Ovarian Cysts in Children and Teens

What is an ovarian cyst?

An ovarian cyst is an abnormal fluid-filled pocket that develops on the inside of a girl’s ovaries. The ovaries are the female reproductive organ and are found in the lower abdomen. The ovaries release an egg during the ovulation phase of each menstrual cycle (period). Cysts in the ovaries are relatively common and can affect girls and women of all ages.

An ovarian cyst can occur in one or both ovaries. The cysts can occur as single sacs or in clusters, and are sometimes filled with other substances like blood in addition to fluid. They can be many different sizes and occur in different locations within the ovary. Most ovarian cysts in children and young women are benign (non-cancerous), but can develop into cancer in rare cases. In severe cases where the cyst is very large and heavy, its unbalanced weight can cause the ovary to twist in an abnormal way. The twisting cuts off blood flow to the ovary and can damage the organ. This rare complication is called ovarian torsion.

What causes ovarian cysts in children and teens?

Many ovarian cysts are caused by normal body processes. Cysts can develop at different stages in the menstrual cycle in response to changing levels of sex hormones.

Ovarian cyst symptoms in children and teens

Small ovarian cysts that go away on their own often cause no symptoms. If the cyst is larger or more serious, it may cause symptoms such as

• Sharp pain in the pelvic (lower abdominal) area during the ovulation phase of the menstrual cycle
• Irregular period
• Pelvic pain that doesn’t go away
• Bloating, swelling, or a feeling of fullness in the lower abdomen
• A need to urinate that doesn’t go away. This can happen if the cyst is large enough to push against the other internal organs and put pressure on the bladder

If a girl develops ovarian torsion, her symptoms will be much more immediate and severe. Symptoms may include

• Severe pelvic pain
• Nausea and vomiting
• Loss of consciousness (passing out)

Diagnosing ovarian cysts in children and teens

Because many ovarian cysts cause no symptoms, they are often diagnosed incidentally (by chance) during tests for other conditions. If a child has symptoms of an ovarian cyst, doctors can use multiple tests to make a diagnosis. These include

• Pelvic ultrasound, which allows the doctor to visualize the cyst. The ultrasound creates an image of the child’s lower abdomen so that the doctor can see the size and location of the cyst.
• Blood testing to check the child's hormone levels.

Treatment for ovarian cysts in children and teens

Treatment for an ovarian cyst depends on the cyst’s size and severity.

• In cases where the cyst is small and causes few or no symptoms, doctors may monitor the cyst with follow-up appointments. Every few months, a doctor will take an image of the ovaries using an ultrasound to make sure that the cyst is not growing. This is repeated until the cyst goes away on its own.
• If the cyst does not go away, doctors may surgically remove the abnormal mass of cells. This is only necessary in a small number of cases.
• If the cyst is particularly large, doctors may drain the fluid out of it or remove it to prevent ovarian torsion.
• A doctor may prescribe hormonal medication like birth control to prevent more cysts from forming.