[9] A ruptured ovarian cyst is usually self-limiting, and only requires keeping an eye on the situation and pain medications for a few days, while the body heals itself.

[5] Rarely, enough blood will be lost that the bleeding will produce hypovolemic shock, which can be a medical emergency requiring surgery.

[2] It can be caused by a pedunculated ovarian cyst that twisted in a way that cuts off the blood flow.

[14] Using combined hormonal contraception may reduce the risk, especially with high-dose pills,[14] but it does not treat existing cysts.

[3] Ovarian cysts are usually diagnosed by pelvic ultrasound, CT scan, or MRI, and correlated with clinical presentation and endocrinologic tests as appropriate.

[5] Usually, an experienced sonographer can readily identify benign ovarian cysts, often with a level of accuracy that rivals other approaches.

[5] Follow-up imaging in women of reproductive age for incidentally discovered simple cysts on ultrasound is not needed until 5 cm, as these are usually normal ovarian follicles.

[16] For incidentally discovered dermoids, diagnosed on ultrasound by their pathognomonic echogenic fat, either surgical removal or yearly follow up is indicated, regardless of the woman's age.

Hydrosalpinx, or fallopian tube dilation, can be mistaken for an ovarian cyst due to its anechoic appearance.

For any thickened septation, nodularity, vascular flow on color doppler, or growth over several ultrasounds, surgical removal may be considered due to concern of cancer.

[18] The CA-125 marker in children and adolescents can be frequently elevated even in absence of malignancy and conservative management should be considered.

Polycystic ovarian syndrome involves the development of multiple small cysts in both ovaries due to an elevated ratio of leutenizing hormone to follicle stimulating hormone, typically more than 25 cysts in each ovary, or an ovarian volume of greater than 10 mL.

[20] Certain malignancies can mimic the effects of clomifene on the ovaries, also due to increased HCG, in particular gestational trophoblastic disease.

Medical imaging showing a simple, smooth bubble of watery liquid is characteristic of a benign cyst.

[13][22] It is recommended that women with an RMI score over 200 should be referred to a centre with experience in ovarian cancer surgery.

[32] Treatment may be required if cysts persist over several months, grow, or cause increasing pain.

[33] Cysts that persist beyond two or three menstrual cycles, or occur in post-menopausal women, may indicate more serious disease and should be investigated through ultrasonography and laparoscopy, especially in cases where family members have had ovarian cancer.

[34] If the cyst is asymptomatic and appears to be either benign or normal (i.e., a cyst with a benign appearance and a size of less than 3 cm diameter in premenopausal women or less than 1 cm in postmenopausal women[8]), then delaying surgery, in the hope that it will prove unnecessary, is appropriate and recommended.

[5] The surgical technique is typically a minimally invasive or laparoscopic approach performed under general anaesthesia,[11] unless the cyst is particularly large (e.g., 10 cm [4 inches] in diameter), or if pre-operative imaging, such as pelvic ultrasound, suggests malignancy or complex anatomy.

[13] For large cysts, open laparotomy or a mini-laparotomy (a smaller incision through the abdominal wall) may be preferred.

[13][11] Additionally, if the pelvic surgery is being done, some women choose to have prophylactic salpingectomy done at the same time, to reduce their future risk of cancer.

[36] If a condition that can cause ovarian cysts, such as endometriosis or polycystic ovary syndrome (PCOS), has been diagnosed, treatment may be different.

Simple, smooth ovarian cysts, smaller than 3 cm and apparently filled with water, are considered normal.

[5] For example, some endometriomas (a type of benign ovarian cyst) will undergo decidualization, which can make them look more like a cancerous tumor in medical imaging.

[5] Malignant tumors discovered during pregnancy are usually germ cell, sex cord–gonadal stromal, or carcinomas, or slightly less commonly, borderline serous or mucinous cysts.

[39] Benign tumors were known in ancient Egypt, and an ovarian cyst has been identified in a mummy, Irtyersenu (c. 600 BC), that was autopsied in the early 19th century.