Ovarian cysts seldom present with any signs and symptoms as these get corrected on their own. However, when cysts fail to resolve and enlarge in size interfering with the blood supply to the organ then it presents with the following signs and symptoms:

• Bowel movements turn painful
• Abdominal swelling
• Abdominal bloating
• Pain during intercourse
• Nausea accompanied by vomiting
• Severe pain in the pelvic region during menstrual cycle
• Pain experienced in the thighs and lower back region
• Breast tenderness

In addition to the above mentioned symptoms, ovarian cysts may also give rise to the following symptoms indicating medical emergency [7]:

• Fever
• Dizziness
• Rapid breathing
• Severe and sharp pain in the pelvic region

• Weight Gain

  Ovarian cyst symptoms are very similar to those found in women with PCOS, such as irregular or non-existent periods, acne and weight gain. [londonwomenscentre.co.uk]

  If you have polycystic ovarian syndrome (multiple cysts in the ovaries) you may also experience weight gain and acne. For more information, see Useful links. [web.archive.org]

  Call your healthcare provider if you have missed or irregular periods, extra hair growth, acne, and weight gain. Key points about PCOS PCOS is a very common hormone problem for women of childbearing age. [stanfordchildrens.org]

  An increase in the need to urinate Excessive bleeding during menstruation Irregular periods Unexplained weight gain Increase in the rate of hair growth Absence of menstrual bleeding Light vaginal spotting Difficulty getting pregnant Infertility Swollen [beatsofhealth.com]

  Other less frequent symptoms include: Pelvic pain Pain during sex Frequent need to urinate Unexplained weight gain Pain during your period Unusual vaginal bleeding Breast tenderness Dull ache in the lower back and thigh The Ovaries The ovaries are two [yanhee.net]

• Nausea

  especially from standing; fainting ; persistent fever ; severe lower abdominal or pelvic pain ; high or low blood pressure unrelated to medications; excessive thirst or urination; unexplained shoulder pain combined with abdominal pain ; persistent nausea [emedicinehealth.com]

  The pressure they put on other organs may also cause bloating or nausea. [verilymag.com]

  Nausea and vomiting may also occur. If a large cyst ruptures, it can be a medical emergency because of heavy bleeding. [dignityhealth.org]

  Women with ovarian torsion present with sudden onset of abdominal pain, often associated with nausea and possibly vomiting and low-grade fever.” Early monitoring is key to finding ovarian cysts before they become a problem. [livescience.com]

  Symptoms Symptoms of ovarian cysts include, pain in the pelvic region during menstruation, abdominal bloating, breast tenderness, nausea, vomiting, pain during intercourse and painful bowel movements. [symptoma.com]

• Abdominal Pain

  A 69-year-old Japanese woman presented to her practitioner complaining of dull lower abdominal pain. She was referred to us for presumed uterine tumor. [ncbi.nlm.nih.gov]

  Most cyst ruptures are self-limiting, requiring only expectant management and oral analgesics for relief of abdominal pain. [web.archive.org]

• Pelvic Mass

  This will identify a pelvic mass and the presence of metastatic disease. Where no obvious disease is identified the dilemma for the gynaecologist is deciding whether the pelvic mass is likely to be malignant and who should operate on the patient. [web.archive.org]

  She was also found to have a pelvic mass and an exploratory laparotomy revealed left ovarian cancer. Based on the histopathological findings, the subcutaneous tumor was diagnosed as a metastasis from the ovarian cancer. [ncbi.nlm.nih.gov]

  Diagnostic value of pelvic examination, ultrasound, and serum CA 125 in postmenopausal women with a pelvic mass. An international multicenter study. Cancer 1994; 74(4):1398-1406. (11) Kroon E, Andolf E. [pelvicmass.tripod.com]

  Patients may present with sudden-onset pelvic pain, pelvic mass, or they may be asymptomatic and the HOC is an incidental finding 4. [radiopaedia.org]

• Lower Abdominal Pain

  A 69-year-old Japanese woman presented to her practitioner complaining of dull lower abdominal pain. She was referred to us for presumed uterine tumor. [ncbi.nlm.nih.gov]

  However, if a larger cyst ruptures, twists, or if there is bleeding into the middle of the cyst, then one-sided lower abdominal pain is common. If the cyst is large then it may cause pressure on the bladder or bowel. [netdoctor.co.uk]

• Abdominal Fullness

  A 32-year old G3P1102 at 29.2 weeks gestation presented with left lower quadrant pressure, right abdominal fullness, and left uterine displacement. [ncbi.nlm.nih.gov]

  These other symptoms can include abdominal fullness, expansion of the abdomen, or bloating, low back pain, indigestion, feeling full after eating only a small amount (early satiety), urinary urgency, difficulty with emptying the bladder completely, feeling [medicinenet.com]

  Ovarian cysts and masses should be suspected in the cases of: Precocious Puberty Dull, aching pelvic pain or "heaviness" Abdominal fullness or bloating Adenexal Mass Unexplained constipation Differential Diagnosis Torsion Pregnancy Ectopic Pregnancy!! [pedclerk.bsd.uchicago.edu]

  Alert your doctor to symptoms that may indicate a problem, such as: changes in your menstrual cycle ongoing pelvic pain loss of appetite unexplained weight loss abdominal fullness The outlook for premenopausal women with ovarian cysts is good. [healthline.com]

  When symptoms do occur, they may include the following: Pain during intercourse or menstruation Abdominal fullness Nausea Vomiting Unusual bleeding Weight gain Inability to empty the bladder completely Breast pain Aching in the pelvic region, lower back [onhealth.com]

• Back Pain

  […] they are: Pelvic pain Painful periods Vaginal pain Pain during intercourse/sex Back pain – lower back Pain after sex – in the abdominal area Pain during bowel movements Most of these changes are caused because of the hormonal imbalance that cysts in [beatsofhealth.com]

  Other ovarian cyst symptoms may include pelvic pain, high blood pressure, lower back pain, abdominal pressure and nausea. [londonwomenscentre.co.uk]

  Symptoms of Ovarian Cysts Symptoms may include: Abdominal bloating/swelling Pelvic pain before or during your period Painful bowel movements Painful intercourse Lower back pain, pelvic pain, or pain on the side of your body Breast tenderness Nausea and [verilymag.com]

  Occasionally they may produce bloating, lower abdominal pain, or lower back pain. The majority of cysts are harmless. If the cyst either breaks open or causes twisting of the ovary, it may cause severe pain. [en.wikipedia.org]

  Larger cysts are more likely to cause signs and symptoms such as: Pain in the abdomen, pelvis, sometimes radiating to the low back, is the most common symptom Feeling of bloating or indigestion Increased abdominal girth Feeling an urge to have a bowel [medicinenet.com]

• Hirsutism

  The study describes the case of a patient, in which as a result of removing an endometrioid ovarian cyst, there was an improvement as regards hirsutism and the decrease of testosterone concentration in the serum of peripheral blood. [ncbi.nlm.nih.gov]

  Hormonal contraceptives are first-line therapy for menstrual abnormalities, hirsutism, and acne in women who have PCOS and who do not desire pregnancy. [msdmanuals.com]

  The ovaries produce abnormally high levels of androgen, resulting in hirsutism and acne. [mayoclinic.org]

  Other symptoms of polycystic ovary syndrome include hirsutism (increased growth of body hair) and difficulty losing weight. What are the complications of an ovarian cyst? If a cyst breaks open, it can cause severe pain and swelling in the abdomen. [my.clevelandclinic.org]

  Common symptoms of PCOS include: irregular periods or no periods at all difficulty getting pregnant (because of irregular ovulation or failure to ovulate) excessive hair growth (hirsutism) – usually on the face, chest, back or buttocks weight gain thinning [nhs.uk]

• Withdrawn

  Postoperatively, after discussion with the parents, support was withdrawn and the child died. [ncbi.nlm.nih.gov]

• Pelvic Pain

  Acute pelvic pain in women is a common diagnostic dilemma encountered by the gynecologist. We describe a case of acute pelvic pain with an unusual etiology. A 40-year-old multipara presented within hours of the onset of acute pelvic pain. [ncbi.nlm.nih.gov]

  […] can include: Bloating or swelling in the abdomen Pain during bowel movements Pain in the pelvis shortly before or after beginning a menstrual period Pain with intercourse or pelvic pain during movement Pelvic pain -- constant, dull aching Sudden and [web.archive.org]

  […] include: Bloating or swelling in the abdomen Pain during bowel movements Pain in the pelvis shortly before or after beginning a menstrual period Pain with intercourse or pelvic pain during movement Pelvic pain -- constant, dull aching Sudden and severe [nlm.nih.gov]

  Irregular menstrual periods A feeling of lower abdominal or pelvic pressure or fullness Chronic pelvic pain or low back pain throughout the menstrual cycle Pelvic pain following exercise or vigorous activity Pain or pressure with urination or bowel movement [emedicinehealth.com]

  They can be asymptomatic or can present with pelvic pain (especially with a woman's period), painful intercourse and infertility. [acfs2000.com]

• Adnexal Mass

  Careful evaluation and consultation must be the mainstay of surgery for adnexal masses. A patient initially diagnosed as having an adnexal mass was discovered to have an anterior meningocele at surgery. [ncbi.nlm.nih.gov]

  Although most adnexal masses are benign, the main goal of the diagnostic evaluation is to exclude malignancy. [dx.doi.org]

• Vaginal Bleeding

  One other case has polycystic ovaries, and the remaining case was referred for vaginal bleeding. Four patients had a familial history of ovarian anomalies and/or infertility. [ncbi.nlm.nih.gov]

  Other less frequent symptoms include: Pelvic pain Pain during sex Frequent need to urinate Unexplained weight gain Pain during your period Unusual vaginal bleeding Breast tenderness Dull ache in the lower back and thigh The Ovaries The ovaries are two [yanhee.net]

• Dyspareunia

  Problems associated with endometriosis include dysmenorrhoea, dyspareunia and infertility. [ncbi.nlm.nih.gov]

  […] movements Pelvic pain before or during menstrual cycle – may be persistent or intermittent- may range from a dull, heavy sensation to a sudden, severe and sharp pain; may start and stop; may occur after any strenuous activity Painful intercourse /sex – dyspareunia [beatsofhealth.com]

  Dyspareunia: This is pelvic pain that occurs during sexual intercourse. Some women might experience pain and discomfort in the abdomen after sex. [medicalnewstoday.com]

  Endometriomas are associated with endometriosis, which can cause dysmenorrhea and dyspareunia. Polycystic ovarian syndrome In polycystic ovarian syndrome, the ovary often contains multiple cystic follicles 2-5 mm in diameter as viewed on sonograms. [emedicine.com]

• Dysmenorrhea

  When the pain is severe, it is referred to as dysmenorrhea. "Dysmenorrhea is common (American College of Obstetricians and Gynecologists, 1999b)." There are two types of dysmenorrhea: Primary dysmenorrhea Secondary dysmenorrhea. [web.archive.org]

  Menstrual irregularities including absence of menstrual bleeding (amenorrhea), heavy bleeding (menorrhagia), and painful periods (dysmenorrhea). [hopkinsmedicine.org]

  The most common symptoms of endometriosis are pelvic pain, secondary dysmenorrhea, dyspareunia, and infertility. Primary dysmenorrhea or dysmenorrhea occurring from the onset of menses should increase a clinician’s suspicion for endometriosis. [emedicine.medscape.com]

  Morbidity also includes menorrhagia, an increased intermenstrual interval, dysmenorrhea, pelvic discomfort, and abdominal distention. Benign cysts rarely cause death. [emedicine.com]

Usually a routine pelvic examination is sometimes enough to detect an ovarian cyst. If the examination does not reveal normal findings then further confirmatory tests may be advised. These include the following:

• Ultrasound tests that shows presence of cysts in the ovaries. This test also helps in determining the size, location and nature of the cysts.
• Pregnancy test if turns out to be positive suggests that the cysts is of corpus luteum type [8].
• Blood test to determine the levels of antigen 125 is carried out. If the level of this particular antigen is found to be elevated then it indicates that cyst can be cancerous in nature. In such cases, further tests to confirm the condition need to be carried out.

In many cases, the cysts get corrected by themselves requiring no treatment. In conditions, when the cysts enlarge in size and cause discomfort to the patients the following treatment regime is suggested:

• Medications such as birth control pills are suggested to stop the ovulation in order to prevent the recurrence of the cysts [9].
• Laparoscopy is a surgical procedure to remove the cysts from the ovaries. Such a kind of method is employed when the cyst is smaller in size.
• Laparatomy is the treatment of choice when the cyst is larger in size. 

Women who develop ovarian cysts while they are still having periods usually require little or no treatment. However, post menopausal women who develop cysts are more likely to develop ovarian cancer. When the cysts are of simple type then the chances of developing cancer is low [5].

Ovarian cysts normally resolve on their own seldom requiring any treatment. However, in cases, when the cysts are diagnosed as been cancerous in nature, it could lead to the following complications:

• Ovarian torsion: It is a rare complication of ovarian cysts, wherein a large cyst that develops on the ovary causes it to twist and shift from its original position. In the condition of ovarian torsion, the blood supply to the ovaries is interrupted causing death of the ovarian tissue. It has been estimated that about 3% of women with ovarian cysts develop ovarian torsion [6].
• Ruptured cysts: This is also a rare accompaniment of ovarian cysts, but can turn life threatening if the condition is not treated on time. Cysts can rupture causing intense pain and internal bleeding.

The most common type of cysts known as functional cysts develop as a result of regular menstrual cycle. Functional cysts are further divided into 2 types: Follicular and luteum cysts. Follicular cysts occur during menstrual cycle when the follicles fail to break open and release an egg. Such a phenomenon causes the fluid to get accumulated inside the follicle giving rise to development of follicular cysts [2]. 

Luteum cysts develop after the follicle has released the egg during the monthly ovulation cycle. Such type of cysts contains some amount of blood along with fluid.

In some cases, taking fertility drugs can also lead to development of large cysts on the ovaries. However, such a condition may get corrected after the menstrual cycle or after pregnancy.

Ovarian cysts are a common occurrence in almost all premenopausal women. It has also been estimated that about 18% of women in their postmenopausal stage develop ovarian cysts. The exact incidence of ovarian cysts however is unknown due to its high resolution rate and lack of appropriate recording of cases [3]. Research has postulated the fact that ovarian cysts are the most common cause of fetal and infant tumor, with a prevalence rate of about 30%.

Under normal conditions, during each menstrual cycle every month, an egg is released by the follicles. In conditions when the follicle fails to break open and release an egg, the fluid continues to stay in the follicle and is not released giving rise to development of cysts. Such a type of cyst that develops within a follicle is known as follicular cysts [4]. The second type of cyst known as the corpus luteum cysts develop after the egg is released from the follicle. A cyst of this type may also contain blood in it.

It is practically impossible to prevent the development of ovarian cysts. However, regular follow up examination with gynecologist can help in detection of cysts in its early stages.

Ovarian cysts are a common problem experienced by almost all women across the globe at least once in their lifetime. In majority of the cases, ovarian cysts that develop, present with no signs and symptoms, are harmless and cause no discomfort to the affected woman. Such type of cysts usually resolve by themselves requiring no treatment [1]. However, those cysts that rupture are a significant cause of discomfort and produce serious debilitating symptoms.

Definition

Ovarian cysts are the ones which develop either on the surface or inside the ovary. These cysts develop in women in the child bearing age. In majority of the cases, the cysts resolve without any treatment.

Cause

There are 2 types of ovarian cysts: Follicular and corpus luteum cysts. The follicular cysts develop when the follicle fails to break and release egg during monthly menstrual cycle. In corpus luteum cysts, mass develops after the follicles have released the egg.

Symptoms

Symptoms of ovarian cysts include, pain in the pelvic region during menstruation, abdominal bloating, breast tenderness, nausea, vomiting, pain during intercourse and painful bowel movements.

Diagnosis

A pelvic examination to observe for tenderness and inflammation of the pelvic region is carried out. In addition, blood tests, pregnancy test, ultrasound of the pelvic are also necessary to confirm the condition.

Treatment

When the cysts enlarge in size and cause discomfort, treatment would include administration of birth control pills to stop the process of ovulation. In addition, surgical procedures may also be required for removal of the cysts [10].

1. Bailey CL, Ueland FR, Land GL, DePriest PD, Gallion HH, Kryscio RJ, et al. The malignant potential of small cystic ovarian tumors in women over 50 years of age. Gynecol Oncol. Apr 1998;69(1):3-7.
2. Castillo G, Alcázar JL, Jurado M. Natural history of sonographically detected simple unilocular adnexal cysts in asymptomatic postmenopausal women. Gynecol Oncol 2004; 92:965.
3. ACOG Practice Bulletin No. 110: noncontraceptive uses of hormonal contraceptives. Obstet Gynecol. Jan 2010;115(1):206-18.
4. American College of Obstetricians and Gynecologists Committee on Gynecologic Practice. Committee Opinion No. 477: the role of the obstetrician-gynecologist in the early detection of epithelial ovarian cancer. Obstet Gynecol 2011; 117:742.
5. Holt VL, Cushing-Haugen KL, Daling JR. Risk of functional ovarian cyst: effects of smoking and marijuana use according to body mass index. Am J Epidemiol. Mar 15 2005;161(6):520-5.
6. Modesitt SC, Pavlik EJ, Ueland FR, et al. Risk of malignancy in unilocular ovarian cystic tumors less than 10 centimeters in diameter. Obstet Gynecol 2003; 102:594.
7. Chan L, Lin WM, Uerpairojkit B, Hartman D, Reece EA, Helm W. Evaluation of adnexal masses using three-dimensional ultrasonographic technology: preliminary report. J Ultrasound Med. May 1997;16(5):349-54.
8. Perrotin F, Potin J, Haddad G, et al. Fetal ovarian cysts: a report of three cases managed by intrauterine aspiration. Ultrasound Obstet Gynecol 2000; 16:655.
9. Osmers R. Sonographic evaluation of ovarian masses and its therapeutical implications [editorial].Ultrasound Obstet Gynecol. Oct 1996;8(4):217-22. 
10. Arisaka O, Shimura N, Nakayama Y, et al. Ovarian cysts in precocious puberty. Clin Pediatr (Phila) 1989; 28:44.