Cysts that rupture may cause severe pain or discomfort at the time, and in polycystic ovaries there may be weight gain and skin hairiness too. Ovarian cysts are diagnosed by ultrasound scans, which are painless and identical to ones pregnant women have. Very large cysts can sometimes be felt by examining the abdomen but this is uncommon. Blood tests, such as a CA-125 test can evaluate the potential of a cyst to become malignant, especially if there is a strong family history of ovarian cancer, but this test can be flawed. Women with an elevated CA-125 may have no cancer whereas a normal level need not exclude cancer, so it must always be used in association with ultrasound scans.
Most cysts require no treatment.
Any cyst which is causing persisting symptoms, is enlarging or which causes concerns medically is removed surgically. This is usually through a keyhole, or laparoscopic incision and only requires a larger scar if the cyst is too large to remove otherwise. Ovarian cysts usually resolve spontaneously and cause no problems. The main problems requiring medical treatment include rupture of the cyst, bleeding into the cyst or twisting round on itself to cut off its blood supply. It is important to report any unusual abdominal pain, especially if this is around the time of ovulation, and any abdominal swelling should never be ignored.