Ultrasound images printed on thermal paper

Adnexal (Ovarian) Cysts

Ovarian cysts, also known as adnexal cysts, are fluid-filled sacs that develop on or within an ovary. They’re very common and often harmless, but sometimes they can cause symptoms or complications that need specialist attention.

What Causes Ovarian Cysts?

Most ovarian cysts are functional, meaning they form as part of the natural menstrual cycle. These cysts typically resolve on their own without treatment. Other cysts include:

  • Dermoid cysts: Contain tissue like hair or skin cells.
  • Endometriomas: Related to endometriosis.
  • Cystadenomas: Develop from ovarian tissue.
  • Polycystic ovaries: Multiple small cysts linked to hormonal imbalance.

Symptoms

Many cysts cause no symptoms and are found incidentally on ultrasound. When symptoms do occur, they may include:

  • Pelvic pain or pressure
  • Bloating or abdominal fullness
  • Painful periods or pain during intercourse
  • Sudden sharp pain if a cyst ruptures or causes ovarian torsion

Diagnosis

Transvaginal ultrasound is the main tool to identify cysts, assess their size, type, and whether they look benign or suspicious. Blood tests like CA-125 may sometimes be needed for further evaluation.

Treatment

Most cysts, especially functional cysts, don’t require surgery and resolve spontaneously. Surgery might be considered if:

  • The cyst is large or growing
  • Symptoms are severe
  • There is suspicion of malignancy
  • Complications like torsion or rupture occur

When surgery is necessary, I aim for minimally invasive (keyhole) techniques to remove the cyst while preserving as much ovarian tissue as possible.

When to Seek Help

If you experience sudden severe pelvic pain, fever, vomiting, or signs of shock, seek emergency care immediately as this may indicate cyst rupture or ovarian torsion.

Dr Sam Holford

Worried about an ovarian cyst?

I provide expert diagnosis & management. I offer clear advice and personalised care for your peace of mind.

Book an appointment

FAQs

Are most ovarian cysts cancerous?
No, the vast majority of ovarian cysts, especially in pre-menopausal women, are benign (not cancerous). However, any cyst needs to be properly evaluated with an ultrasound to assess its features, and post-menopausal cysts are looked at more carefully.
Do I need surgery to remove my ovarian cyst?
Not usually. Many cysts, particularly 'functional' cysts that are part of the menstrual cycle, resolve on their own. We often monitor them with a follow-up ultrasound. Surgery is typically only recommended if the cyst is very large, causing significant pain, or has suspicious features.
What is ovarian torsion?
Ovarian torsion is a medical emergency that happens when an ovary, sometimes with a large cyst, twists on its blood supply. It causes sudden, severe pelvic pain, often with nausea, and requires urgent surgery to untwist the ovary and save it.
Can ovarian cysts affect my fertility?
Most simple cysts do not affect fertility. However, cysts related to conditions like endometriosis (endometriomas) or Polycystic Ovary Syndrome (PCOS) can be associated with difficulties conceiving. If surgery is needed, the goal is always to preserve as much healthy ovarian tissue as possible.

Resources

Please note: This information is general in nature and not a substitute for medical advice tailored to your specific situation.