Think of ovarian cysts as the pimples of the reproductive system: mostly benign, sometimes painful, and annoying AF.
Usually, your ovaries (those reproductive organs where eggs are produced) chug along according to schedule. But sometimes, they can develop ovarian cysts—tiny fluid- or tissue-filled sacs that are typically no big deal.
Hold on, tell me a little more about ovarian cysts
'The vast majority of ovarian cysts are benign, follicular cysts that come and go with your cycle and need no further management' says Dr Taraneh Shirazian, M.D., a gynaecologist at NYU Langone Health. You likely don't even notice them—according to the Office on Women's Health (OWH), most women make at least one cyst each month, due to their regular periods.
But sometimes, the cysts are too large, there are too many, or they just don't go away on their own, says Shirazian. In those cases, surgery could be required so they don't become cancerous or cause too many hellish symptoms.
And 'hellish' isn't an understatement—if a cyst (or cysts) start causing issues, you'll feel it; and, left untreated, problematic cysts could rupture or even grow large enough to make your ovary twist around the fallopian tube, according to the American College of Obstetricians and Gynecologists (ACOG). That's known as ovarian torsion, which can cause sudden, severe pain and the possible loss of your ovary.
Luckily, those little cysts show signs once they start to go rogue—here's what to look out for, so you can call your doctor ASAP and get things taken care of.
1. You have some pretty awful pelvic pain
The most common ovarian cyst symptom is pain in the lower right or left side of the pelvis, right where the ovaries are, says Shirazian—and it doesn't go away. 'You might feel it when you exercise, you might feel it when you’re sexually active, but it will be a pain in that specific place that is constant and stays even after your menstrual cycle goes away.'
If the pain becomes severe or even unbearable, it's a sign that you might have an ovarian torsion, says Shirazian. When that happens, it cuts off the ovary's blood supply, which causes really bad pain, says Shirazian—the type that will send you straight to the emergency room (hopefully).
2. You're feeling super-bloated
Swelling is obviously a vague symptom, but it can be related to ovarian cysts depending on their size. 'Most women experience cysts under 10 centimetres. But some cysts can grow to be very big, like the size of a watermelon,' says Dr Eloise Chapman-Davis, a gynaecological oncologist at Weill Cornell Medicine and New York-Presbyterian.
'Many women will write that off as weight gain, but abdominal pain and bloating could be the result of a mass growing in the stomach. So if the weight is only in your stomach, or you can't figure out any reason you'd be gaining weight in the first place, that's a red flag.'
3. You feel full all the time
Like with uterine fibroids, ovarian cysts can cause a feeling a heaviness in the abdomen. 'A cyst is a mass, and it’s occupying space, which can give you that feeling of pressure,' says Shirazian.
Sure, you can get a somewhat similar feeling with constipation, but unless you have cysts in both ovaries, this sensation will only strike one side of your pelvis. If your bathroom habits are fine, but you've been feeling this way for two to three weeks, it's worth finding out if an ovarian cyst might be to blame, Chapman-Davis says.
4. You don't want to have sex because it hurts
Here's the thing: Sex should never hurt, so if it does, it means something is up. If you’re having penetrative sex and you feel pain on one side versus the other, there’s a chance it could be related to an ovarian cyst.
'Some cysts, when they become big, can fall behind the uterus, and in that case are sitting right by your cervix,' says Chapman-Davis. 'So you might feel pain with deep penetration.' Endometriomas (ovarian cysts related to endometriosis) can also cause pain during sex, because they’re located closer to the cervix, she adds.
5. You feel like you have to go wee all the time (but sometimes can't go)
Another symptom of ovarian cysts that many women mention, according to Chapman-Davis, is feeling the urge to pee all of the time. 'If the cyst is pushing against your bladder, you may feel like you have to urinate,' she says. 'Or some women feel that they need to go more frequently, but it’s harder for them to go,' because of a blockage by the cyst.
6. You have constant back or leg pain
Of course, back or leg pain could be attributed to a ton of different things, but if your doc has ruled everything else out, it might be worth exploring an ovarian cyst as a reason.
Ovarian cysts can hurt your back or legs when they become too big. 'You don’t have that much room in your pelvis, so when a cyst gets too large, depending on where it is in the pelvis, it can lead to back or leg pain,' says Chapman-Davis, explaining that cysts can compress the nerves that run along the back of your pelvis.
7. You're experiencing bleeding outside of your normal cycle
When ovarian cysts develop, they can mess with your hormones—women with polycystic ovarian syndrome (PCOS), which basically means they develop tons of little cysts on their ovaries, can often experience irregular bleeding, whether due to frequent ovulation or a lack of ovulation.
That's because of an imbalance of oestrogen, progesterone, and testosterone, says Dr Alyssa Dweck, ob-gyn and author of The Complete A to Z for Your V. If you're experiencing other symptoms commonly associated with PCOS, like weight gain, fertility issues, and acne, it's best to bring it up to your doc.
