Complex Ovarian Cyst: Symptoms, Causes, and Treatment

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Complex Ovarian CystAll women have a risk of developing ovarian cysts during their childbearing years. These cysts commonly appear and disappear without the slightest notice as most cases do not present any symptoms. When this tiny, fluid-filled sacs contains solid matter, it is referred to as a complex ovarian cyst. We will discuss the different types and causes of complex ovarian cysts to help you recognize the symptoms and know when to seek treatment.

You may experience an ovarian cyst at any point between the stages of puberty and menopause. Located on the surface or inside our ovaries, these cysts are a natural part of our menstrual cycle. A cyst that becomes a complex ovarian cyst is not part of this process, however. It a rare occurrence.

What Are Complex Ovarian Cyst Symptoms?

Although most ovarian cysts do not have any symptoms, there are circumstances that offer varying degrees of pain and other signs. These will depend on the size, stage, and type of cyst.

  • Pressure in abdomen
  • Bloating
  • Nausea
  • Vomiting
  • Frequent urination
  • Severe lower abdominal pain
  • Irregular periods
  • Difficult sexual intercourse
  • Heartburn
  • Anxiety

Complex Ovarian Cyst Causes, Risk Factors, and Complications

Most research has yet to determine a cause behind the formation of an ovarian cyst, but it has been linked to a hormonal shift or change. A more direct explanation for the presence of these cysts can be found on the U.S. National Library of Medicine’s MedlinePlus web site.

“Each month during your menstrual cycle, a follicle grows on your ovary. The follicle is where an egg is developing. Most months, an egg is released from this follicle, called ovulation. If the follicle fails to break open and release an egg, the fluid stays in the follicle and forms a cyst,” the site reads.

Unlike these regular follicle cysts, a complex ovarian cyst is not a result of the menstrual cycle process. The three types of complex ovarian cysts have their own sources and can result in overgrowth leading to further complications. This also includes the risk of ovarian cancer.

You should be aware of the various risk factors associated with complex ovarian cysts.

  • Genetics
  • Menstruation before age of 12
  • Irregular periods
  • Hypothyroidism
  • Obesity
  • Infertility and treatments
  • Tobacco use

Complications that can rise from a complex ovarian cyst rupturing include:

  • Bleeding
  • High fever
  • Extreme pain
  • Weakness
  • Dizziness
  • Vomiting

Types of Complex Ovarian Cysts

Another important aspect of complex ovarian cysts are the different types of cysts and their effects on our body.

1. Dermoid

As the most common complex ovarian cyst, the dermoid cyst contains bone, teeth, hair, and skin fragments. They increase in size at a slow rate and can grow large enough to shift the ovary in its place, causing more pain.

2. Endometrioma

Also referred to as chocolate cysts, endometrioma cysts form when uterus cells grow elsewhere such as in the ovaries, bladder, fallopian tubes, or in the bowel. These cysts are filled with excess blood and cause severe pain, headaches, and vaginal bleeding as they grow in size.


A complex ovarian cyst comprising of the outer ovary cells is known as a cystadenoma. This benign cyst can either be filled with a thick and sticky fluid or a thin and watery fluid. They can rupture causing severe pain and grow up to 100 pounds with a 12-inch diameter. As they grow and twist, cystadenomas put pressure on the bowel and bladder and restrict the blood supply to the ovaries.

Diagnosing Complex Ovarian Cyst

For proper diagnoses, you should seek advice from a medical professional. You will need to discuss any symptoms, medical history, family history, and have a pelvic exam. The doctor may suggest no treatment and request a follow-up appointment. You may need to have the following tests to determine the cause of symptoms present, including a pregnancy test.

  • Ultrasound
  • Complete Blood Count (CBC)
  • Endocervical swabs
  • Urinalysis
  • Serum biomarker testing

Complex Ovarian Cyst Treatment

We now know most complex ovarian cysts may disappear on their own, but if not, you may require surgery. Treatment will depend on the size, type, accompanying symptoms, and the age of the patient.

Ultrasound – An ultrasound test will be repeated over a short time period to determine if the cyst is shrinking or has disappeared.

Oral Contraceptives – The birth control pill is prescribed to help prevent ovarian cancer in those with recurring outbreaks of these cysts.

Surgery – Exploratory laparotomy or pelvic laparoscopy will be performed on those patients with presenting symptoms, large complex ovarian cysts, and those pre- or post-menopausal.

An ovarian cyst can be referred to as a normal fact of life for some women, at least in the cases where it goes unnoticed. A complex ovarian cyst may pose more of a serious health condition as it can be a type of cyst that grows to interfere with the flow of blood and put pressure on vital organs. The various types of complex ovarian cysts can have mild to severe symptoms. If time does not diminish the cyst, you may need to consult with a medical professional and more serious cases may require surgery.

“Complex Ovarian Cyst,” MD Health;, last accessed March 21, 2017.
Grabosch, S., “Ovarian Cysts,” Medscape, January 18, 2017;, last accessed March 21, 2017.
Pietrangelo, A., “Complex Ovarian Cysts: What You Should Know,” Healthline, June 27, 2016;, last accessed March 21, 2017.
“Ovarian Cysts,” Medline Plus;, last accessed March 21, 2017.

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