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Ovarian cysts: No biggie, but birth control can help

Everything you never wanted to know—but probably should—about your ovaries.

by Robin Wallace, MD

Patients almost always have the same look on their face when we talk about ovarian cysts. It’s that look of, “OMG, I have a ticking time-bomb in my pelvis!” I worry that they imagine a giant green blob growing larger and larger inside them, like a Chia pet, that might one day suddenly explode.

The good news is that this imaginative view of an ovarian cyst is far worse than the reality. Many women will have an ovarian cyst at some point in their lives, and most won’t even know it.

But what do ovarian cysts have to do with birth control? Many hormonal contraceptive methods—like the pill, the patch, the ring, and the shot—affect the ovaries. These methods lead to fewer cysts, while other methods can cause more. Let’s start with a quick review of what’s going on “in there, down there.”

Ovulation 101

For a woman with a typical menstrual cycle, an egg is released from one ovary each month. The fancy name for the process is ovulation. To get the egg ready for release, a sac filled with fluid develops around it (fancy name = follicle). When a follicle grows larger than expected, it is called a functional cyst*. A cyst is basically a bubble—a collection of fluid with a thin wall around it.

Cysts 101

So what does “larger than expected” mean? Cysts are usually half an inch to one inch in size—pretty small. But since an ovary is usually about the size of an almond, a cyst may double the size of the ovary to which it’s attached. Most of the time, the body reabsorbs this fluid within a few months and we are none the wiser. Sometimes a cyst can cause symptoms, such as:

  • Abdominal discomfort or bloating

  • Pelvic pain that comes and goes, or is different from your usual menstrual cramps

  • Pain during bowel movements

  • Pain during sex

If your doctor finds a cyst on your ovary during a pelvic exam or ultrasound, most of the time you can be reassured that it will disappear on its own. You may want to have a follow-up visit to make sure.

Less often, a cyst keeps growing and becomes a problem. It’s important to know the warning symptoms of a more serious cyst:

  • Sudden and severe pain in your pelvis or lower abdomen

  • Pain that comes with fever or vomiting

  • Pain that causes dizziness or fainting

These are reasons to see a doctor right away. Complications of ovarian cysts are rare, but if a woman has a cyst and one of these symptoms, she could be experiencing ovarian torsion (when a large cyst causes the ovary to twist) or rupture (when the cyst opens and may cause bleeding).

Where does birth control come in?

One of the main ways hormonal birth control prevents pregnancy is by stopping ovulation—so the egg never leaves the carton, so to speak. The pill, the patch, the ring, and the shot are most reliable at blocking ovulation, so women using these methods may have fewer ovarian cysts. If you tend to get ovarian cysts, your provider may recommend one of these methods to prevent future cysts.

The progestin-only or mini-pill has an unpredictable effect on ovulation and may lead to more cysts. These almost always disappear on their own, but if you've had problems with cysts in the past, the mini-pill may not be the best contraception for you. (FYI, the mini-pill is not a common birth control choice: so few women in the U.S. use it, we can’t even get a reliable estimate.) Norplant, an old contraceptive implant that’s no longer available in the U.S., also had this side effect. Studies of the new implants (Implanon and Nexplanon) suggest that cysts are less of an issue.

Birth control has other benefits.

There are other ways birth control can contribute to ovarian health too. The pill reduces your risk of ovarian cancer by at least 40%—and the longer you use it, the more it helps! This is true even for women with a family history of ovarian cancer. And since the patch and the ring have the same combination of hormones as the combination pill, we expect they also protect against ovarian cancer. All hormonal methods, including the shot, the implant, and the hormonal IUD, also protect against endometrial cancer (cancer of the uterine lining). So for all those years you don’t want to be pregnant, choosing a highly effective method of contraception can also be a smart move toward a healthier future.

* What if it’s not just a functional cyst? There are other types of cysts that can grow on the ovary. These often need additional medical attention, including surgical removal, but are far less common than functional cysts. Most of these are benign, meaning not cancerous, but some extremely rare ones are cancerous. If someone in your family had ovarian cancer, it is important to tell your doctor.

Robin Wallace, MD, is a Family Physician for the San Francisco Department of Public Health and is currently a clinical fellow in Family Planning at the University of California, San Francisco. As the middle of three daughters in her family, she has always been a passionate advocate for girl power and women's health, and appeared as Captain Contraception for a super heroes party in medical school.

can you get pregnant if your on the pill and also have ovarian cyst.

2012-06-26 17:21:50 UTC

Ariel

Yeah, if you miss a couple of pills.

2012-09-16 13:49:43 UTC

Tami

Yeah, if you miss a couple of pills.

2012-09-16 13:49:43 UTC

Tami

Once I get my cyst remove can i get pregnant

2012-09-17 23:43:28 UTC

Jessica Lastie

can being on birth control aggravate a cyst?

2012-09-24 14:00:25 UTC

jessica w

so I have had this cyst in me since May, I went to the gynecologist about it they told me to get on birth control or I could take ibuprofen to calm it down and relax it. It's the third time so far it's the same thing every time nothing has helped with calming it down I don't like feeling like a pill popper. So if I get over my fear of something being inside of me and going to the doctors, would it help me if after I went on birth control?

2012-09-30 06:17:39 UTC

Suzzette

Can i have sex with my boyfriend after stop feeling pain and my medication is finish?

2013-10-22 08:33:05 UTC

Natasha British

Can i have sex with my boyfriend after stop feeling pain and my medication is finish?

2013-10-22 08:33:05 UTC

Natasha British

Thanks for your question, Krissa. Without knowing your full medical history, its hard to know exactly what your doctor is referring to. Some women will have more than one cyst on their ovaries at a time (called 'polycystic ovaries'), while other women will have complex cysts - both of which are different from the simple cysts from ovulation described in this article. If you are concerned, it is best to talk to your doctor directly.

2013-10-30 01:23:07 UTC

Robin Wallace

Docter please sugest me, i have a again having ovaroan cyst 11yrs befor i thrown my left ovari and tube,i saw 11yrs before at that time my bouth ovari had cyst left had about 10cm and right had 25mm my age wa young now my age is 39 i dont know why,i never have pregnant before i had cyts my both tube were blocked then letter 3yrs iam having these kind problem

2013-11-16 10:33:39 UTC

Sitashma Adhikari

Hi Natasha - It's difficult to say based on what you wrote—you should check with your doctor. If you had a functional ovarian cyst and are no longer feeling pain in your abdomen, it is likely safe to have sex.

2014-01-08 01:30:02 UTC

Robin Wallace

hi...i have chocolate cyst (most like)on my ovary.is it dangerous & will its going to create problem in my future for conceiving..??? & i also know that is it cancerous..??

2014-01-25 17:22:08 UTC

farheen

hi...i have chocolate cyst (most like)on my ovary.is it dangerous & will its going to create problem in my future for conceiving..??? & i also know that is it cancerous..??

2014-01-25 17:22:08 UTC

farheen

I was put on Lo Loestrin Fe after developing ovarian cysts and they did shrink. After being on this pill for 6 months I had developed fairly noticeable melasma which from what I understand is caused by the estrogen in the birth-control pill. So I stopped taking the pill but since then have been putting on weight while my melasma fades which makes me think the cysts have probably returned or continued to grow. From what I understand this is the cysts shrinkage is from the estrogen and this pill has the lowest dose of estrogen. I was planning to go back on the pill next month knowing that my melasma will most likely return. How can a balance these two conditions?

2014-02-24 20:17:34 UTC

Sarah Scott Smith

if you cant afford birth control to control it, what can you do for it?

2014-02-27 01:38:11 UTC

india dorsey

what can i do to control the cysts without taking birth control?

2014-02-27 01:39:55 UTC

india dorsey

if you cant afford birth control to control it, what can you do for it?

2014-02-27 01:38:11 UTC

india dorsey

what can i do to control the cysts without taking birth control?

2014-02-27 01:39:55 UTC

india dorsey

if you cant afford birth control to control it, what can you do for it?

2014-02-27 01:38:11 UTC

india dorsey

what can i do to control the cysts without taking birth control?

2014-02-27 01:39:55 UTC

india dorsey

Hi India, and thanks for your question. It all depends on what kind of cysts you're talking about, so this would be a question for your medical provider. In general, if we're talking about a cyst from ovulation (another word for these are follicles) the only way to control them is to stop ovulating - and this means birth control. There's probably no or low-cost ways to get birth control in your area. http://bedsider.org/where_to_get_it

2014-03-06 03:57:19 UTC

Colleen Krajewski, MD, MPH

I've been trying to get pregnant since October and my doctor says that my infertility is because of my cyst on my right ovary. She put me on the shot for 6 months saying that the pill will help shrink the cyst. If, when I go back in April, she says that the shot did not in fact help shrink the cyst, what would be my next step?

2014-03-13 16:26:49 UTC

Jamie

I've been trying to get pregnant since October and my doctor says that my infertility is because of my cyst on my right ovary. She put me on the shot for 6 months saying that the pill will help shrink the cyst. If, when I go back in April, she says that the shot did not in fact help shrink the cyst, what would be my next step?

2014-03-13 16:26:49 UTC

Jamie

I keep getting ovarian cysts, I also was diagnosed with endometriosis when I was younger, I'm now 22, and I have now gotten another ovarian cyst one on my right side, my ob/gyn put me on depo provera shot, it's been almost a month now that I have been on it and it feel like my cyst ruptured but I had no bleeding, I'm worried if it does or did rupture then where does the cyst go? Also since I already had a cyst before getting on depo Provera can I get pregnant?

2014-05-31 02:56:04 UTC

Jamie Carosino

It's great you have an ob/gyn who's helping you with your cysts and endometriosis. Some methods, like depo provera, can really help with those things. It's a common misconception, but cysts don't drain like a funnel through your uterus and vagina, they get reabsorbed in your abdomen. If you're using your depo prover as directed you shouldn't be at risk of pregnancy.

2014-06-25 00:09:46 UTC

Colleen Krajewski, MD, MPH

It's great you have an ob/gyn who's helping you with your cysts and endometriosis. Some methods, like depo provera, can really help with those things. It's a common misconception, but cysts don't drain like a funnel through your uterus and vagina, they get reabsorbed in your abdomen. If you're using your depo prover as directed you shouldn't be at risk of pregnancy.

2014-06-25 00:09:46 UTC

Colleen Krajewski, MD, MPH

hi,saw my gyna yesterday n had to do a pelvic scan.t revealed that i had an ovarian cyst on my rght ovary measuring4.8 by 3.4cm.the cyst has internal hemorrhage & no pouch of douglas fluid was seen.was put on cycle 1 pills fr a month...my question is,after the completion of the pills is that all,or will i have to continue with the pills again?

2014-07-04 11:53:00 UTC

Night Koya

hi,saw my gyna yesterday n had to do a pelvic scan.t revealed that i had an ovarian cyst on my rght ovary measuring4.8 by 3.4cm.the cyst has internal hemorrhage & no pouch of douglas fluid was seen.was put on cycle 1 pills fr a month...my question is,after the completion of the pills is that all,or will i have to continue with the pills again?

2014-07-04 11:53:00 UTC

Night Koya

Hi Night, This is a question only your doctor can answer, since it depends on each individual woman's circumstances.

2014-07-09 00:56:26 UTC

Colleen Krajewski, MD, MPH

Hi Night, This is a question only your doctor can answer, since it depends on each individual woman's circumstances.

2014-07-09 00:56:26 UTC

Colleen Krajewski, MD, MPH

I have a 6.6 cyst in my left ovaries I just started taking the pills do you know how long it will take for the pills to kick in?

2014-07-11 04:33:23 UTC

Carmen Garcia

I have a 6.6 cyst in my left ovaries I just started taking the pills do you know how long it will take for the pills to kick in?

2014-07-11 04:33:23 UTC

Carmen Garcia

I have been diagnosed with poly cystic ovarian syndrome. I've been trying to get pregnant for over a year, so my ob-gyn ran test after test on me and finally came to the conclusion that I have poly cystic ovarian syndrome. He prescribed me one month of birth control pills to see if it would "flush" out the cysts I have. I just finished week two of the three weeks of birth control I have and I am bleeding already. I'm not sure if it is because the cysts are "flushing" out, if it is my period coming early which I thought the birth control would prevent, or if I should be concerned and talk to my doctor about it. Any suggestions?

2014-08-07 18:23:33 UTC

Ashley

If I have a family history of polycystic ovary syndrome is it better for my ovaries sake to use a hormonal method even if I'd prefer the long lasting effect of an IUD such as ParaGard?

2014-09-16 13:37:39 UTC

Alyssa T.

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