Ovarian Cysts: Symptoms, Causes, and Treatment in the UK

An ovarian cyst is a fluid-filled sac that develops on one of the ovaries. Ovaries are part of the female reproductive system that produce eggs and hormones such as oestrogen and progesterone. Most women will develop at least one cyst during their lifetime, often without even realising it. In the majority of cases, these cysts are small, non-cancerous (benign), and resolve on their own within a few months.

According to NHS guidance, cysts usually only cause symptoms if they are large, block the blood supply to the ovaries, or rupture. Understanding the different types of cysts and their symptoms is the first step toward effective management. If you are experiencing unexplained pelvic discomfort, you can speak to a GP online to discuss your symptoms and determine the best course of clinical investigation.

Functional Cysts

These are the most common type and are linked to the menstrual cycle. They include:

• Follicular cysts: These occur when a follicle (the sac that contains an egg) does not release the egg or discharge its fluid, causing it to grow into a cyst.
• Corpus luteum cysts: After an egg is released, the follicle becomes the corpus luteum. If this sac fills with blood or fluid instead of breaking down, a cyst forms.

Pathological Cysts

These are caused by abnormal cell growth and are not related to the menstrual cycle. They can develop before or after the menopause. Examples include:

• Dermoid cysts: These can contain various tissues, such as hair or skin, because they grow from embryonic cells.
• Cystadenomas: These develop on the outer surface of the ovary and can grow quite large.
• Endometriomas: Caused by endometriosis, where tissue similar to the lining of the womb grows outside the womb, sometimes forming cysts on the ovaries.

Many women with ovarian cysts have no symptoms. However, if a cyst grows, you may experience:

• Pelvic pain: This ranges from a dull, heavy ache to a sharp, sudden pain in the lower abdomen on the side of the cyst.
• Bloating: A persistent feeling of fullness or swelling in the stomach.
• Pain during intercourse: Known as dyspareunia, this can be a common indicator of pelvic issues.
• Changes in menstrual patterns: Periods may become heavier, lighter, or irregular.
• Urinary symptoms: A large cyst may press on the bladder, leading to a frequent need to urinate.
• Difficulty emptying bowels: Pressure on the rectum can cause discomfort or changes in bowel habits.

If you present with symptoms, a GP will typically perform a physical examination of the abdomen. Under NICE guidelines, the primary diagnostic tool is a pelvic ultrasound. This can be done transabdominally (over the stomach) or transvaginally (using a small internal probe) to provide a clear image of the ovaries.

Management depends on the cyst's size, appearance, and whether you have reached the menopause. Options include:

• Watchful waiting: For small, simple cysts, doctors often recommend a repeat scan in 6 to 12 weeks to see if the cyst has resolved naturally.
• Blood tests: You may be asked to take a CA125 test. While this protein can be elevated in ovarian cancer, it is also raised by benign conditions like endometriosis or fibroids.
• Surgical removal: If the cyst is large, persistent, or looks potentially suspicious, a gynaecologist may recommend surgery, usually via laparoscopy (keyhole surgery).

Navigating women's health concerns can be stressful. If you are experiencing persistent bloating, pelvic heaviness, or changes to your cycle, seeking early advice is vital. You can book a consultation with an online doctor in the UK to discuss your history and symptoms from the comfort of your home.

An online GP can provide a referral for a private ultrasound scan or advise you on the necessary steps to take with your local NHS surgery. They can also offer guidance on pain management strategies using paracetamol or ibuprofen while you wait for diagnostic results. Accessing a treatment for ovarian cysts UK pathway often begins with this initial conversation, ensuring you don't have to manage the discomfort alone.

While rare, two serious complications can occur:

• Ovarian Torsion: This happens when a large cyst causes the ovary to twist, cutting off its own blood supply. This is a medical emergency and causes sudden, agonising pain, often accompanied by nausea and vomiting.
• Ruptured Cyst: If a cyst bursts, it releases fluid or blood into the pelvic cavity. While some ruptures cause minimal discomfort and heal on their own, a large rupture can lead to severe pain and internal bleeding.

If you experience these symptoms, you must seek urgent medical assistance via A&E or 111.