Ovarian Cysts

What are ovarian cysts? 

Ovarian cysts are fluid-filled sacs that form on or within the ovaries. They are relatively common, particularly during the reproductive years, and are often found incidentally during routine pelvic scans. Most cysts are benign, cause no symptoms, and resolve on their own. However, some can become large, painful, or cause complications that need to be treated.

There are several types of ovarian cysts. The most common are functional cysts, which develop as part of the menstrual cycle:

• Follicular cysts — occur when a follicle fails to release an egg and continues to grow.

• Corpus luteum cysts — form after ovulation, when the follicle seals off and fluid accumulates inside.

Other, less common types include:

• Dermoid cysts (teratomas) — contain tissue such as hair, skin or teeth, as they originate from germ cells.

• Endometriomas — develop in people with endometriosis, when endometrial-like tissue attaches to the ovary.

• Cystadenomas — arise from the ovarian surface and may contain watery or mucous material.

In rare cases, they may rupture or lead to ovarian torsion, a serious condition where the ovary twists on itself, cutting off its blood supply.

What causes ovarian cysts? 

Ovarian cysts can form for a variety of reasons; some linked to the normal hormonal changes of the menstrual cycle, and others due to underlying medical conditions.

• Hormonal fluctuations — play a key role in the formation of functional cysts. These cysts are usually harmless and often resolve on their own within a few weeks or months.

• Endometriosis — may lead to the formation of endometriomas when tissue similar to the uterine lining grows on the ovaries.

• Pregnancy — can result in a corpus luteum cyst, which supports early pregnancy but may persist and enlarge.

• Severe pelvic infections — may spread to the ovaries and fallopian tubes, forming abscesses or inflammatory cysts.

• Previous ovarian cysts — increase the likelihood of developing more in the future.

In most cases, cyst formation is not something you can control or prevent entirely. However, regular check-ups and pelvic scans can help detect cysts early and guide appropriate management.

What are the symptoms of ovarian cysts? 

Many ovarian cysts cause no symptoms at all and are only discovered during routine pelvic exams or imaging. However, some cysts, particularly larger or more complex ones, can lead to noticeable discomfort or changes in your menstrual and pelvic health.

Common symptoms include:

• Pelvic pain or pressure — may cause chronic pelvic pain that is dull or sharp, and can come and go or persist on one side.

• Abdominal bloating or swelling — caused by a growing cyst pressing on nearby structures.

• Menstrual irregularities — such as delayed, heavier or lighter periods.

• Pain during intercourse — especially with deep penetration.

• Frequent urge to urinate — due to pressure on the bladder.

• Difficulty emptying the bladder or bowel — in some cases, cysts may press against these organs.

• Lower back or thigh pain — if the cyst causes referred pain.

• Sudden, severe pelvic pain — which may indicate a ruptured cyst or ovarian torsion and requires immediate medical attention.

Who is at risk of ovarian cysts in Singapore? 

Ovarian cysts can affect women of all ages, but certain factors, whether hormonal, medical or lifestyle-related, may increase the likelihood of developing them. 

You may be at higher risk if you:

• Are of reproductive age — functional cysts are most common between menarche and menopause.

• Have irregular menstrual cycles — due to fluctuating hormone levels.

• Have a history of ovarian cysts — past occurrences raise the chances of recurrence.

• Have polycystic ovary syndrome (PCOS) — PCOS is a condition where multiple small cysts form on the ovaries.

• Have endometriosis — which may lead to endometriotic cysts or endometriomas.

• Are undergoing fertility treatment — ovulation-inducing drugs can increase the risk of cyst formation.

• Have had pelvic infections — which may cause inflammation and secondary cysts.

• Are pregnant — especially in early pregnancy when corpus luteum cysts may form.

How are ovarian cysts diagnosed? 

If you are experiencing pelvic discomfort or your scan has picked up something unusual, it’s natural to feel concerned. Diagnostic tests are often recommended, like:

• Pelvic examination — to check for swelling, tenderness or a mass in the lower abdomen.

• Transvaginal ultrasound — provides clear images of the ovaries, which helps us assess the size, shape, and type of cyst.

• Abdominal ultrasound — may be used in addition to or instead of transvaginal scans, depending on your comfort or situation

• Hormone tests — to evaluate oestrogen, progesterone, LH, FSH, or testosterone levels if there are concerns about irregular cycles or PCOS.

• Tumour marker blood tests — such as CA-125 may be done if a cyst appears suspicious or complex.

• Follow-up scans — to track any changes in the cyst’s size or appearance over time.

What are the treatment options for ovarian cysts in Singapore? 

Not all ovarian cysts need treatment and many go away on their own. However, when they cause symptoms, grow in size, or show signs of complexity, the right medical care can make all the difference. At Holistic Gynaecology & Fertility, we offer a range of treatment options tailored to your needs, health goals, and lifestyle. 

Depending on your situation, treatment may include:

• Monitoring — small, symptomless cysts often resolve naturally, and we monitor them with regular ultrasounds and check-ups.

• Hormonal therapy — such as birth control pills to help regulate your cycle and reduce the chances of new cysts forming.

• Pain management — using safe, targeted medications to ease discomfort and improve your daily comfort.

• Laparoscopic (keyhole) surgery — a minimally invasive procedure to remove larger or persistent cysts while preserving your ovaries when possible.

• Laparotomy — a more extensive surgery that may be required for very large or potentially cancerous cysts.

• Holistic support — including lifestyle advice, stress management, and integrative approaches for women looking for non-surgical support alongside medical care.

Summary

These fluid-filled sacs usually aren’t a cause for concern, and can resolve on their own. However, if you start experiencing pelvic discomfort, irregular periods, or have concerns about ovarian cysts, schedule a consultation with us for a personalised assessment and treatment plan tailored to your needs.