How Ovarian Cysts Are Treated

Ovarian cysts are common in people with ovaries. Most cysts are asymptomatic (have no symptoms) and don't require medical treatment.

Ovarian cysts often heal on their own. When they don't, treatments can help. These vary based on factors such as your age and the size of the cyst. In some instances, an ovarian cyst may rupture. Some cysts may also become large or cause symptoms, such as pain during menstruation or sex. In these instances, treatment may be needed.

Your healthcare provider may recommend at-home strategies for symptomatic cysts, such as taking nonprescription pain medication. They may also recommend watchful waiting to monitor an existing cyst. In some instances, surgery to remove the cyst may be needed.

Ovarian cysts can be symptoms of conditions that affect fertility. Treatments ranging from preventive medication to surgery may be recommended if you have an underlying condition that causes cysts, such as polycystic ovary syndrome (PCOS, in which there are multiple cysts on the ovaries and a hormonal imbalance) or endometriosis (a condition in which the uterine lining grows outside of the uterus).

This article will discuss the various treatments for ovarian cysts and explain when each is needed.

Over-the-Counter (OTC) Therapies

Functional ovarian cysts form during ovulation and are the most common type. Functional cysts are usually asymptomatic and resolve within one to three months without treatment. In some instances, they may cause pain or abdominal pressure that feels similar to menstrual cramps.

Mild pain or discomfort may be helped by taking OTC pain medication, such as:

• Advil or Motrin (ibuprofen)
• Aleve (naproxen)
• Tylenol (acetaminophen)

Cyst pain or discomfort that doesn’t go away easily or that lasts longer than several days should be brought to your healthcare provider’s attention.

Watchful waiting and diagnostic testing with pelvic ultrasound (uses sound waves to produce images) may be recommended for several months. This will help your healthcare provider keep track of changes in the cyst's appearance or size.

Prescriptions

Prescriptions for ovarian cysts may include pain medication and contraceptives containing hormones.

Hormonal Medication

Hormonal contraceptives, such as birth control pills, are sometimes used to prevent the formation of ovarian cysts. If you have a history of recurrent ovarian cysts, such as those caused by PCOS, your healthcare provider may recommend this treatment.  

Oral contraceptives prevent you from ovulating naturally. This can stop functional cysts from developing. The use of oral contraceptives to prevent cysts from forming is commonplace. However, evidence is lacking about its effectiveness in treating existing cysts.  

Birth control pills and other hormonal medications may also treat ovarian endometriomas (cysts caused by endometriosis). Hormonal medication won’t stop ovarian endometriomas from forming, but it may stop them from enlarging.

Pain Medication

If the pain caused by ovarian cysts doesn't respond to OTC drugs, your healthcare provider may prescribe stronger pain medication. Ruptured cysts may sometimes cause pain that requires prescription medication for relief.

Some prescription pain medications have side effects, including dizziness, nausea, and the potential for addiction. Talk to your healthcare provider about the benefits and risks of any drug prescribed for ovarian cyst pain.

Surgeries and Specialist-Driven Procedures

Surgery may be needed in some cases of ovarian cysts. This includes laparoscopy and laparotomy.

Laparoscopy (Laparoscopic Ovarian Cystectomy)

In some instances, ovarian cyst surgery may be required to remove a large, infected, or ruptured cyst. Symptomatic ovarian endometriomas may also be removed laparoscopically.

The procedure most often used to remove ovarian cysts is laparoscopic ovarian cystectomy. Your surgeon will make one or more incisions (cuts) in your abdomen. They will insert a thin tube with a camera on its tip (laparoscope) through the incision and remove the cyst with surgical instruments.

Ruptured cysts can cause extensive bleeding and severe pain. These symptoms signal a potential medical emergency and the need for surgery.

Infected ovarian cysts are sometimes caused by pelvic inflammatory disease (PID). If an infected cyst ruptures, sepsis (a life-threatening reaction to an infection) can result. Infected cysts that don't respond to antibiotics may be removed via surgical incision and drainage.

Ovarian endometriomas can be very painful and typically indicate severe endometriosis. Removal of endometriomas may improve your ability to get pregnant naturally.

However, their removal may also reduce fertility potential by lowering ovarian reserve (the possible quantity of eggs in the ovaries). If you are planning to become pregnant, talk to a fertility specialist, such as a reproductive endocrinologist, about endometrioma treatment and other options you may have.

Laparotomy

Laparotomy may be recommended to remove very large cysts and cancerous (malignant) cysts. Instead of multiple small cuts, your surgeon will make one large incision in your abdomen to remove the cyst.

Malignant cysts are uncommon. They're most likely to occur in people who have gone through menopause (the time marking 12 straight months without a menstrual cycle). If cancer in an ovarian cyst is confirmed with a biopsy (removing a sample of tissue to be analyzed in a lab), the entire ovary may be removed during a laparotomy.

Summary

Ovarian cysts are common in people with ovaries during their reproductive years. Ovarian cysts often resolve on their own without the need for treatment. Cysts that are large, ruptured, or infected may require treatments ranging from taking over-the-counter pain medication to surgery.

A Word From Verywell

If you have pain during your periods or sex, talk to your healthcare provider. You may have an ovarian cyst that requires some type of treatment. Cysts usually resolve on their own, but not always. Having a healthcare provider's input can give you peace of mind plus guide you toward treatments that can improve your quality of life.