Ovarian cysts

Last updated: 27 Apr. 2026
Reviewed by: Specialist doctors from the Elfcare quality team

Do you ever feel a dull ache in your lower abdomen, notice irregular periods, or experience bloating before your cycle? These symptoms can sometimes point to ovarian cysts – small, fluid-filled sacs that form on or inside the ovaries.

Ovarian cysts are among the most common gynaecological findings and the vast majority are benign, resolving on their own without intervention. But some persist, grow, or signal underlying hormonal conditions that benefit from early identification.

Elfcare's pelvic MRI and hormonal blood panel give a complete picture of ovarian health, often revealing findings that ultrasound alone would miss.

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What are ovarian cysts?

An ovarian cyst is a fluid-filled sac that develops within or on the surface of an ovary. These are quite common during a woman’s reproductive years and often form as part of the normal menstrual cycle.

There are two main types:

  • Functional cysts: the most common type, forming when a follicle fails to release an egg or doesn't reabsorb after ovulation. They typically disappear within one to three menstrual cycles.

  • Endometriomas: cysts formed by endometrial tissue growing on the ovary; associated with endometriosis and can affect fertility.

  • Dermoid cysts: benign tumours containing tissue such as hair or fat; grow slowly and rarely resolve without surgical removal.

  • Cystadenomas: develop from ovarian surface cells and can grow large; require monitoring and sometimes removal.

  • PCOS-related cysts: multiple small follicles associated with polycystic ovary syndrome, reflecting hormonal imbalance rather than discrete cyst formation.

Symptoms of ovarian cysts

Most ovarian cysts cause no symptoms and are discovered incidentally on imaging. When symptoms occur, they include:

  • Pelvic pain or pressure (especially on one side)

  • Bloating or abdominal fullness

  • Irregular or heavier menstrual cycles

  • Pain during or after intercourse

  • Frequent urination or difficulty emptying the bladder

  • Nausea or breast tenderness

  • Sudden sharp pain (if a cyst ruptures or twists)

Because cysts are often silent, regular monitoring and hormone testing help ensure small imbalances are caught before they become bothersome.

What causes ovarian cysts?

Ovarian cysts develop through a range of hormonal, structural, and metabolic mechanisms. Common contributing factors include:

  • Ovulatory changes: the egg-release process sometimes leaves fluid trapped in the follicle.

  • Hormonal imbalance: excess oestrogen or irregular ovulation patterns.

  • Endometriosis: tissue growth outside the uterus can form cysts on the ovaries (endometriomas).

  • Pregnancy: sometimes, cysts develop early in pregnancy and then resolve.

  • Polycystic ovary syndrome (PCOS): multiple cysts linked to insulin resistance and hormonal imbalance.

Understanding these causes helps you track your cycle and hormonal trends more effectively.

How are ovarian cysts detected?

Detection combines advanced pelvic imaging to visualize cyst structure with blood tests to analyze the hormonal and metabolic drivers.

Pelvic MRI: MRI is the gold standard for characterizing cysts, offering much higher detail than ultrasound. It accurately distinguishes between functional cysts, endometriomas, and more complex lesions. Elfcare’s MRI captures the ovaries directly, allowing us to identify and monitor cysts during your routine health check.

Blood analysis: Blood tests provide the hormonal context behind cyst formation and help identify conditions like PCOS. Key biomarkers on Elfcare’s pannel include:

  • Oestradiol and progesterone: reflect ovulation and hormonal cycle rhythm; imbalances can indicate anovulation or luteal phase dysfunction

  • LH and FSH: assess ovarian cycle regulation; an elevated LH/FSH ratio is characteristic of PCOS

  • Testosterone: elevated in PCOS and androgen excess conditions associated with cyst formation

  • HbA1c and fasting glucose: insulin resistance is a key driver of PCOS and associated cyst formation

  • CRP: systemic inflammation marker; elevated in endometriosis-related inflammation

By integrating these results, we can determine whether a cyst is a normal part of your cycle or an indicator of a health concern that requires attention.

Why early detection matters

Most ovarian cysts are self-resolving but identifying the type and context matters.

An endometrioma left undetected can grow, affect fertility, and worsen endometriosis. A complex cyst with concerning features requires prompt evaluation to exclude ovarian malignancy. PCOS identified early through hormonal and metabolic markers allows for treatment that reduces long-term risks, including type 2 diabetes, cardiovascular disease, and fertility complications.

Incidental detection through MRI and blood testing gives women information they can act on, at a stage when outcomes are most favourable.

How Elfcare can help

Elfcare's full body MRI images the pelvis as standard — directly visualising the ovaries and identifying cysts, their size, composition, and characteristics. MRI's ability to differentiate between cyst types is particularly valuable for distinguishing benign functional cysts from endometriomas or more complex lesions that require follow-up.

Our blood test covers the key hormonal markers — oestradiol, progesterone, LH, FSH, and testosterone — alongside metabolic markers linked to PCOS and insulin resistance. Together, imaging and blood results give a complete picture of ovarian and hormonal health.

If our MRI or blood tests identify a suspicious finding, we take care of further diagnostics or refer you to the appropriate specialist.

Book a consultation to learn more

Summary

Ovarian cysts are common and usually benign, but their type and hormonal context determine their health impact. Early awareness through precise imaging and hormonal tracking allows you to detect changes and manage reproductive well-being before symptoms arise.

High-resolution pelvic MRI accurately characterizes the structure of a cyst, identifying whether it is functional, an endometrioma, or a more complex lesion, while comprehensive blood panels assess the metabolic and hormonal imbalances that often drive cyst formation.

By understanding these underlying factors, such as insulin resistance or androgen excess, you can make proactive choices for your comfort and long-term hormonal health.

Last updated: 27 Apr. 2026
Reviewed by: Specialist doctors from the quality team at Elfcare

FAQ

  • Ovarian cysts are fluid-filled sacs forming on or within an ovary. They are very common during the reproductive years and most are functional, forming as part of the normal menstrual cycle and resolving spontaneously. Pathological cysts, including endometriomas, dermoid cysts, and cystadenomas, are less common and may require monitoring or treatment.

  • Most ovarian cysts cause no symptoms. When present, symptoms include one-sided pelvic pain or pressure, bloating, irregular periods, pain during intercourse, and urinary frequency. Sudden severe pelvic pain may indicate cyst rupture or ovarian torsion — both require immediate medical assessment.

  • Functional cysts arise from normal ovulatory processes. Endometriomas are caused by endometriosis. PCOS-related cysts result from insulin resistance and hormonal dysregulation. Hormonal imbalance, androgen excess, and chronic inflammation are common underlying factors across multiple cyst types.

  • Pelvic imaging is the primary detection tool. MRI can differentiate between cyst types with high accuracy, distinguishing benign functional cysts from endometriomas, dermoid cysts, and complex lesions. Blood tests assess the hormonal and metabolic context, identifying underlying conditions such as PCOS or endometriosis.

  • Yes. Elfcare's full body MRI images the pelvis as standard and can identify ovarian cysts, assess their characteristics, and differentiate between types. Our hormonal blood panel assesses the underlying imbalances associated with cyst formation. If a suspicious finding is made, we take care of further diagnostics or refer you to the appropriate specialist.

  • Most functional cysts resolve without treatment and require only monitoring. Persistent, large, or symptomatic cysts may be managed with hormonal therapy or surgical removal. Endometriomas associated with endometriosis often require specialist management. PCOS-related cysts are addressed through treatment of the underlying hormonal and metabolic condition.