Ovarian Cysts

What is Ovarian Cysts?

An ovarian cyst is a fluid-filled sac that forms on or inside an ovary. In women who still have periods, a cyst can form as part of ovulation, and about one in five women develops at least one pelvic mass in her lifetime.^[1] Most cysts in women of reproductive age are functional and benign and do not need surgery, but some cause complications that need prompt treatment.^[1]

Common symptoms

Many ovarian cysts cause no symptoms and are found by chance on an exam or imaging.^[1] When symptoms occur, they can include a dull or sharp ache on one side of the lower abdomen, a feeling of bloating or fullness, pain during sex, and changes in periods.^[1] A cyst that ruptures, bleeds or twists the ovary can cause sudden, severe pain.^{[1, 2]}

Causes and risk factors

Functional cysts are linked to the normal monthly cycle, when a follicle that releases an egg can fill with fluid.^[1] Other types include dermoid cysts, cystadenomas and endometriomas, which are cysts related to endometriosis.^[1] Persistent cysts that do not resolve over a few cycles are more likely to be one of these non-functional types.^[3]

Hormonal conditions such as polycystic ovary syndrome can also affect the ovaries, although the ovarian changes in that condition are a different matter from a single cyst.^[1]

How it is diagnosed and treated conventionally

Cysts are usually found on a pelvic exam and identified with ultrasound, sometimes followed by MRI. Blood tests may be added when a cyst looks concerning.^{[1, 4]}

Management depends on the type of cyst, your age and your risk factors.^[1] A review of eight randomized trials found that birth control pills did not make functional cysts resolve faster, and that watching and waiting for two or three cycles is reasonable. If a cyst persists, surgery is often considered.^[3] Simple cysts seen on ultrasound can often be followed without intervention.^[4]

Why Ovarian Cysts calls for a whole-person approach

Ovarian cysts should be diagnosed and followed by a physician. The pain and discomfort that come with a cyst can have more than one source, and supportive care is aimed at comfort and well-being while your doctor monitors or treats the cyst. No study has shown that this care helps with ovarian cysts or changes the cyst itself.

The factors below are the ones most relevant to this page. They describe why symptoms can feel stronger than the size of a cyst alone would suggest, and where supportive care is aimed.

The menstrual cycle and hormones

Functional cysts arise from ovulation, so they are tied to the hormonal rhythm of the cycle.^[1] This is one reason repeat imaging after a few cycles is a standard way to see whether a cyst has resolved.^[3]

Pelvic pain

Pelvic pain from a cyst, or from a condition that sits alongside it, can become a problem of its own. A 2025 meta-analysis of 38 randomized trials in women with chronic pelvic pain found that multimodal physical therapy lowered pain, while psychological approaches alone did not change pain intensity.^[5]

Endometriosis and inflammation

Endometriomas are cysts caused by endometriosis, a chronic inflammatory condition that can cause pelvic pain, nodules and infertility.^[6] If a cyst is an endometrioma, the pain often comes from the endometriosis as well as the cyst.^[6]

Menstrual pain

Period pain is common in women of reproductive age, and its treatment is studied separately from cysts.^[7] Non-pharmacological options such as exercise and topical heat have been reviewed for it alongside acupuncture and herbs.^[8]

Acupuncture as supportive care in Ovarian Cysts

What the research shows

No clinical trials of acupuncture for ovarian cysts themselves turned up in a PubMed search, so there is no evidence that it shrinks a cyst or prevents new ones. The research below concerns related pain symptoms.

In women with chronic pelvic pain, a 2025 meta-analysis of 38 trials could not reach a conclusion about acupuncture, because the pooled result for pain was not statistically significant and too uncertain to grade.^[5]

For endometriosis-related pain, a Chinese multicenter trial randomized 106 women to real or sham acupuncture. Period pain fell more with real acupuncture right after treatment, and pain lasted fewer days, but the difference was no longer significant 12 weeks after treatment ended. Nonmenstrual pelvic pain and pain with sex did not differ between groups.^[9] A meta-analysis of 14 trials found less pain with acupuncture, but its authors cautioned that the studies were limited by design and quality problems.^[6] An earlier Cochrane review found only one eligible trial, so its evidence was limited.^[10]

For primary period pain, a Cochrane review found the evidence insufficient to say whether acupuncture works, with low-quality evidence overall.^[7] A later network meta-analysis of 33 trials suggested that acupuncture, exercise and topical heat probably reduce pain over the short term, and called for larger, better trials.^[8]

How acupuncture may work

For pain in endometriosis, researchers have proposed that acupuncture may change levels of prostaglandins, endorphins, dynorphins and substance P.^[6] These are proposed explanations and have not been shown to apply to ovarian cysts.

What treatment involves

Treatment uses fine, sterile, single-use needles placed at points on the abdomen, lower back, legs and elsewhere, usually left in place for about 20 to 40 minutes. We reassess after a short course of visits. The endometriosis pain trial used 30-minute sessions three times a week for 12 weeks, with daily sessions during painful periods, which is a research schedule and not a recommendation.^[9]

In prospective studies, about 9 in 100 patients had a minor reaction such as bleeding, soreness or redness at a needle site, and serious events occurred in about 1 in 10,000 patients.^[11] Tell the practitioner first if you have a bleeding disorder, take blood thinners or are pregnant. Please do not have acupuncture in place of an urgent assessment for sudden or severe pelvic pain.

Ayurvedic medicine as supportive care in Ovarian Cysts

The Ayurvedic view

In Ayurveda, cystic growths are traditionally described as granthi, a swelling or knot, and are linked to imbalance of Kapha and sometimes Vata and Pitta. These are traditional categories used to plan care, not medical diagnoses.

Therapies that may be used

Care is chosen for the individual and traditionally combines:

• Diet and daily routine, such as regular meals and steady sleep hours
• Gentle warm oil massage and stress-reducing practices
• Herbs prescribed individually by a qualified practitioner

Panchakarma procedures are not appropriate during pregnancy, acute illness or frailty, or before a cyst has been medically assessed. They are not used for sudden pelvic pain, which can signal a ruptured cyst or a twisted ovary that needs emergency care.^{[1, 2]} Ayurvedic products should come from tested sources, because about one fifth of those bought online contained detectable lead, mercury or arsenic.^[12]

What the research shows

No clinical trials of Ayurvedic treatment for ovarian cysts were found in PubMed. Searches for Ayurveda in this area return studies of polycystic ovary syndrome, which is a different condition with its own page, not studies of ovarian cysts. Any benefit for ovarian cysts is therefore unknown, and we make no claim that Ayurvedic care affects a cyst.

Herbal medicine as supportive care in Ovarian Cysts

Herbs and formulas that have been studied

Chinese herbal medicine has traditionally used formulas that move blood and break up masses for gynecologic conditions. One of these, Guizhi Fuling pills, is traditionally used for blood stasis conditions and has been reviewed for endometriosis.^[13] Its five ingredient herbs have been studied for pain-relieving, anti-inflammatory and blood-flow effects.^[13]

What the research shows

No clinical trials of herbal medicine for ovarian cysts were found. The review of Guizhi Fuling pills for endometriosis summarized laboratory and network-pharmacology findings and proposed mechanisms, and it did not establish clinical effectiveness.^[13] For menstrual pain, a network meta-analysis found that herbs reduced pain compared with placebo or no treatment, but the authors called for better-quality research.^[8]

Safety and herb-drug interactions

Herbs are active substances and can interact with medicines. Case reports describe bleeding or clotting problems when warfarin was combined with herbs including dang gui (Angelica sinensis), dan shen (Salvia miltiorrhiza), ginger, ginseng and Boswellia.^[14] St. John's wort has been reported to cause unexpected bleeding between periods when taken with oral contraceptives.^[15] Tell us about any hormonal medicine you take.

Herbal and dietary supplements can also cause liver injury.^[16] In one study, about one fifth of Ayurvedic products bought online contained detectable lead, mercury or arsenic.^[12] Herbs should come from tested sources and be prescribed individually. Tell us if you are pregnant, trying to conceive or breastfeeding, or have liver or kidney disease.

Translating traditional medicine into modern biological language

The links drawn here are interpretation, not equivalence. Chinese medicine may describe a pelvic mass with pain as stagnation of qi and blood stasis. Researchers studying related formulas look at inflammation, pain signaling and blood flow.^[13] Ayurveda's granthi describes a localized swelling in a Kapha-type imbalance. No study has shown that this corresponds to any particular type of ovarian cyst.

How this care fits with your medical care

This care is complementary and supportive. Keep your gynecologist or primary care physician, follow their plan for monitoring or treating a cyst, and do not stop or change prescribed medicines, including hormonal birth control, without your prescriber. For a condition like this, we ask that you are under a physician's care for it and that your treating team knows you are receiving complementary care.

We do not diagnose ovarian cysts or decide whether a cyst can be watched. Please bring your ultrasound and other imaging reports, any blood test results, and a full list of medicines and supplements. Cysts found during pregnancy need obstetric care, and any supportive care should be coordinated with that team.^[17]

When to seek urgent medical care

Sudden pelvic pain can mean a ruptured cyst or a twisted ovary, and twisting is a surgical emergency.^{[1, 2]}

• Sudden, severe pain in the lower abdomen or pelvis
• Pelvic pain with nausea or vomiting
• Fever with pelvic pain
• Dizziness, fainting or weakness with abdominal pain, which can signal internal bleeding
• Pelvic pain with a positive pregnancy test or a possibility of pregnancy
• A cyst that keeps growing, or new swelling of the abdomen, on imaging or on your own

If any of these occur, call 911 or go to the nearest emergency department.