Most functional ovarian cysts are harmless, do not cause symptoms, and go away without treatment. When treatment is needed, treatment goals include:

• Relieving symptoms of pelvic pain or pressure.
• Preventing more cysts from developing by preventing ovulation (if recurrence is a problem). Treatment with birth control pills prevents ovulation.

Initial treatment

Because functional ovarian cysts typically go away without treatment within 1 to 2 menstrual cycles, your doctor may recommend a period of observation without treatment (watchful waiting) to see whether your ovarian cyst gets better or goes away on its own. Your doctor will do another pelvic exam in 1 to 2 months to see whether the cyst has changed in size.

If an ovarian cyst doesn't improve in 1 to 2 menstrual cycles, your doctor may want to do more tests to be sure that your symptoms are not caused by another type of ovarian growth. Home treatment with heat and pain-relieving medicine can often provide relief of bothersome symptoms during this time.

Ongoing treatment

A functional ovarian cyst that persists through 2 to 3 menstrual cycles, has an unusual appearance on ultrasound, or causes symptoms may require treatment with either medicines or surgery.

• Your doctor may suggest that you try birth control pills for several months to stop more cysts from forming.
• Surgical removal of the cyst (cystectomy) through a small incision (laparoscopy) may be needed if a painful functional ovarian cyst does not go away despite medical treatment. If a cyst has an unusual appearance on ultrasound or if you have other risk factors for ovarian cancer, your doctor may recommend surgical removal through a larger abdominal incision (laparotomy) instead of by using laparoscopy.

What To Think About

Cysts after menopause. After menopause, ovarian cancer risk increases. This is why all postmenopausal ovarian growths are carefully checked for signs of cancer. Some doctors will recommend removing the ovaries (oophorectomy) when any kind of cyst develops on an ovary after menopause. But the trend in medicine seems to be moving away from surgery for small and simple cysts in postmenopausal women. In the five years after menopause, some women will still have functional ovarian cysts now and then. Some postmenopausal ovarian cysts, called unilocular cysts, which have thin walls and one compartment, are rarely linked to cancer.¹