When Do Ovarian Cysts Need to Be Removed?

Ovarian cysts are fluid-filled sacs that appear on or near your ovaries. Researchers estimate that between 8% and 18% of women experience ovarian cysts, even if they’re past menopause. Most ovarian cysts are benign, but some can become malignant (cancerous) or result in other complications, such as a painful rupture or twisted ovary.

When expert OB/GYN Emil W. Tajzoy, MD, PLLC, diagnoses ovarian cysts, he also tells you what type of cyst you have. The type of cyst determines whether your best course of action is to remove the cyst, let it resolve on its own, start hormone therapy, or watch and wait.

Functional cysts

Functional cysts form during your normal menstrual cycle. The two types of functional cysts are:

Follicular cysts

Follicular cysts occur when the follicular sac in which your egg grows doesn’t release the egg. Follicular cysts usually resolve within a couple of menstrual cycles.

Corpus luteum cysts

Corpus luteum cysts occur when the follicle does release the egg, but fluid builds up in the follicular sac. Corpus luteum cysts also usually resolve on their own, but may cause pain or bleeding.

Functional cysts are benign. If your cysts are small and aren’t causing any pain or symptoms, Dr. Tajzoy doesn’t recommend any treatment. If they’re causing pain or menstrual problems, he may prescribe birth control pills to prevent new cysts from forming. He may also advise periodic ultrasound studies to monitor the size of your cysts and ensure they resolve.


Nonfunctional ovarian cysts

Nonfunctional ovarian cysts aren’t related to your menstrual cycle or to the release of an egg. Most nonfunctional ovarian cysts are benign.  However, some have the potential to become malignant, rupture, twist your ovary, or grow large enough to cause symptoms.

Dermoid cysts

Dermoid cysts can be present from birth and are composed of skin, hair, muscle, and organ tissue. They’re almost always benign, but can twist or rupture. Large dermoid cysts may cause uncomfortable symptoms, in which case Dr. Tajzoy may recommend surgical removal.


If you have endometriosis, you may develop cysts that are related to the excess uterine lining tissue that forms around your ovaries. Endometrioma cysts are usually benign.


These large cysts form on the outside of your ovaries. They can grow very large, but are almost always benign. If they press on your bladder or cause discomfort, Dr. Tajzoy recommends surgical removal.

Malignant cysts

Some ovarian cysts that persist become cancerous as you age. However, this is rare. Dr. Tajzoy recommends yearly ultrasound screenings as part of a “watch and wait” strategy for persistent cysts that persist or occur after menopause. If your cyst looks suspicious for cancer, or if he suspects an ovarian tumor, he recommends immediate surgical removal.


Symptoms = Treatment

Most ovarian cysts resolve on their own or cause no symptoms or complications. Dr. Tajzoy monitors your cysts to ensure your health. If you experience any of the following symptoms, contact his office for an evaluation:

A ruptured cyst may only require pain management. Large, twisted, or cancerous cysts should be surgically removed.


Minimally invasive cyst removal

If Dr. Tajzoy recommends surgery for your cysts, he uses a minimally invasive laparoscopic approach whenever possible. You can recover from laparoscopic ovarian cyst removal in the comfort and privacy of your own home. When your cyst is suspicious for cancer, Dr. Tajzoy may refer you to a surgical oncologist.

If you notice troubling symptoms that may be related to ovarian cysts, or want to have your cysts monitored, contact our Dallas office by phone or using the online form.

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