Do ovarian cysts hurt?

Written by Xia Hu
Obstetrics and Gynecology
Updated on June 16, 2025
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Ovarian cysts are mostly painless, but larger cysts, especially those larger than 10cm and extending beyond the pelvic area, may cause some mild discomfort and bloating. Another scenario involves severe pain when there is torsion of the cyst's pedicle. Pain can also occur if the cyst becomes infected. Thus, treatment depends on the specific circumstances. Generally, simple cysts do not show obvious symptoms and are often discovered during routine examinations, especially during an ultrasound. If an ovarian cyst experiences torsion or infection, prompt treatment is necessary. Larger ovarian cysts may also require surgical intervention. Therefore, the treatment for ovarian cysts should be based on the presence of symptoms and size.

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Obstetrics and Gynecology
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Are ovarian cysts serious?

Ovarian tissue is very complex in composition. It is the site with the most types of primary tumors among all body organs. Different types of ovarian tumors exhibit significant differences in histological structure and biological behavior. Benign ovarian tumors are typically small, often asymptomatic, and are usually discovered incidentally during gynecological examinations. As cysts grow, one may experience abdominal bloating or feel a mass in the abdomen. During examination, abdominal distention can be observed, the mass is usually mobile, percussion shows a dull sound, and there is no shifting dullness. If the tumor is malignant, there are often no symptoms in the early stages; later stages mainly present with symptoms of abdominal bloating, abdominal masses, and gastrointestinal symptoms. If adhesions occur with surrounding tissues, symptoms of compression, such as abdominal pain, back pain, and leg pain may also appear. Therefore, ovarian tumors should be treated promptly once detected.

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Written by Xia Hu
Obstetrics and Gynecology
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Symptoms of ovarian cyst carcinogenesis

The main symptom of malignant transformation of ovarian cysts is increased abdominal pain, which generally occurs on one side, including either the left or right side, since the ovaries are present on both sides. If the cyst is unilateral, rapid growth can cause lower abdominal distension and pain. Therefore, when such symptoms aggravate, timely examination is necessary. Initially, a gynecological examination is recommended to assess the boundaries of the ovarian cyst and to palpate its nature and texture. These are essential evaluations. If there is a potential for malignancy, sometimes nodular changes, which may be metastases, can be detected in the posterior cul-de-sac. Subsequently, an ultrasound should be performed, with vaginal ultrasound generally providing greater accuracy.

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Ovarian cysts have no symptoms

Many ovarian cysts are asymptomatic, generally detected during physical examinations or gynecological assessments, sometimes palpable as masses. An ultrasound can confirm the diagnosis by assessing the size of the mass near the adnexa, as well as the location and characteristics of the cyst. Often after an ultrasound, it may also be necessary to check for ovarian tumor markers. This is because ultrasound may reveal mixed masses that could potentially be malignant. If tumor markers are normal, not elevated, the likelihood of malignancy is low. If an ovarian cyst is discovered, regular check-ups are necessary, typically involving ultrasound examinations as many individuals display no obvious symptoms.

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Written by Liu Jian Wei
Obstetrics and Gynecology
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What should I do if an ovarian cyst ruptures?

Ovarian cyst rupture refers to the expulsion of the fluid inside an ovarian cyst out of the cyst due to external forces. When an ovarian cyst ruptures, the patient can suddenly experience severe pain in the lower abdomen on one side, which is often unbearable. At the same time, symptoms such as nausea and vomiting may accompany the pain. If the fluid inside the cyst is irritating, for example, the fluid in an endometriosis cyst which resembles chocolate, this fluid can promote widespread abdominal pain. This irritation can lead to peritonitis. Generally, an ovarian cyst rupture requires immediate surgical intervention for treatment.

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Do ovarian cysts require the removal of the ovary?

When women discover ovarian cysts, it is not necessarily required to remove the entire ovary. For example, in women of childbearing age, the ovary can continue to ovulate, aiding in normal conception and secreting hormones to maintain normal endocrine function. In such cases, surgery to remove the ovarian cyst while preserving the healthy ovarian tissue can be performed. However, if a woman is nearing menopause or has already undergone menopause and discovers a large ovarian cyst, the function of the ovaries may have gradually declined or already ceased. If surgery is performed to remove the ovarian cyst, there is a possibility of recurrence, and the function of the ovary may already be lost. In this case, it might be appropriate to proceed with the removal of the ovary.