Ovarian and tubal cysts and masses are frequent findings in gynecology. Most of them are benign and disappear on their own or remain stable for years. A smaller number need closer monitoring or surgery, either because they cause symptoms or because they look suspicious.
Hearing that you have a cyst on the ovary or a mass in the tube often creates anxiety about cancer and fertility. A careful evaluation helps to distinguish what is common and benign from what requires more urgent attention.
In Lisbon, Dra. Joana Faria evaluates ovarian and tubal cysts and masses in Portuguese, English, French, and Spanish. The aim is to explain clearly what has been found, assess the level of risk and define a plan that makes sense for your life and your projects.
This page focuses on ovarian and tubal cysts and masses. For related topics you can also read the page on reproductive tract diseases and the specific pages about endometriosis, myomas and adenomyosis.
What it is
An ovarian cyst is a fluid filled sac that develops in or on the ovary. Most cysts are functional, which means they are part of the normal cycle and disappear spontaneously. Other cysts are benign tumors, endometriotic cysts or, more rarely, malignant tumors.
A tubal mass can be a hydrosalpinx, which is a tube dilated and filled with fluid, an inflammatory process or, less frequently, a tumor.
Common types of benign ovarian cysts include:
- Functional cysts such as follicular cysts and corpus luteum cysts, which usually regress over a few cycles.
- Benign tumors like dermoid cysts (mature teratomas) or serous and mucinous cystadenomas.
- Endometriotic cysts related to endometriosis, often filled with old blood.
Radiologists and gynecologists use ultrasound characteristics, size and how the cyst changes over time to decide whether it is likely to be benign or whether it needs further study.
Main symptoms and when to worry
Many ovarian cysts and tubal masses cause no symptoms and are found by chance during an ultrasound done for another reason.
When symptoms are present, they may include:
- Pain or discomfort in the lower abdomen on one or both sides.
- A feeling of fullness or pressure in the pelvis.
- Changes in the menstrual cycle, such as irregular bleeding or spotting.
- Pain during sexual intercourse, especially with deep penetration.
- In the case of large masses, visible increase in abdominal size.
You should seek urgent care if you experience:
- Sudden intense pelvic pain, often on one side, sometimes with nausea or vomiting, which can be a sign of torsion of an ovary or cyst.
- Pain with fever and general malaise, which can suggest infection.
- Very heavy bleeding, dizziness or fainting.
These situations do not always mean a serious problem, but they must be evaluated quickly to exclude emergencies.
Diagnosis: exams and what to expect
Diagnosing and classifying ovarian and tubal cysts and masses relies mainly on imaging, especially ultrasound, combined with your age, symptoms and personal and family history.
During the evaluation, you can expect:
- Clinical history
Discussion about your menstrual cycle, pain, digestive and urinary symptoms, previous cysts or surgeries and any family history of ovarian or breast cancer. - Gynecologic examination
Assessment of the vulva, vagina and cervix and bimanual palpation to feel the uterus and adnexa and to check for tenderness or masses. - Transvaginal and abdominal pelvic ultrasound
Key exam to characterise the cyst or mass. The report describes size, internal structure, presence of septa or solid areas, blood flow and whether one or both sides are affected. - Follow up ultrasound
In many cases, repeating the exam after a few weeks or months helps to see whether the cyst is regressing, stable or growing. - Blood tests
Sometimes tumor markers such as CA125 or other tests are requested. These markers are not specific for cancer and can be altered in many benign conditions, but they are useful in some contexts, especially around menopause. - MRI or CT scan
In selected cases, advanced imaging adds detail before deciding about surgery.
Most of the time, these elements are enough to define whether the cyst or mass can be monitored or whether surgery is advisable. Dra. Joana Faria will go through the exam results with you step by step.
Treatment options and realistic expectations
Treatment depends on several factors: your age, whether you are before or after menopause, your symptoms, the size and appearance of the cyst or mass and your plans regarding pregnancy.
Main approaches include:
- Watchful waiting
Many functional cysts and clearly benign lesions can be monitored with periodic ultrasound, especially in young women without symptoms. The advantage is avoiding unnecessary surgery. The limit is the need to repeat exams and to re evaluate if symptoms appear or change. - Hormonal treatment
Hormonal contraception and other hormonal treatments may reduce the formation of functional cysts and help control pain, especially when cysts are related to ovulation or to endometriosis. They do not make all cysts disappear but can reduce new ones. - Surgical treatment
Laparoscopic surgery is often used to remove cysts while preserving as much healthy ovarian tissue as possible. In some situations, especially for very large or complex masses or when cancer is suspected, a larger incision or more extensive surgery may be needed. The cyst is analysed in the laboratory to confirm its nature. - Management focused on fertility
When you are trying to conceive, it is important to balance the benefits of removing a cyst with the need to protect ovarian reserve. In some cases, a conservative approach with close monitoring is preferable to immediate surgery.
Realistic expectations are important. Even after successful surgery, new functional cysts can appear in the future. Endometriotic cysts can recur, especially if endometriosis is active and there is no hormonal suppression. The aim is to choose the strategy that offers the best balance between safety, symptoms and fertility preservation.
How Dra. Joana Faria approaches ovarian and tubal cysts and masses in practice
Dra. Joana Faria knows that reading an ultrasound report can be worrying, especially when it includes terms like complex mass or solid component. Her approach is to translate this language into clear information and to focus on your individual risk, not only on isolated words.
In daily practice she:
- Listens to your symptoms and personal history before deciding on any intervention.
- Reviews ultrasound and MRI images with you whenever possible so that you can see what the report describes.
- Explains which characteristics suggest a benign cyst and which ones justify a more cautious approach.
- Discusses in detail the pros and cons of monitoring versus surgery, including impact on recovery and on ovarian reserve.
- Works with experienced surgical teams when surgery is needed and coordinates care with fertility and oncology specialists when appropriate.
The goal is that you feel informed and supported, with a plan that is adapted to your situation instead of a one size fits all recommendation.
