Ovarian cysts occur frequently in women of all ages and can be physiological, benign or malignant. As cysts often first present in primary care, it is important that GPs assess the cyst and determine appropriate follow up. Patient history, age, menopausal status and physical examination will help determine the risk of a concerning cyst and whether referral to a specialist is warranted. First-line investigations include transvaginal ultrasound and, in some cases, testing for cancer antigen 125 levels.
Ovarian cysts can be physiological, benign or malignant. Although most ovarian cysts encountered in general practice are of no clinical concern, certain scenarios warrant further investigation, follow up and/or specialist referral. We present a structured approach to assessment based on common clinical scenarios (Flowchart), allowing GPs to distinguish physiological from more concerning ovarian cysts.