Ovarian cysts are sacs that can contain water, blood or fat.  They are very common in women and usually do not cause any symptoms. Most ovarian cysts form naturally and disappear within a few months without any treatment. They are usually the result of hormonal irregularities.

Normally, follicular cysts, which contain reproductive cells called follicles that carry egg cells and can be up to 3 cm in size, form in the ovaries during each menstrual cycle. These cysts are normal and necessary for reproduction. The cyst then ruptures and the egg is released. If the egg is fertilized with sperm, pregnancy occurs; if the egg is not fertilized, it is excreted after 14 days as menstrual bleeding. As a result of hormonal imbalance, the cyst may not rupture and may continue to grow. Sometimes the bleeding after rupture does not stop and it becomes a blood-filled cyst (hemorrhagic cyst).  Follicular cysts and hemorrhagic cysts usually do not require treatment and disappear on their own within two months. Sometimes blood cysts do not stop bleeding and may require surgical intervention. The most common cysts in reproductive age are called simple cysts and are not dangerous.


If the simple cysts mentioned above are very large, have not disappeared for a long time, if there is a suspicion that the cyst is a simple cyst, if it prevents ovulation, surgery should be considered.

Endometrioma (chocolate cyst), dermoid cyst, inflammatory cysts can also be seen in the ovaries.

Chocolate Cysts (Endometrioma): These cysts, popularly known as chocolate cysts, usually develop due to endometriosis. Endometriosis can prevent pregnancy because it is a condition that develops when the endometrium (the inner lining of the uterus) tissue inside the uterus is found outside the uterus. If pregnancy is prevented by chocolate cysts, these cysts may need to be surgically removed if they are very large.

Dermoid Cysts: These cysts are cystic structures that cause suspicion of cancer due to their hard structure. These cysts begin to form when the patient is in the womb. They may contain fat, hair, bone and teeth. Surgical removal is recommended if they are cancerous or extremely large. Very small dermoid cysts cannot be surgically removed. Cysts that do not show cancerous features but are considered as dermoid cysts should be followed up regularly

Cysts should be evaluated according to the patient’s age and history. Ultrasound or other imaging methods cannot be used to determine whether the cyst is benign or malignant. Examination by a physician experienced in cancer can reveal the type of cyst with a higher probability. As the age of the patient increases, the likelihood of malignancy of ovarian cysts also increases. Cysts with suspected malignancy (malignancy-cancer) should be operated on by a gynecooncologist if possible.


Patients may suspect that they have ovarian cancer. Since the ovaries are organs located in the abdomen, the presence of a cyst can be detected by examination and ultrasound. Patients should suspect an ovarian cyst and consult a physician, especially in the presence of the following findings.

Severe abdominal and groin pain

Low back pain

Abdominal bloating, indigestion

Hand mass in the groin area


Ovarian cysts can be easily detected by ultrasound and examination. Contrast-enhanced MRI (MRI with medication) is useful to better understand the size of the cyst, whether it is benign or malignant, its spread and the condition of the blood vessels. Blood tests such as CA-125, HE4, CA 15-3, CEA, CA 19-9, ß-hcg, AFP also provide information about the cyst. Especially in cysts that are thought to be malignant, these tests are necessary to evaluate treatment response.


Follow-up: Most ovarian cysts do not require treatment. For these cysts, it is enough to see your doctor periodically. Your cyst may remain the same size, shrink or disappear completely. A sudden onset of pain during follow-up can be important. The cyst may have burst, flipped over or bled. Contact your doctor in case of sudden onset of pain.

Birth control pills: This is actually a somewhat old treatment method that we do not use very often in our patients. It can be useful in the treatment of simple cysts. The aim is to suppress ovulation and prevent the development of new follicles. Thus, a new cyst will not interfere with the existing cyst.