

To verify the cyst has resolved, or has been absorbed back into the body, an ultrasound test should be done 4 to 6 weeks after your initial diagnosis.

In some cases, it may be necessary to surgically remove the cyst, if it

  • does not resolve
  • increases in size
  • causes the ovary to twist, as mentioned above
  • causes unmanageable pain
  • has significant bleeding with rupture


It is important to see your health care provider if you have any abdominal pain. Although, if you have an ovarian cyst, don't be surprised if you are allowed to heal yourself! This is because most cysts will be reabsorbed into the body on their own.


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