Symptoms of malignant and benign ovarian cysts

Written by Xia Hu
Obstetrics and Gynecology
Updated on May 19, 2025
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Some benign ovarian cyst symptoms are relatively mild, with the most common being slight lower abdominal bloating and pain. However, if there are malignant changes, the pain can be more severe, often causing widespread abdominal pain and even cramp-like pain similar to intestinal obstruction. If the malignant tumor metastasizes, nearby areas may show symptoms. For example, if it spreads to the bladder, symptoms such as frequent urination and urgency can occur. If it metastasizes to the intestines causing intestinal obstruction or adhesions, it may lead to abdominal bloating, lower abdominal pain, cessation of passing gas, and even vomiting. Distant metastasis, such as to the lungs, might present symptoms like coughing and coughing up blood, so the symptoms of malignant tumors tend to be more varied.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Symptoms of benign ovarian cysts

When women develop benign ovarian cysts, the clinical symptoms are somewhat related to the number and size of the cysts. For example, when the cysts are relatively small in diameter, they usually exhibit no clinical manifestations and are often only discovered during routine gynecological exams or ultrasound screenings. As the cysts grow in size, some women may experience heaviness and pain on one side of the lower abdomen, along with a sore back. These abdominal symptoms can worsen with excessive fatigue, staying up late, or during intercourse. Some women may also experience abnormalities in their menstrual cycle, such as changes in the amount of menstrual bleeding, duration of menstruation, or irregular vaginal bleeding.

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Written by Shen Li Wen
Obstetrics and Gynecology
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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.

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Written by Xia Hu
Obstetrics and Gynecology
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Causes of ovarian cysts

There are several common causes of ovarian cysts. The first is during the ovulation process where the follicle fails to release an egg, resulting in the formation of follicular cysts. The ultrasound typically shows these as simple cysts containing follicular fluid. Another situation is the corpus luteum cyst, which occurs after ovulation when the ovary forms a wound surface and a corpus luteum. Cysts can also develop during the growth of the corpus luteum. These two types of cysts generally disappear after the next menstrual period and are considered physiological cysts that usually require no treatment. However, some cysts result from pathological changes in ovarian cells, or even from tumors. On an ultrasound, these appear differently, often as mixed composition masses, in which case surgical treatment is recommended.

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Written by Liu Jian Wei
Obstetrics and Gynecology
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How to eliminate ovarian cysts?

Currently, most ovarian cysts in clinical practice require surgical removal. However, not all ovarian cysts need to be removed surgically. For some ovarian cysts, such as pelvic inflammatory cysts, anti-inflammatory treatment can be given first. After one course of anti-inflammatory treatment, the treatment effect should be evaluated. If the treatment effect is unsatisfactory, surgical treatment can be considered again. Furthermore, if the ovarian cyst is not large, it is also not indicated for surgical removal. Therefore, the severity of the condition needs to be assessed before treating an ovarian cyst.

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Written by Hou Jie
Obstetrics and Gynecology
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Causes of ovarian cysts

The cause of ovarian cysts is unclear, with many factors that can lead to ovarian cysts. The most common type of physiological ovarian cyst is the follicular cyst. The most common pathological causes are chronic inflammation or abnormalities in hormone secretion and endocrine factors, but most causes are unclear. If an ovarian cyst is discovered, it is recommended to regularly check with a color Doppler ultrasound, which is a common gynecological test for tumor markers. If the results are abnormal, timely surgical treatment is recommended to more directly understand the nature of the ovarian cyst. If the cyst is smaller than five centimeters in diameter and has good internal sound transmission, it can be observed regularly; otherwise, aggressive surgical treatment is advised.