Can an ovarian cyst cause a delayed menstrual period (menstruation)?

From the Guidelines

Yes, an ovarian cyst can cause a late period. Ovarian cysts are fluid-filled sacs that develop on or within the ovaries and can disrupt normal hormonal balance and ovulation patterns. Functional cysts like follicular cysts or corpus luteum cysts are particularly likely to affect menstruation timing. These cysts can alter hormone production, especially estrogen and progesterone, which regulate the menstrual cycle. When hormone levels are disrupted, the endometrial lining may not shed on schedule, resulting in a delayed period.

Key Points to Consider

• Polycystic ovary syndrome (PCOS), characterized by multiple small cysts on the ovaries, commonly causes irregular or missed periods due to hormonal imbalances and anovulation 1.
• If you experience a late period along with symptoms like pelvic pain, bloating, or unusual fullness, it's advisable to consult a healthcare provider. They may recommend an ultrasound to check for cysts and determine appropriate management, which could range from watchful waiting to hormonal medication or, in rare cases, surgical intervention depending on the type, size, and symptoms of the cyst 1.
• The O-RADS US risk stratification and management system provides a means to consistently interpret and manage adnexal lesions, including ovarian cysts, based on their risk of malignancy 1.
• The system categorizes lesions into different risk categories, including physiologic, almost certainly benign, low risk, intermediate risk, and high risk, to guide management decisions 1.
• For example, simple cysts less than 3 cm in diameter are considered physiologic and do not require further management, while larger cysts or those with solid components may require follow-up or referral to a specialist 1.
• It's essential to note that the risk of malignancy in ovarian cysts is generally low, especially in premenopausal women, and most cysts can be managed conservatively with regular follow-up 1.
• However, if a cyst is suspected to be malignant or is causing symptoms, surgical intervention may be necessary to remove the cyst and prevent potential complications 1.

From the Research

Ovarian Cysts and Menstrual Disturbances

• Ovarian cysts can cause menstrual disturbances, including irregular vaginal bleeding or menorrhagia, particularly functional cysts 2.
• The presence of an ovarian cyst can lead to symptoms such as pelvic pain, pressure symptoms, and discomfort, which may be associated with menstrual irregularities 2.
• Functional cysts, which are common in premenopausal women, can resolve spontaneously without the need for intervention, but may be linked to irregular menstrual bleeding 2, 3.

Relationship Between Ovarian Cysts and Late Periods

• While there is no direct evidence that ovarian cysts can cause a period to be late, menstrual disturbances, including irregular bleeding, can occur in women with ovarian cysts 2, 4.
• The use of hormonal contraception, such as progestogen-only oral contraception, can increase the frequency of functional ovarian cysts, which may be associated with menstrual irregularities, including changes in menstrual cycle length 4, 5.
• However, the relationship between ovarian cysts and late periods is not well established, and more research is needed to understand the potential effects of ovarian cysts on menstrual cycle length 2, 3, 6.