Fluid-filled sacs that develop on the ovaries, extremely common in women of reproductive age. Most are functional cysts (follicular or corpus luteum) that resolve spontaneously within 1-3 menstrual cycles. Pathological cysts include dermoid cysts, endometriomas, and cystadenomas. Rarely, cysts may be malignant, especially in postmenopausal women.

• 1Transvaginal ultrasound
• 2CA-125 tumor marker (especially if postmenopausal)
• 3MRI for complex cysts
• 4CT scan (limited use)
• 5Pregnancy test
• 6Hormone level testing

Functional cysts resolve spontaneously in 80-90% of cases within 2-3 menstrual cycles. 5-10% of premenopausal women develop cysts requiring surgical intervention. Ovarian torsion occurs in 3-5% of cysts >5 cm. Malignancy risk is <1% in premenopausal women but increases to 15-20% in postmenopausal women with complex cysts. After surgical removal, recurrence occurs in 5-10%. Fertility generally preserved with cystectomy.

• Hormonal contraceptives (reduce functional cysts by 50%)
• Regular gynecologic examinations
• Early evaluation of pelvic pain
• Managing endometriosis if present
• Avoiding fertility medications when possible