Ovarian cysts
Ovarian cysts What are ovarian cysts? An ovarian cyst is a fluid-filled sac that develops on an ovary. Most ovarian cysts occur naturally, are a common women's health condition which can go away on their own. However, they can prevent you conceiving and become large enough to block the blood supply to the ovary and cause damage. What are the symptoms of ovarian cysts? Usually, a woman ma
What it is
Functional cysts (follicular, corpus luteum) form as part of the normal cycle and resolve over 8–12 weeks. Benign neoplastic cysts (dermoid, endometrioma, serous cystadenoma) may grow and need surgical removal. Suspicious cysts (multilocular, solid, vascular, large) need expert assessment and tumour markers. Post-menopausal new cysts deserve a higher index of suspicion.
Symptoms and signs
- Most ovarian cysts are asymptomatic and found incidentally on scan.
- Pelvic pain or pressure, particularly cyclical.
- Acute severe pelvic pain (suggests cyst rupture or torsion — emergency assessment).
- Pain on intercourse, urinary frequency or bowel symptoms from mass effect.
- New ovarian cyst in a post-menopausal woman — always warrants expert review.
How we investigate
Transvaginal pelvic ultrasound with IOTA descriptors. Tumour markers (CA-125, HE4, ROMA index) based on age and ultrasound features. Pelvic MRI for complex cysts. Surgical assessment where the picture is uncertain.
Treatment options at The Vesey
- Watch-and-wait for simple cysts < 5 cm in pre-menopausal women — typically repeat scan in 8–12 weeks.
- Hormonal suppression — combined contraceptive pill to prevent recurrent functional cysts.
- Laparoscopic cystectomy for symptomatic, large, persistent or complex cysts.
- Laparoscopic oophorectomy for selected cases — particularly post-menopausal or where ovarian preservation is not appropriate.
- Direct referral to gynae-oncology for any suspicious feature.
Can an ovarian cyst affect fertility? +
Yes, certain types can. Endometriomas (chocolate cysts) reduce ovarian reserve over time and are strongly associated with endometriosis. Very large cysts can cause ovarian torsion, which is a surgical emergency risking loss of the ovary. Early assessment protects fertility.
What is ovarian torsion and is it an emergency? +
Ovarian torsion occurs when a cyst causes the ovary to twist on its blood supply. It causes sudden severe one-sided pelvic pain, often with nausea. It is a surgical emergency — if you have these symptoms, go to A&E immediately. Non-emergency ovarian cyst review can be arranged at The Vesey.
Do all ovarian cysts need surgery? +
No. Simple cysts under 5 cm in pre-menopausal women typically resolve on their own and need a repeat scan in 8–12 weeks. Surgery is considered for cysts that are large, persistent, complex-looking, symptomatic, or arise post-menopause.
What blood tests are done for an ovarian cyst? +
CA-125 is the most commonly used tumour marker, but it is not specific to ovarian cancer. We often use it alongside HE4 and calculate the ROMA index to assess risk more accurately. In younger women, we may also check AFP and beta-HCG to rule out germ-cell tumours.
Pricing at a glance
Initial gynaecology consultation £260. Transvaginal pelvic ultrasound from £240. Tumour marker panel from £150. Surgical pricing on individual quotation. Insurance accepted: BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix.
Book an appointment
When to see a specialist
Book if you have a known cyst awaiting follow-up, acute or recurrent pelvic pain, a new cyst post-menopause, or want a second opinion on whether surgery is the right next step.
Cost and pathway
Initial gynaecology consultation £260. Transvaginal pelvic ultrasound from £240. Tumour marker panel from £150. Surgical pricing on individual quotation.
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