Right now, you could have a tiny sac of fluid on or inside an ovary and not even know it.

These growths, called ovarian cysts, are usually harmless and come and go without any symptoms or issues. However, some types of ovarian cysts can cause problems and even put you at a higher risk of infertility.

If you are a woman who is concerned about fertility, understanding ovarian cysts is important, especially considering there isn’t much you can do to prevent them, and they are often only discovered during a routine women’s health exam.

This article will tell you exactly what you need to know about ovarian cysts, how cysts on the ovaries form, if there is anything you can do to prevent them, and their potential impact on your reproductive health.

What are Ovarian Cysts?

Ovarian cysts are growths that can develop on or inside a woman’s ovaries. They are incredibly common, and if you have ovaries, chances are you’ve had one at some point without even knowing it.

Don’t let the word “growth” alarm you. The vast majority of ovarian cysts are benign (noncancerous), cause no harm, and disappear on their own without treatment or lasting effects.

Most cysts don’t even cause symptoms, and when they do, they often feel like menstrual cramps, bloating, or other typical hormonal changes. Because of this, many women only find out they have a cyst on their ovary when it’s discovered during a routine check-up.

Ovarian cysts come in different sizes, but most are small—typically around 1–3 centimeters. These tiny sacs are usually filled with fluid, which can vary depending on the type of cyst. Some contain clear fluid, others may have mucus-like material, and some can even hold old menstrual blood.

There are several types of ovarian cysts, and while most are harmless, some can cause complications. A few types are also linked with a lower chance of becoming pregnant, making them a concern for women trying to conceive.

We will go over each type in detail a little further down and deep dive into the common concern: Can ovarian cysts cause infertility? But first, let’s answer two of the biggest questions women have—what causes ovarian cysts, and is there any way to prevent them?

What Causes Ovarian Cysts?

Ovarian cysts can happen for a few different reasons, but most of the time, they’re just a normal part of having a period.

Each month, your ovaries grow little sacs called follicles that hold and release eggs. Usually, the follicle breaks open when it’s time to ovulate and then disappears. But sometimes, instead of going away, it fills with fluid and sticks around a little too long—that’s when it becomes a cyst.

Other causes of ovarian cysts include:

  • Hormonal Imbalances: Irregular ovulation or excess estrogen can lead to cyst formation.
  • Endometriosis: This condition causes tissue similar to the uterine lining to grow outside the uterus, sometimes forming cysts called endometriomas on the ovaries.
  • Pregnancy: Sometimes, a cyst forms early in pregnancy to support the growing embryo but doesn’t go away as expected.
  • Pelvic Infections: Severe infections can spread to the ovaries and lead to cyst-like abscesses.
  • Genetic or Structural Factors: Some women may be more prone to developing cysts due to genetic predisposition or underlying conditions affecting their ovaries.

Can You Avoid Ovarian Cysts?

Not exactly. Ovarian cysts aren’t like other health conditions, such as high blood pressure or diabetes, where there are lifestyle changes you can make to drastically lower your risk.

There’s no guaranteed way to prevent ovarian cysts. However, some things can potentially reduce the risk of developing them or help catch issues early.

  • Birth Control Pills: Hormonal birth control prevents ovulation, which lowers the chances of developing functional cysts (the most common type).
  • Treating Endometriosis: If you have endometriosis, managing the condition can lower the risk of developing endometriomas on the ovaries.
  • Regular Pelvic Exams: Routine check-ups help detect cysts early before they cause complications.

  • Addressing Underlying Health Issues: If you have frequent ovarian cysts, your doctor may check for hormonal disorders or other factors that could be contributing.

While you can’t completely prevent ovarian cysts, being in tune with your body and staying proactive about your health can help manage risks and catch problems early.

Types of Ovarian Cysts

There are various types of ovarian cysts. Most are harmless, asymptomatic and go away on their own without you ever knowing they were even there. Unless one is discovered during a pelvic exam, most women never know they have a cyst on their ovary.

That said, some ovarian cysts do cause symptoms. There are also types that can grow large, rupture, or lead to complications if left untreated, and others that have the potential to impact fertility.

The Most Common Types of Ovarian Cysts

Most ovarian cysts are functional, meaning they develop as a normal part of the menstrual cycle and are usually harmless. Here are the two most common types.

Follicular Cyst

This is the most common type of ovarian cyst. It develops when a follicle, a small sac in the ovary that contains an immature egg, does not rupture to release the egg during ovulation. Instead, the follicle continues to grow and fills with fluid, forming a cyst.

Follicular cysts are usually harmless, painless, and do not impact fertility. They often disappear on their own within a few menstrual cycles and rarely cause symptoms. Most people don’t even know they had one unless it was large.

If symptoms do occur, they may include mild abdominal discomfort (usually on one side), a delayed or missed period, and, in rare cases, pain during sex (typically only if the cyst is large).

Corpus Luteum Cysts

After an egg is released during ovulation, the empty follicle transforms into a structure called the corpus luteum, which produces hormones to support early pregnancy. Usually, it breaks down if pregnancy does not occur. However, sometimes, instead of breaking down, it fills with fluid and forms a cyst.

Corpus luteum cysts are usually harmless, rarely affect fertility, and often resolve on their own within a few weeks or months. They are generally asymptomatic, but when symptoms occur, they may include pelvic pain (usually on one side), bloating or a sensation of fullness, irregular or heavier periods, or mild spotting between cycles.

These cysts are more prone to rupture than follicular cysts, which can cause sudden, sharp pain. They may also cause pain during sex, especially if they are large, as vigorous movement can increase the risk of rupture.

Less Common Types of Ovarian Cysts

While less common, there are other types of ovarian cysts, some of which are more prone to being symptomatic and have the potential for complications or impact fertility.

Dermoid Cysts (Mature Cystic Teratomas)

These cysts develop from embryonic cells and can contain various types of tissue, such as hair, skin, teeth, or fat. They are usually benign but can grow large. In rare cases, they may cause ovarian torsion, a painful twisting of the ovary that requires emergency treatment.

Endometriomas

These cysts form due to endometriosis, a condition where uterine-like tissue grows outside the uterus. When endometrial tissue attaches to the ovary and forms a cyst, it is called an endometrioma. These cysts are often filled with dark, old blood, giving them the nickname “chocolate cysts.”

Endometriomas can cause severe pelvic pain, especially during your period and intercourse. Unlike follicular and corpus luteum cysts, endometriomas can impact fertility and are actually a leading cause of reproductive challenges.

Cystadenomas

These cysts develop from the cells covering the outer surface of the ovary and can be filled with either watery (serous cystadenoma) or mucus-like (mucinous cystadenoma) fluid.

While usually benign, they can grow quite large—sometimes over several inches in diameter—and may cause pressure, bloating, or discomfort. Large cystadenomas may require surgical removal.

The Connection Between Ovarian Cysts and Infertility

A frequent concern for women diagnosed with ovarian cysts is how they might impact becoming pregnant. Your ovaries are small, fruit-sized organs that play a crucial role in fertility by producing eggs and regulating hormones, so it makes sense that you would be concerned that any type of growth on or inside your ovaries has the potential to impact fertility.

The good news is that most ovarian cysts are harmless and don’t impact fertility. However, some can interfere with ovulation, ovarian function, or overall reproductive health– all things that can impact fertility.

The effect of an ovarian cyst on becoming pregnant depends on its type, size, and underlying cause. Some cysts form as part of the normal ovulation process and don’t cause any problems, while others result from conditions like endometriosis or PCOS, which can make it difficult to conceive.

Here is a breakdown of ovarian cysts that may impact fertility and those that typically do not:

Ovarian Cysts That Can Potentially Cause Fertility Issues:

  • Endometriomas: Associated with endometriosis, which can damage ovarian tissue and interfere with ovulation and implantation.

  • Large or Multiple Cystadenomas: Rare, but if they grow large enough, they may require surgery that could affect ovarian function.

  • Severe or Recurrent Corpus Luteum Cysts: Typically harmless, but in rare cases, repeated corpus luteum cysts or complications (like rupture or ovarian torsion) could impact ovarian function.

Ovarian Cysts That Do NOT Typically Affect Fertility:

  • Follicular Cysts: These form as part of the normal ovulation process and usually resolve on their own without affecting fertility.

  • Corpus Luteum Cysts: Unless, in rare cases, as noted above, corpus luteum cysts generally do not impact fertility.

  • Dermoid Cysts (Mature Cystic Teratomas): Usually benign and do not interfere with ovulation or hormone production.

Even if a cyst does affect fertility, treatment options—including medication, lifestyle changes, or surgical removal—can often improve your chances of conceiving.

If you’re trying to get pregnant and have concerns about ovarian cysts, your OBGYN or a fertility specialist can help determine the best course of action.

Signs You Might Have an Ovarian Cyst

Most ovarian cysts cause no symptoms and go away on their own. However, when symptoms do occur, regardless of the type, they can include:

  • Pelvic Pain (a dull or sharp ache, usually on one side of the lower abdomen)
  • Bloating or a feeling of fullness in the abdomen
  • Changes in your period (irregular, heavier, or lighter-than-normal bleeding)
  • Frequent urination or difficulty emptying the bladder
  • Pain during intercourse

If you experience sudden, severe abdominal pain or signs of internal bleeding (such as dizziness or fainting), you should seek immediate medical attention.

What is the Treatment for Ovarian Cysts?

In most cases, ovarian cysts resolve on their own without the need for treatment. If they do require treatment, what will depend on the type, size, and whether they cause symptoms.

Your OBGYN will determine the best course of action based on your specific situation, but the most common approaches include:

  • Watchful Waiting: Most cysts resolve on their own within a few months, only requiring monitoring through follow-up exams or ultrasounds.
  • Birth Control pills: Hormonal contraceptives can help prevent new cysts from forming but won’t shrink existing ones.

  • Surgery: If a cyst is large, causing severe symptoms, growing, or suspected to be cancerous, surgical removal may be necessary. This can be done through laparoscopy (minimally invasive surgery) or laparotomy (open surgery), depending on the case.
  • Pain Management: Over-the-counter pain relievers like ibuprofen may help with discomfort.

Polycystic Ovaries and PCOS: A Different Condition

Polycystic ovaries are not true ovarian cysts; they are a symptom of Polycystic Ovary Syndrome (PCOS), but it’s worth discussing polycystic ovaries because they are often confused with ovarian cysts. Additionally, while ovarian cysts are not the cause of PCOS, they can be a symptom of PCOS.

Both polycystic ovaries and ovarian cysts affect the arteries. Follicles in PCOS can even look like cysts on an ultrasound, but they are not the same as functional ovarian cysts like follicular or corpus luteum cysts. They differ in causes, symptoms, and impact on fertility.

Ovarian cysts are fluid-filled sacs that develop on or inside an ovary. They can form for various reasons, including normal ovulation, hormonal imbalances, or conditions like endometriosis. Most ovarian cysts are temporary, do not cause symptoms, and resolve on their own. Some, however, can grow large, cause pain, or lead to complications like rupture or ovarian torsion.

Polycystic ovaries, on the other hand, are a characteristic of PCOS, a hormonal disorder that affects ovulation. In PCOS, the ovaries contain many small, immature follicles (often mistaken for cysts) that fail to release eggs regularly. Unlike ovarian cysts, these follicles are not the result of fluid accumulation but rather an underlying hormonal imbalance that disrupts ovulation.

The biggest concern with PCOS is its long-term impact on fertility, metabolism, and overall health, whereas ovarian cysts typically only become an issue if they are large, painful, or persistent.

Having an ovarian cyst does not mean you have PCOS. Women can develop ovarian cysts without having PCOS, and not all women with PCOS develop large cysts. That said, ovarian cysts can be a symptom of PCOS.

If you’re experiencing irregular periods, difficulty conceiving, or symptoms like excess hair growth or acne, it’s worth discussing PCOS with your doctor. If you’ve been diagnosed with ovarian cysts, ensure you monitor them with your healthcare provider.

When To See A Doctor About Ovarian Cysts

Chances are, you’ve already had an ovarian cyst and never even knew it. Most ovarian cysts are harmless and go away on their own without causing any issues. However, there are times when a cyst on your ovary may need medical attention.

You should schedule an appointment with an OBGYN for evaluation if you have:

  • Ongoing pelvic pain or discomfort that doesn’t go away
  • Changes in your menstrual cycle, such as irregular periods or unusually heavy bleeding
  • Bloating, pressure, or a feeling of fullness in your lower abdomen
  • Pain during intercourse that is new or worsening
  • Difficulty getting pregnant, especially if you have been trying for a while

You should consider immediate medical care if you experience:

  • Sudden, severe pelvic pain (which could indicate a ruptured cyst or ovarian torsion)
  • Dizziness, weakness, or fainting (signs of internal bleeding or a medical emergency)
  • Rapid breathing or fever (possible infection or serious complications)

OBGYN Care in Middle Tennessee

If you have concerns about ovarian cysts and infertility and live in the Brentwood, Franklin, or Nashville, TN metropolitan area, our gynecologist is accepting new patients and would love to help with any concerns you have about ovarian cysts, fertility, pregnancy, or any other aspects of women’s health.

We understand it can often take months to get an appointment with an OBGYN, especially if you are a new patient. That’s why we leave room in our schedule just for new patients, making it easy to book your first appointment.