Ovarian Cysts: What to Know
You went in for an ultrasound and there it was on the screen. Your doctor pointed to it, said it was a cyst on your ovary, and told you it was probably nothing to worry about. Probably. That word stayed with you.
Now you're aware of it. You feel a dull ache on one side that you may or may not have noticed before the ultrasound. You're wondering if the bloating you've been living with is related. You're wondering whether this is why your periods have been heavier, whether it could affect your fertility, whether "watch and wait" means something is wrong but no one is doing anything about it.
A cyst on your ovary sounds alarming. In most cases, it is a normal part of how your reproductive system functions. Understanding what type of cyst you have, whether it needs intervention, and what your body is communicating through it is what matters.
What Is an Ovarian Cyst?
An ovarian cyst is a fluid-filled sac that develops on or within an ovary. They are extremely common. Research published in the American Journal of Obstetrics and Gynecology estimates that most premenopausal women will develop at least one ovarian cyst during their reproductive years, and the majority will never know because the cyst forms, functions, and resolves without symptoms.
Your ovaries produce a follicle each cycle as an egg matures. Sometimes that process creates a cyst. These are called functional cysts, and they come in two forms. A follicular cyst develops when the follicle doesn't release the egg and continues to grow. A corpus luteum cyst forms when the follicle releases the egg but the sac doesn't shrink afterward and fills with fluid. Both types are benign and usually resolve within one to three menstrual cycles.
Other types of ovarian cysts have different origins and implications.
Endometriomas develop when endometrial tissue grows on the ovary, forming a cyst filled with old blood. These are associated with endometriosis and can affect fertility. For more on this condition, see our article on endometriosis and fertility.
Dermoid cysts (teratomas) contain tissue like hair, skin, or teeth. They are congenital, grow slowly, and are almost always benign. They can become large enough to require surgical removal.
Cystadenomas develop from ovarian tissue and can grow large, causing pressure and discomfort. They are typically benign.
This is why your ultrasound report matters. The type, size, and appearance of the cyst determine whether it needs treatment, monitoring, or will resolve on its own.
How Ovarian Cysts Show Up
Many cysts cause no symptoms at all. When symptoms are present, they can include a dull or sharp ache on one side of the lower abdomen, bloating or abdominal fullness, pelvic pressure, pain during intercourse, changes in menstrual bleeding, frequent urination, and a feeling of heaviness in the pelvis.
The character of the symptoms often reflects the type of cyst. Functional cysts tend to produce mild, cyclical discomfort that shifts with your menstrual cycle. Endometriomas are more likely to cause persistent pain, painful periods, and pain during intercourse. Large cysts of any type can cause pressure symptoms and bloating that worsens over weeks. For more on what pelvic pain communicates, see our article on painful periods.
When to seek urgent care. Sudden, severe pelvic pain with nausea or vomiting can indicate a ruptured cyst or ovarian torsion (twisting of the ovary). Both require immediate medical attention.
Do Ovarian Cysts Affect Fertility?
Most ovarian cysts do not prevent pregnancy. Functional cysts form as part of normal ovulation and typically resolve without affecting your ability to conceive.
The exceptions are specific. Endometriomas can affect fertility by damaging ovarian tissue, creating inflammation, and affecting egg quality. Research published in Fertility and Sterility found that endometriomas larger than 4 centimeters are associated with reduced ovarian reserve and lower IVF outcomes. Large cysts of any type can interfere with ovulation by compressing ovarian tissue.
PCOS deserves its own mention. The "cysts" in polycystic ovary syndrome are actually small, immature follicles, and they reflect a hormonal and metabolic condition that affects ovulation. PCOS is diagnosed based on a combination of irregular ovulation, elevated androgens, and characteristic ovarian appearance. It requires a different treatment approach than a single ovarian cyst. For more on this condition, see our article on PCOS and fertility.
If you have an ovarian cyst and are trying to conceive, the type and size of the cyst determine whether it's relevant to your fertility. Your RE can advise based on imaging.
Why Cysts Develop
Hormonal patterns. Functional cysts develop when the normal hormonal sequence of follicle growth, ovulation, and corpus luteum regression doesn't complete as expected. Hormonal imbalances, including estrogen dominance and anovulatory cycles, can increase the likelihood of cyst formation. For more on how these hormonal patterns work, see our article on irregular periods.
Endometriosis. Endometriomas form as a direct result of endometrial tissue growing on the ovary. The underlying drivers of endometriosis, including inflammation, immune dysregulation, and hormonal imbalance, are also the drivers of these cysts.
Inflammation. Chronic inflammation in the pelvic environment can contribute to cyst formation and persistence. Research published in Obstetrics & Gynecology found that inflammatory markers are elevated in women with recurrent ovarian cysts, suggesting that the inflammatory environment plays a role in why some cysts persist while others resolve.
Stress and nervous system activation. Chronic stress affects the hypothalamic-pituitary-ovarian axis, which governs the hormonal cascade that controls follicle development and ovulation. When this communication is disrupted, the conditions for cyst formation increase.
Why Standard Approaches Often Fall Short
The standard approach to most ovarian cysts is watchful waiting: monitor the cyst with repeat ultrasounds and wait for it to resolve. For functional cysts, this is usually appropriate. Most will disappear within one to three cycles.
When cysts persist or recur, the standard response is hormonal birth control to suppress ovulation, which prevents new functional cysts from forming. This addresses cyst prevention but doesn't address what caused the hormonal imbalance that produced the cyst. If you stop the birth control, the pattern often resumes.
For large or complex cysts, surgery may be recommended. When a cyst needs to come out, surgery is the right intervention. What surgery doesn't address is the internal environment, including the hormonal patterns, inflammation, and circulatory issues that allowed the cyst to develop.
Many women we see have been through cycles of monitoring and waiting, sometimes for months, while their symptoms persist and their questions go unanswered. Understanding what your body is doing and supporting it through the process changes the experience.
What Actually Helps
Acupuncture. Research published in the Journal of Alternative and Complementary Medicine found that acupuncture influences the hypothalamic-pituitary-ovarian axis, supporting the hormonal communication that governs follicle development and ovulation. Acupuncture improves blood flow to the ovaries and pelvis, reduces inflammation, and calms the nervous system. For functional cysts, treatment supports the body's ability to resolve the cyst. For endometriomas and persistent cysts, treatment addresses the underlying patterns of stagnation and inflammation.
Chinese herbs. Herbal formulas for ovarian cysts are tailored to the specific pattern present. Blood stasis formulas address poor circulation and accumulation. Phlegm-damp formulas address metabolic imbalance. Qi stagnation formulas address stress and emotional constraint. The classical formula Gui Zhi Fu Ling Wan has been used for centuries in Chinese medicine for gynecological accumulations and has research supporting its use for ovarian cysts and endometriomas.
Anti-inflammatory nutrition. Reducing processed foods, sugar, excess dairy, and alcohol lowers systemic inflammation. Increasing vegetables, omega-3 fatty acids, quality protein, and fiber supports the anti-inflammatory environment. Blood sugar stability matters because insulin spikes affect hormonal balance and can promote cyst growth.
Stress regulation. Chronic stress disrupts the hormonal communication that governs your cycle. Acupuncture, breathwork, somatic practices, and sleep optimization all support the nervous system shift that allows the ovarian function to normalize.
What This Looks Like in Practice
A woman came to us at 33. She had been trying to conceive for eleven months and had just completed an unsuccessful IUI. During her follow-up imaging, her RE discovered a cyst on her right ovary, likely functional. He told her to wait and repeat the ultrasound in six weeks.
She checked her fertility tracking app every morning, logging her pain location and intensity like data she could control. She told us she needed to do something while she waited. The waiting without action was the hardest part.
She was experiencing pelvic pain on her right side, bloating that worsened premenstrually, and the emotional weight of an unsuccessful IUI compounded by a new diagnosis. Her RE wasn't concerned about the cyst, but she was.
We started with weekly acupuncture focused on improving pelvic circulation, reducing inflammation, and calming her nervous system. We added a modified Gui Zhi Fu Ling Wan formula to address blood stasis.
Her follow-up ultrasound at six weeks showed the cyst hadn't changed. She was discouraged. She told us she'd been doing everything right and her body still wasn't cooperating. We adjusted her herbs, added dietary changes to reduce inflammation, and stayed with the treatment plan.
By her third month, her bloating had resolved and the pelvic pain had faded. Her next ultrasound showed the cyst had decreased significantly. By month four, it was gone. She told us, quietly, that the cyst resolving had given her something she'd been missing since the failed IUI: the sense that her body was still working, still capable, still on her side.
She conceived two cycles later.
Read stories from women we've worked with →
Frequently Asked Questions
Do ovarian cysts go away on their own? Most functional cysts resolve within one to three menstrual cycles without treatment. Endometriomas and other complex cysts are less likely to resolve spontaneously and may require medical intervention or ongoing support. If a cyst persists beyond three months, or if symptoms worsen, further evaluation and treatment are appropriate.
Can ovarian cysts cause infertility? Most ovarian cysts do not affect fertility. Functional cysts are part of normal ovulation and typically resolve on their own. Endometriomas can impact fertility by damaging ovarian tissue and creating inflammation. Large cysts can interfere with ovulation. If you're trying to conceive, the type and size of the cyst determine whether intervention is needed.
What does ovarian cyst pain feel like? Ovarian cyst pain is typically a dull ache or pressure on one side of the lower abdomen. It may come and go with your cycle or be persistent. Sharp, sudden pain can indicate a ruptured cyst or ovarian torsion, both of which require immediate medical attention. Bloating, pain during intercourse, and changes in menstrual flow can also accompany ovarian cysts.
Your Next Step
If you've been diagnosed with an ovarian cyst and want to support your body while it's being monitored, or if you're experiencing symptoms that need attention, we can help. We look at the full picture, including your hormones, your cycle, your stress levels, and the inflammatory environment, and create a plan that addresses what's driving the pattern.
This is at the heart of our Preconception & Fertility stage. Our team has decades of combined training in Chinese medicine, somatic therapies, and nervous system regulation. If you recognize yourself in this article, we would be honored to support you.
Contact us at 212.432.1110 or info@fafwellness.com.
Keep Reading:
• Endometriosis and Fertility: What You Need to Know
• PCOS and Fertility: A Root-Cause Approach