Ovarian Cysts: When to Worry and Surgical Considerations

Ovarian cyst

Hello, a few days ago I experienced mild abdominal swelling and pain.
A gynecological ultrasound revealed a mass over 6 centimeters, which the doctor suggested could be a cyst or a corpus luteum cyst.
Since it is fluid-filled and lacks solid tissue and septations, I was advised not to worry too much and to observe whether it would shrink and disappear on its own.
If not, surgery would be considered.
However, the next day, my family took me to a different hospital for another ultrasound, and the result showed it was 5 centimeters.
Does this indicate that it has shrunk, or could there be measurement differences between facilities? The hospital here recommends proceeding with surgery soon and does not advise delaying observation due to potential risks.
We understand that all medical procedures carry risks, but is my situation considered high risk, and is surgery truly necessary without prior observation? Additionally, regarding sexual experience, does non-invasive masturbation count? Could sexual activity lead to the formation of a cyst? Thank you.

Fei, 20~29 year old female. Ask Date: 2019/03/22

Dr. Huang Yuande reply Obstetrics and Gynecology

Thank you for your question.
In young women, ovarian cysts are often functional ovarian cysts that typically resolve on their own; however, close monitoring is still necessary.
Generally, surgery is required if the cyst is larger than 7 centimeters, if tumor markers are abnormal, or if there are abnormalities detected on ultrasound.
The difference between 6 centimeters and 5 centimeters could be attributed to measurement error.
The formation of cysts is related to masturbation and sexual activity.
The Chiayi Hospital of the Ministry of Health and Welfare cares about your health!

Reply Date: 2019/03/22

More Info

When it comes to ovarian cysts, particularly those that are classified as functional cysts such as follicular or corpus luteum cysts, it is essential to understand both the nature of these cysts and the appropriate management strategies. In your case, the ultrasound revealed a cyst measuring over 6 cm, which later measured 5 cm at a different facility. Variations in measurement can occur due to differences in technique, the timing of the ultrasound, and the resolution of the imaging equipment used. A decrease in size is generally a positive sign, indicating that the cyst may be resolving on its own.

Regarding the management of ovarian cysts, the recommendation to observe rather than immediately proceed to surgery is common practice, especially for functional cysts that are likely to resolve spontaneously. Functional cysts are typically benign and can often shrink or disappear within a few menstrual cycles. However, the decision to observe or to operate can depend on several factors, including the size of the cyst, the presence of symptoms, and any concerns about the potential for malignancy.

In your case, the recommendation for surgery may stem from concerns about the cyst's characteristics or your symptoms. If the cyst is causing significant pain or if there are atypical features that raise suspicion for a more serious condition, surgical intervention may be warranted. It's crucial to have a thorough discussion with your healthcare provider about the risks and benefits of surgery versus observation, especially considering your individual health history and any symptoms you may be experiencing.

As for your question regarding sexual activity and its potential impact on ovarian cysts, non-invasive sexual activities, such as masturbation, are generally not associated with the development of ovarian cysts. Ovarian cysts can occur due to normal physiological processes related to the menstrual cycle, and while certain conditions like endometriosis or polycystic ovary syndrome (PCOS) can lead to the formation of cysts, typical sexual activity does not cause them.

If you are experiencing persistent pain or other concerning symptoms, it is essential to communicate these to your healthcare provider. They can help determine whether further evaluation or intervention is necessary. Additionally, if you have any concerns about the risks associated with surgery or the nature of your cyst, seeking a second opinion from another gynecologist may provide additional clarity and reassurance.

In summary, while many ovarian cysts can be safely monitored, factors such as size, symptoms, and imaging characteristics can influence the decision to proceed with surgery. Open communication with your healthcare provider is key to making an informed decision that aligns with your health needs and concerns.

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