From the Guidelines
For ovarian cysts, the primary precaution is regular monitoring through pelvic exams and ultrasounds, especially for cysts larger than 5 cm or those causing symptoms, as most cysts are functional and resolve spontaneously without intervention 1.
Key Precautions
- Regular monitoring with pelvic exams and ultrasounds is crucial, particularly for cysts larger than 5 cm or those causing symptoms.
- Over-the-counter pain relievers like ibuprofen (400-600 mg every 6 hours) or acetaminophen (500-1000 mg every 6 hours) can help manage discomfort.
- Birth control pills may be prescribed to prevent new cyst formation, typically taken daily for 3-6 months.
- It is essential to watch for warning signs requiring immediate medical attention: severe pelvic pain, fever, vomiting, rapid breathing, dizziness, or weakness, as these could indicate cyst rupture or torsion.
Lifestyle Recommendations
- Maintaining a healthy lifestyle with regular exercise and a balanced diet supports overall reproductive health.
- Most ovarian cysts resolve spontaneously within 1-3 menstrual cycles without intervention.
Medical Evaluation and Surgery
- However, persistent or complex cysts require medical evaluation to rule out serious conditions.
- If surgery becomes necessary, laparoscopic procedures are typically used, allowing for shorter recovery times compared to open surgery 1.
Risk of Malignancy
- The risk of malignancy in simple cysts is very low, with studies suggesting that simple cysts, regardless of size and menopausal status, are not associated with an increased risk of cancer 1.
- A recent meta-analysis demonstrated that in 987 unilocular cysts removed surgically in premenopausal women, the risk of malignancy was 0.6% 1.
From the Research
Precautions for Ovarian Cysts
To manage ovarian cysts effectively, several precautions can be taken:
- Refrain from exercise or strenuous activity if regression to normal ovarian size has not been documented, as exercise-induced ovarian torsion is a potential risk 2
- Avoid using combined oral contraceptives as a treatment for functional ovarian cysts, as they do not hasten resolution of the cysts 3, 4
- Consider watchful waiting for two or three cycles, as most cysts resolve without treatment within a few cycles 3, 4
- If cysts persist, surgical management may be indicated, especially for pathological cysts such as endometrioma or para-ovarian cyst 3, 4
- In cases of ovarian cyst accidents, such as rupture, haemorrhage, or torsion, early laparoscopy and de-torsion of the twisted tube or ovary may be necessary 5
- For recurrent cyst rupture or haemorrhage, suppression of ovulation with combined oral contraceptives and fixation of the ovary may be considered to prevent recurrent torsion 5
- During pregnancy, a waiting policy is often advocated for unilocular and anechoic ovarian cysts with thin borders, while ovarian cysts at risk of complication (size > or =6 cm) may require scheduled surgery, ideally in the beginning of the second trimester 6