Ovarian Cyst Pain: Symptoms and When a Pelvic Ultrasound May Help

A dull ache on one side of your pelvis. Pressure that keeps returning. Bloating that feels different from usual. Or sudden pelvic pain that catches you off guard.

There are many possible reasons for these symptoms, and an ovarian cyst is one of them.

Ovarian cysts are common. Many cause no symptoms and disappear naturally without treatment. Others can become painful, grow larger, rupture or occasionally contribute to twisting of the ovary.

Symptoms alone cannot tell you whether a cyst is present.

When an ovarian cyst is suspected, a pelvic ultrasound is one of the main imaging tests used to examine the ovaries and surrounding pelvic structures. The NHS notes that ultrasound is commonly used when an ovarian cyst is suspected. (nhs.uk)

This guide looks specifically at ovarian cyst pain, when symptoms may need investigation, what happens if a cyst ruptures, why ovarian torsion requires urgent attention and what a pelvic or transvaginal ultrasound can show.

If your symptoms are persistent but not an emergency, you can explore VitalScan’s dedicated pelvic imaging service here:

Explore Pelvic Ultrasound at VitalScan

An ovarian cyst is a fluid-filled sac that develops on or within an ovary.

The ovaries sit on either side of the uterus and are part of the reproductive system.

Ovarian cysts are very common, particularly before menopause. Many develop naturally and resolve without treatment within a few months. (nhs.uk)

There are different types of ovarian cyst, and their significance depends on factors such as their size, appearance, whether they are causing symptoms and whether they persist.

Finding a cyst does not automatically mean something serious is wrong.

The purpose of imaging is to understand what is there, what it looks like and whether further monitoring or assessment may be needed.

Ovarian cyst pain can feel different from person to person.

Some people describe a dull or heavy sensation in the pelvis. Others experience pressure, intermittent discomfort or a sharper pain on one side.

The NHS lists pelvic pain ranging from a dull, heavy sensation to sudden, severe and sharp pain among possible ovarian cyst symptoms. (nhs.uk)

Possible symptoms include:

• Dull pelvic aching
• Pressure or heaviness in the lower abdomen
• Pain on one side of the pelvis
• Sudden sharp pelvic pain
• Pain during sex
• Abdominal bloating or swelling
• Feeling full sooner than expected
• Needing to urinate more frequently
• Difficulty emptying the bowel

An ovarian cyst is only one possible explanation.

Pelvic pain can come from the ovaries, uterus, bowel, bladder, pelvic muscles and several other structures. This is why persistent symptoms usually need proper assessment rather than self-diagnosis.

Ovarian cyst pain is commonly felt in the lower abdomen or pelvis.

Because there is an ovary on each side of the uterus, discomfort may sometimes feel stronger on the left or right.

However, the location of pain cannot tell you whether a cyst is present or which ovary is affected.

A pelvis ultrasound can provide structural images of both ovaries and the surrounding pelvic organs.

Yes.

A cyst affecting one ovary may cause discomfort that feels more noticeable on that side.

The pain might be:

• Dull and persistent
• Intermittent
• A feeling of pressure
• Sharp during certain movements
• Sudden and severe if a complication occurs

Persistent one-sided pelvic pain deserves assessment, particularly when it is new, worsening or accompanied by other symptoms.

It can.

Larger or symptomatic ovarian cysts may cause abdominal bloating, swelling or a feeling of pelvic pressure.

Some people also report feeling unusually full after eating only a small amount. These are recognised possible symptoms of ovarian cysts, but they are not specific to cysts and can occur with many other conditions. (nhs.uk)

Persistent or unexplained bloating should therefore be investigated rather than automatically attributed to an ovarian cyst.

Pelvic conditions can sometimes cause pain that is difficult to localise precisely, and discomfort may be felt towards the lower back.

However, lower back pain is extremely common and has many musculoskeletal and non-gynaecological causes.

Back pain alone is not enough to suggest an ovarian cyst. If it occurs alongside persistent pelvic pain, pressure or other pelvic symptoms, further assessment may be appropriate.

The cartilaginous disc within the TMJ is held in position by ligaments and muscle tone. When the surrounding muscles become tight or the ligaments are stretched, the disc can slip forward out of its normal position between the bones of the joint. This is called internal derangement or disc displacement. It is one of the most clinically significant causes of both jaw clicking a

Many small ovarian cysts never cause symptoms.

Pain becomes more likely when a cyst:

• Becomes larger
• Places pressure on nearby structures
• Bleeds
• Ruptures
• Has more complex features
• Contributes to twisting of the ovary

The NHS notes that ovarian cysts are more likely to cause symptoms if they become very large, rupture or twist and affect the blood supply to the ovary. (nhs.uk)

This is also why the characteristics of a cyst on ultrasound matter, rather than simply whether a cyst exists.

An ovarian cyst can sometimes split or rupture.

Some ruptured cysts cause mild or short-lived symptoms. Others can cause significant pain and, in some circumstances, internal bleeding.

What Does a Ruptured Ovarian Cyst Feel Like?

A ruptured ovarian cyst may cause:

• Sudden pelvic pain
• Sharp lower abdominal pain
• Pain concentrated on one side
• Increasing abdominal discomfort
• Nausea
• Feeling faint or dizzy in more serious cases

Not every episode of sudden pelvic pain is caused by a ruptured cyst.

Other potentially urgent conditions can produce similar symptoms, including ovarian torsion and ectopic pregnancy.

Sudden or severe pelvic pain therefore needs appropriate medical assessment rather than waiting for a routine scan.

Ovarian torsion occurs when the ovary twists around the tissues supporting it.

This can interfere with the blood supply to the ovary and requires urgent medical assessment.

An ovarian mass or cyst can sometimes increase the risk of torsion.

Possible symptoms can include:

• Sudden severe pelvic or lower abdominal pain
• Pain on one side
• Nausea
• Vomiting
• Rapidly worsening pain

Recent NHS patient guidance highlights sudden severe pelvic pain, pain with vomiting or fever, faintness, dizziness and rapidly worsening abdominal swelling as symptoms requiring urgent attention because they may indicate torsion, cyst rupture or internal bleeding. (MFT)

Is Ovarian Torsion an Emergency?

Yes. Suspected ovarian torsion requires urgent assessment.

If you develop sudden severe pelvic pain, especially with nausea or vomiting, seek urgent medical help rather than arranging a routine private ultrasound appointment.

The investigation starts with the symptoms and wider clinical picture.

Depending on your circumstances, assessment may include:

• Medical and symptom history
• Clinical examination
• Pelvic ultrasound
• Blood tests in particular circumstances
• Repeat ultrasound
• Specialist assessment
• Further imaging where appropriate

The NHS states that someone suspected of having an ovarian cyst will commonly be referred for an ultrasound, often performed using a probe placed inside the vagina. (nhs.uk)

Yes.

Pelvic ultrasound is one of the main imaging methods used to identify ovarian cysts.

VitalScan’s Pelvic Ultrasound service assesses the uterus, ovaries and surrounding pelvic structures. The scan can identify ovarian cysts or masses and provide information about ovarian size and morphology.

Ultrasound does not use ionising radiation.

Explore VitalScan’s Pelvic Ultrasound Scan

What Can an Ultrasound Tell You About an Ovarian Cyst?

Finding a cyst is only part of the assessment.

An ovarian cyst ultrasound may provide information about:

• Whether a cyst is present
• Which ovary it affects
• Its size
• Its location
• Its appearance
• Whether it appears simple or more complex
• Whether there are cysts affecting both ovaries
• Whether there is free fluid within the pelvis
• Other structural findings involving the uterus or ovaries

VitalScan’s pelvic scan specifically includes ovarian assessment and identification of ovarian cysts or masses. The service also evaluates free fluid within the pelvis, which can be relevant in several clinical contexts including ruptured cysts. 

The ultrasound findings need to be interpreted alongside your symptoms and medical history.

What Is the Difference Between a Simple and Complex Ovarian Cyst?

Ultrasound can describe features of an ovarian cyst rather than simply reporting that one exists.

A simple cyst generally has a straightforward fluid-filled appearance.

A cyst with more complicated internal features may be described differently and can require further assessment depending on its appearance, size, symptoms, age and menopausal status.

This does not mean that a complex-looking cyst is automatically cancerous.

Ultrasound characteristics are used as part of a wider clinical assessment. NICE’s ovarian cancer guidance includes features such as multilocularity, solid areas, bilateral lesions and other findings when assessing ovarian masses. (Nice)

There are two common approaches to pelvic ultrasound.

Transabdominal Pelvic Ultrasound

A transabdominal scan is performed across the lower abdomen.

Gel is placed on the skin and an ultrasound probe is moved over the area.

You may be asked to attend with a comfortably full bladder because this can improve the view of the pelvic organs.

Transvaginal Ultrasound

A transvaginal ultrasound is an internal scan using a slim, covered ultrasound probe.

Because the probe is positioned closer to the pelvic organs, it can provide detailed images of the ovaries, uterus and endometrium.

VitalScan offers both a Uterus and Ovaries Ultrasound and a Transvaginal Ultrasound, with the appropriate approach depending on what needs to be assessed.

The NHS also notes that transvaginal ultrasound is commonly used when investigating a suspected ovarian cyst. (nhs.uk)

If an internal scan is not suitable or you do not wish to have one, discuss the available alternatives before your appointment.

A pelvic ultrasound can provide detailed images of your ovaries and surrounding pelvic structures and may help identify a cyst or other structural cause for your symptoms.

Check our latest offer and explore Pelvic Ultrasound

Not every ovarian cyst requires treatment.

Many cysts resolve naturally, particularly functional cysts before menopause.

Sometimes a repeat scan is recommended to check whether a cyst has:

• Disappeared
• Reduced in size
• Remained unchanged
• Increased in size
• Changed in appearance

The NHS states that when a cyst is identified, repeat ultrasound may be used to monitor it and confirm whether it has resolved. (nhs.uk)

The timing and need for follow-up should be determined by the healthcare professional managing your care rather than by repeatedly booking scans without clinical guidance.

An ultrasound finding does not automatically mean that treatment is needed.

The next step depends on factors such as:

• Your symptoms
• The cyst’s size
• Its ultrasound appearance
• Whether it persists
• Your age
• Whether you have been through menopause
• Other relevant clinical findings

Many cysts can simply be monitored.

Others may need gynaecological review, further imaging or treatment.

Your scan report can provide useful structural information for your GP or gynaecologist to consider when deciding what happens next.

MRI is a diagnostic support tool, not a standalone decision-maker for surgery. Where surgical intervention is being considered, a maxillofacial surgeon may also use arthroscopy, which allows direct visualisation inside the joint. MRI findings are best interpreted alongside clinical assessment by a clinician with experience in TMJ disorders.

Ultrasound is generally the first imaging investigation used for suspected ovarian cysts.

MRI may be considered in selected circumstances when an ovarian or adnexal mass needs more detailed characterisation.

Current NICE material notes that MRI can be offered for further characterisation when an adnexal mass remains indeterminate on ultrasound. (Nice)

VitalScan’s Gynaecological MRI provides detailed imaging of the ovaries, uterus, cervix and surrounding pelvic structures.

Explore Gynaecological MRI at VitalScan

MRI is not automatically required because an ovarian cyst has been found.

The decision should depend on the ultrasound findings and appropriate clinical advice.

No.

This is an important distinction.

An ovarian cyst is an individual fluid-filled structure on or within an ovary.

Polycystic ovary syndrome (PCOS) is a hormonal condition with a different diagnostic pathway. The follicles that can appear in polycystic ovarian morphology are not the same as a typical ovarian cyst.

This article focuses specifically on ovarian cyst pain, cyst complications and imaging rather than the hormonal symptoms and diagnostic criteria associated with PCOS.

Endometriosis can sometimes cause an ovarian cyst called an endometrioma.

These are cysts associated with endometriosis and represent a different clinical problem from many common functional ovarian cysts.

NICE recommends transvaginal ultrasound when endometriosis is suspected because it can help identify ovarian endometriomas, deep endometriosis and other possible causes of symptoms. (Nice)

However, a normal ultrasound does not rule out all forms of endometriosis.

VitalScan also notes that pelvic ultrasound can identify some features associated with endometriosis, while some forms may require further investigation.

Most ovarian cysts are benign.

The NHS notes that the vast majority of ovarian cysts are non-cancerous, although the likelihood of malignancy becomes more relevant after menopause. (nhs.uk)

An ultrasound cannot simply label every ovarian mass benign or malignant from one isolated feature.

Assessment may depend on:

• Ultrasound appearance
• Age
• Menopausal status
• Symptoms
• Blood-test results where appropriate
• Specialist review

Current NICE guidance recommends CA125 testing and, depending on age and the result, abdominal and pelvic ultrasound for people aged 40 or over with persistent symptoms that could suggest ovarian cancer. If ultrasound findings suggest ovarian cancer, urgent specialist referral is recommended. (Nice)

Having an ovarian cyst does not mean that you have ovarian cancer.

Persistent or concerning symptoms should simply be assessed through the appropriate clinical pathway.

Most ovarian cysts are not emergencies.

However, some symptoms require urgent assessment.

Seek urgent medical help if you experience:

• Sudden severe pelvic or lower abdominal pain
• Severe pain with nausea or vomiting
• Feeling faint or dizzy
• Rapidly worsening pain
• Significant abdominal swelling
• Fever alongside severe pelvic pain
• Heavy bleeding with severe pain

These symptoms can occur with complications such as ovarian torsion, cyst rupture or internal bleeding. (nhs.uk)

A routine private ultrasound should not delay emergency assessment.

If you are unsure whether your symptoms require urgent care, contact NHS 111.

Read NHS guidance on ovarian cysts

For a transabdominal pelvic ultrasound, gel is applied to the lower abdomen and an ultrasound probe is moved gently across the skin.

For a transvaginal ultrasound, a slim covered probe is gently inserted into the vagina to obtain more detailed images of the ovaries and uterus.

VitalScan’s pelvic ultrasound assesses structures including:

• The ovaries
• Uterus
• Endometrial lining
• Pelvic fluid
• Bladder where clinically relevant

A written report is produced following the examination and can be shared with your GP, gynaecologist or another healthcare professional. 

Do You Need a Full Bladder for a Pelvic Ultrasound?

A comfortably full bladder may be required for a transabdominal pelvic ultrasound because it can improve the view of the pelvic structures.

Preparation can differ depending on whether you are having a transabdominal or transvaginal examination.

Follow the instructions supplied for your appointment.

For more detailed preparation advice:

Read VitalScan’s guide to preparing for an ultrasound

If you have persistent, non-emergency pelvic pain or have been advised to investigate a suspected ovarian cyst, VitalScan offers private pelvic ultrasound in Milton Keynes.

The dedicated Pelvic Ultrasound service includes assessment of the uterus and ovaries and can identify ovarian cysts, masses and other structural findings. VitalScan also offers transvaginal ultrasound where a more detailed internal assessment is appropriate. 

A GP referral is not required for VitalScan’s current pelvic ultrasound pathway, although the clinic advises contacting the team if you are unsure which scan is appropriate. 

Your report can then be shared with your GP, gynaecologist or another healthcare professional if further assessment is needed.

Want to Understand What May Be Causing Your Pelvic Pain?

If you are experiencing persistent pelvic pain, pressure or symptoms that could be related to an ovarian cyst, a pelvic ultrasound may provide useful structural information about your ovaries and surrounding pelvic organs.

Check our latest offer and explore Pelvic Ultrasound

If your ultrasound findings require more detailed imaging, your healthcare professional may advise whether further assessment such as a Gynaecological MRI is appropriate.

Pelvic pain and pressure can have many possible causes.

An ovarian cyst is one possibility, but symptoms alone cannot confirm whether a cyst is present or explain its characteristics.

A pelvic ultrasound can provide detailed images of the ovaries, uterus and surrounding pelvic structures. If a cyst is identified, the scan can provide information about its size, location and appearance to support appropriate next steps.

VitalScan offers both Uterus & Ovaries Ultrasound and Transvaginal Ultrasound at its Milton Keynes clinic. The report can be shared with your GP, gynaecologist or another healthcare professional involved in your care. 

Concerned About an Ovarian Cyst or Persistent Pelvic Pain?

Check our latest offer and explore Pelvic Ultrasound

You can also read How to Prepare for an Ultrasound or explore Gynaecological MRI if further imaging has been recommended.

This article provides general information and does not replace personalised medical advice, diagnosis or treatment. Sudden severe pelvic pain, particularly with nausea, vomiting, dizziness or fainting, requires urgent medical assessment.