Functional Cysts of Ovary and Signs to Watch

Q: In my ultrasound report, I read the following note –
One large cyst about 62.8 x 52.8 mm seen in right adnexa. What is this cyst and is it a matter of worry? I am 23 years old.
By: Shalini

Reply:

In your age, such cyst are more likely to be a functional ovarian cyst.

In a normal monthly cycle of a female, one of the two ovaries release egg each month. The egg is released in the fallopian tube. It travels through the tube into the uterus.

Sometimes, the egg is not released. Or after releasing the egg, the bag containing it does not shrink back. It enlarges to form a fluid filled sac which occupies space in the adnexa.

Such a sac is called a functional cyst.

These are quite common. They are found more commonly in females who take oral contraceptive pills. Such cysts are harmless and usually reduce with time to disappear on their own.

Watch These Signs

You need to be watchful about your cyst. Though it appears harmless at the moment, you may require intervention in any of the following situations

  • If you develop any symptom like pain, heaviness, bleeding, menstrual irregularities or nausea during menses.
  • The cyst may grow in size. Large cyst require surgical drainage before they twist or rupture.
  • If the cyst ruptures, bleeds or burst.
  • In case you develop more of such lesions.

A screening test for carcinoma can be done. Blood levels of CA125 (a protein) are measured. The level is elevated in malignant conditions.

Take Care,

Buddy M.D.

Medical Advice (Q&As) on “Functional Ovarian Cyst

  1. Joell

    I have been going back and forth to the doctor for various symptoms for over a year. I have back pain, upper abdominal pain, gas, bloating, bowel problems, frequent urination, nausea, and sometimes vomiting. I have the Mirena IUD for 4 years now. I stopped get a period 4 months ago and severe lower abdominal pains. So I went to the ER and found that I had a complex septated cyst measuring 3.2×2.7×2.6cm on my right ovary. My right ovary measured 4.5×3.2×3.0cm. I was advised to do a follow-up at 6 weeks. I did, and the cyst has shrunk some to 2.0×1.5×1.9 and is described as a complex cyst with peripheral vascularity. Is this okay? Is the cyst going away on it’s own. I am still having most of my symptoms, and I am so uncomfortable and in pain most of the time even though the cyst is relatively small. Also, this time they also found a 1.5×1.5×1.7cm cyst with echogenic wall and peripheral vascularity on my left ovary that is described as likely representing a corpus luteal cyst, and that is a probable left ovarian corpus luteal cyst. Can this also be causing the pain? It used to be on one side, and now there’s pain on both sides. Also, there is a small amount of fluid within the posterior cul-de-sac. I am 33, and I have 3 kids. I had a c-section with each one. I have never had these kinds of symptoms or pains before in my life until now. I have never been diagnosed with cysts, but my Sister was and required a hysterectomy. Also my Mother has cancer, so the presence of anything new going on with my body is nerve racking. Please advise. The Dr.s I have don’t seem to know what to do, but they are planning to remove my Mirena IUD to see if my symptoms subside.

    Thank you!

    Reply
    1. Buddy M.D. Post author

      It would be good to remove the Mirena IUD for some time. Though these symptoms are unlikely to be because of it, it is likely to add up to the symptoms.

      Since you are not having regular menses, have cysts in your ovaries, it is evident that there is some hormonal disturbance going on in your body. There can be many reasons for it like any new pill, undue stress etc. Try removing any such potential cause of disturbances from your life.

      It is common to get ovarian cysts in reproductive period of life. You may read above about corpus luteal cysts. Usually these cysts resolve by themselves in a few months. Sometimes, external hormones are given to make them shrink.

      Malignancy in very unlikely. Since you are only 33 years old, surgery is not suggested.

      Reply
  2. Seema

    Sir, I am 30yrs old with two kids, I had severe pain in right side of my waist during periods, so I went for a scan where in they found a cyst in my right ovary measuring 3.4*2.7 cm with internal echoes and the radiologist there told me to wait for three periods cycle and then recheck after that. Now firstly I would like to know is there any problem with it, will I need a surgery for this? Will I have to go through the same pain every month during my periods or will it subside with the medications that the doctor give? Thank U in advance.

    Reply
    1. Buddy M.D. Post author

      The commonest cause of cysts in your age group are functional ovarian cysts.

      Just relax, it is quite probable, that the cyst will resolve on its own with time. Your radiologist may tell you that it has gone, when you visit him again for the repeat scan.

      If it stays, you may require hormonal pills for some time. Surgery is not required in such cases.

      You may talk to your doctor about having some pain medications for the time being. The pain would subside with treatment.

      Reply
  3. Arpit sharma

    My wife aged 29. Her pelvic ultra sound report showed a mixed echogenic mass in ovary right side of uterus measuring 43mm ×31 mm in size with PID and free fluid seen in cul-de-sac. Doctor prescribed antibiotic and anti inflammatory drugs and possible surgery. Please advice further. I am so worried.

    Reply
    1. Buddy M.D. Post author

      There is some infection in your pelvic cavity. First of all, this infection needs to be treated.

      For that, take the medication prescribed to you by your doctor.

      Do you have any pain abdomen, menstrual problems?

      If yes, let us know for a better insight into your problem.

      The cyst in your ovary does not sound worrisome. It is likely to be a functional cyst. Read more about it in the above written article. These are common in your age group and require no treatment. They are likely to regress on their own in 2 to 3 cycles.

      Reply
      1. arpit

        Thank you very much doctor for your prompt reply. She feels little pain abdomen and legs. She goes to urinate frequently. Beside this, she has no other problems. After the ultra sound, her urine exam shows the pus cell and albumin traced. Now, what is your view about it? Thanks in advance.

        Reply
        1. Arpit Sharma

          The Gynecology doctor and surgeon concern about female genital tuberculosis. They said that because there is no test to diagnosis genital T.B., so you may take the treatment for T.B. for a while. Is it safe to take any drugs without proper diagnosis? They are not much concern about the mix echogenic mass right side of the uterus as per their discussion. Please advice further. Thank you very much.

          Reply
          1. Buddy M.D. Post author

            The main problem your wife seems to have is her pelvic infection. Fallopian tubes are the commonest place to be affected with infective bugs. You may forget about the cyst for now.

            Diagnosing tuberculosis is not easy. This requires taking a sample tissue from T.B. affected area and sending it for histopathological examination.

            Your wife is most probably suffering from some infection, may be tuberculosis or something similar. The most probable region to be affected is fallopian tube.

            Taking a sample tissue from the fallopian tube would require doing a laparoscopic surgery.

            This is why, most doctors prefer starting anti tubercular medicines on the basis of symptoms and their speculation only.

            However, you may talk to your doctor about taking a laparoscopic biopsy.

  4. Pooja

    Hello Doctor,
    I am 25 years, unmarried. I got right ovarian cyst 5.2 x 4.4 cm size in my reports and no free fluid found in cul-de-sac. Is there any problem? What can be the best treatment for this? Is surgery is necessary for this? Please tell me if there can be any complications for future? Thanks in advance.

    Reply
    1. Buddy M.D. Post author

      What are your symptoms? Why did you get an ultra sound done? Let us know for a better insight into your problem.

      Ovarian cysts in your age are usually not dangerous. They are mostly functional cyst, as you may read above, which respond to medical treatment. Surgery is rarely needed.

      Reply
      1. Pooja

        Thanks for your reply.

        Symptoms like – Lower Back pain, irregular period, continuous headache, tiredness/fatigue all time etc. These are the basic reasons so doctor has recommended me for ultrasound.

        Reply
        1. Buddy M.D. Post author

          You may be having a temporary hormonal problem.

          Transient hormonal fluctuations may lead to the formation of ovarian cysts. These cysts are called functional cysts.

          Usually, they regress on their own in 2 to 3 cycles. If they don’t regress and lead to menstrual problems, hormonal pills may be given externally to manage them.

          Hormonal treatment for 3 to 6 months treats most of the patients.

          Surgery is required if the adnexal mass is too big or has a risk of bleeding.

          Reply
  5. Ankita

    Hello doctor,

    I just want to discuss my friend’s problem. She is unmarried. She is suffering from back pain, lower abdominal pain, gas, headache, frequent urination, nausea, weight gain, irregular period, pain during menstrual cycle and sometimes vomiting. After the ultra sound, she got
    ADENEXA : Right ovary shows an anechoic cyst of 5.4 x 4.4cm in size. Left ovary is normal (36.9 x 21.1mm) and no free fluid seen in cul-de-sac. Now firstly, I would like to know is there any problem with it, will I need a surgery for this? Will it be complicated in future for conceiving? Please advice.

    Reply
    1. Buddy M.D. Post author

      It would be difficult for her to conceive if you leave this condition untreated. If she gets proper treatment, the ovarian cyst would regress and all her symptoms would subside. Then there will be no problem as far as having a baby is concerned.

      She appears to have a small functional cyst in her ovary. Surgery is not required. You need to see a gyne.

      She may first try out medical treatment. Doctors may consider giving her hormonal pills for about 3 to 6 months. Most cases of ovarian cysts get cured by this treatment.

      In cases who do not respond to pills, surgery is required.

      Reply
      1. Ankita

        Hello Doctor,

        But when she had consulted with Gyne, she advised her to get marriage and conceiving a baby within three years.
        Why she said this? What can be the reason for this? At this time, She is 25 years old.

        Reply
        1. Buddy M.D. Post author

          It’s difficult to say. You may ask her to explain this is more details. She must be having reasons for what she said.

          Reply
  6. Rosie

    Sir, I am 36 years of age was seen by the medical personnel. Chronic chest pain radiated to my back. Chest X-Ray was done. Heart normal in size, lungs normal, no pleural effusion noted, bloods investigation done everything was in a normal range. So ultrasound scan was done abdomen and pelvis. Liver, gall bladder, both renals and spleen are all normal but A/V uterus measures 5-3*4.3cm, endometrium measures 0.4, left adnexa measures 3.0*2.7*3.6?cm. Right ovary not seen and no free fluid in POD. I have a 7 year old daughter and a miscarriage in may last year. My menstrual cycle lasts for days. Last pap smear was done last year and also I’m having gastric too. So doctor, can I have some advice, because I am worried.

    Reply
  7. rosie

    Sir, thanks very much for the answer to the above question. I had my menstrual cycle for this month but it only last for 2 days, I am not having back pain but only gastric pain, but I am still worried?

    Reply
    1. Buddy M.D. Post author

      You may be having some temporary hormonal problem. Are you stressed up at home or work place? You need to relax.

      Gastric problem is very likely to be related to the ovarian cyst. As the cyst regresses, all your problems would subside.

      Visit a gyne. You may need to take some hormonal pills for 3 to 6 months.

      Reply
  8. Smita

    I had my first period at the age of 11. I was having regular from the last 5 years but from the end of the last year, I missed my periods for almost 3 month. I showed it to the doctor he said there is no problem. He gave medicine and after having that I again started having my periods. Now again it’s been 4 months and I am not having periods. I showed it to doctor again. He said it’s normal and there is nothing to worry and there is no symptoms of nothing at all. Still I am really tensed.

    Reply
  9. Rahmath Nisha

    I have a small cyst in my left ovary which measures about 2.3×1.7cms. Is that dangerous or it can be cured by pills?

    Reply
    1. Buddy M.D. Post author

      It is not necessary for all ovarian cyst to become malignant with time.

      However, a small percentage of them may turn malignant.

      Reply
  10. Kayesha

    Hey doctor
    I’m nineteen years old,I recently had a baby.
    When I was 17 weeks pregnant I did an untra sound,and it said I have a cyst measuring 3.4cm
    I don’t have any pain but I’m passing some brown discharge, and I notice some blood…is this a bad sign for me ?

    Reply
    1. Buddy M.D. Post author

      This may not be from the cyst. Since you’ve had a baby recently, it’s better to see a gyne for internal check up. It’s important to know the source of bleeding. It may be from your cervix.

      Reply
  11. april

    I am 39 years old. I had hysterectomy 4 years ago – they removed everything except my right ovary. I have had ct scan at ER because I have constant lower left quadriant pain. It feels sharp and very painful. Sometimes if feels like bricks and bloating. I have regular BM. The pain is constant. One trip to ER said Kidney Stones, one trip said Diverticulitis, one said UTI, and last said Cysts on my right ovary. 3.4 x 2.4 cm right adnexal cyst and 14 mm benign right adrenal adenoma. My WBC was high at 15.8. MCH low at 26.8 Neutroopphil Abs high at 10.4 and monocytes abs high at 1.5. Ketones (5) and UA Blood (25) were abnormal. I havent had menstrual cycle since hysterrectomy. I have had blood during intercourse and a “raw” blood smell – Flagyl seem to help that smell. I still have the following symptoms with the acute constant pain lower quad pain – tiredness/fatique, back pain, low grade fewer, leg pain, bloating, adominal swelling, tenderness to touch and movement.

    I have had 2 c-sections previous, gallbladder removal, tubal prior to hysterectomy.

    Reply
  12. Githa

    My age is 32 years i have 3.4×3.6 cm ovarian cyst on right ovary and 2.9×3cm ovarian cyst on left ovary,i have regular periods not yet pregnent

    Reply
  13. Sai

    I diagnosed with 3.4×4.7cm simple cyst on right ovary.how to get rid this cyst.i have no symptoms regarding this cyst i am not pregnant yet

    Reply
        1. Buddy M.D. Post author

          A simple cyst may just be one finding. You need a thorough gyne evaluation to detect what the problem would be.

          It could be a hormonal issue. Are your menses normal and regular? Did you take any contraceptive pills in the past to avoid pregnancy?

          Reply
          1. Buddy M.D. Post author

            Alright.

            Cyst may or may not suggest a hormonal disturbance. A thorough gyne exam is required for diagnosis.

  14. Rejoice

    I am 21yrs old. I have been feeling a sharp pain in my left side abdomen like three times a year since two years now. I went for a scan and I was told its ovarian cyst which measures from about 3.0cm×3.6cm.do I take drugs or does it require a surgery

    Reply
  15. Tricia Richardson

    I am 40 years and I went for an ultra sound since I had an irregular menstrual for the past two months and the result was a simple cyst measuring 3.4 ×2.9cm on the right ovary. Should I be worried and what can be done? I was also been diagnosis with hyperthyroidism a few months ago.

    Reply
    1. Buddy M.D. Post author

      This is a pretty big sized cyst. Are you taking medicines to treat Hyperthyroidism?

      This cyst may also respond to this treatment. If it doesn’t, your gyne may have to treat it separately. It would be important to keep a close watch over it. A further increase in size could be dangerous.

      Reply

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