Ovarian cysts can sound pretty sinister, but they’re actually much more common than you might think. While they’re most commonly seen during the reproductive years, ovarian cysts can develop at virtually any age, even during fetal development in utero.

One Saudi Arabian study examining 244 cases of ovarian cysts really puts that into perspective: in the study the youngest patient was just 3 months old, while the oldest was 77 years old.

It’s important to note, that though they are observed throughout women's lifetime, ovarian cysts become less common after menopause. While many postmenopausal cysts are still benign, they deserve closer evaluation because the risk of ovarian malignancy increases with age and should always be investigated after menopause.

What Are Ovarian Cysts: 

Ovarian cysts are fluid-filled sacs that develop on or within the ovary. Most women don’t even know they have one because many ovarian cysts are small, harmless, and resolve spontaneously on their own without treatment.

Cysts become more concerning when they grow large enough to cause noticeable symptoms like pelvic pain, pressure, bloating, or discomfort, or, God forbid, they rupture. While many ruptured ovarian cysts can be managed without intervention, some women report severe pain, which requires prompt medical attention. 

Symptoms that warrant medical evaluation, particularly when they come on suddenly, can include:

• Sudden, severe pelvic or abdominal pain
• Fever
• Nausea or vomiting
• Weakness
• Dizziness or feeling faint
• Unexpected vaginal bleeding

Ovarian torsion is another, more serious complication that can occur when an ovary twists around the tissues and ligaments that support it, sometimes due to the weight of a larger ovarian cyst or mass. This can reduce or completely cut off blood flow to the ovary and is considered a medical emergency requiring immediate evaluation.

Types Of Ovarian Cysts: 

There are two broad categories of ovarian cysts: functional cysts and nonfunctional or complex cysts.

During the reproductive years, the ovaries develop small, fluid-filled structures called follicles each month. Normally, one dominant follicle matures, ruptures, and releases an egg during ovulation.

Functional cysts develop as part of this normal menstrual cycle and are the most common type of ovarian cyst. They include:

• Follicular cysts: occur when a follicle doesn’t rupture and release its egg and instead continues to grow and fill with fluid.
• Corpus luteum cysts: after an egg is released, the remaining follicle becomes the corpus luteum. Occasionally, the corpus luteum can fill with fluid or blood and form a cyst.

Cysts that develop for reasons unrelated to the normal menstrual cycle are considered nonfunctional cysts. These can include endometriomas associated with endometriosis, dermoid cysts (mature cystic teratomas that contain different types of tissue, including skin, hair, fat, and even teeth), cystadenomas, and, less commonly, malignant ovarian masses.

Why Do Ovarian Cysts Form: 

Ovarian cysts can develop for several different reasons, but many of the most common types are closely connected to the hormonal changes that occur throughout the menstrual cycle. Some are simply part of normal ovarian function, while others are associated with underlying conditions or abnormal tissue growth. Factors and conditions that can contribute to the development of ovarian cysts include:

• Pregnancy

• Ovarian cysts are sometimes discovered during pregnancy, particularly early on. One of the most common is a corpus luteum cyst, which forms from the follicle that released the egg that resulted in pregnancy. The corpus luteum produces progesterone to support the early pregnancy and, in some cases, can fill with fluid or blood and form a cyst. Most corpus luteum cysts resolve on their own as the pregnancy progresses.

• Hormone Imbalances (Estrogen Dominance)

• The hormonal imbalance that occurs when estrogen levels are high, or high relative to progesterone, may contribute to an environment where certain ovarian cysts are more likely to develop.

• Polyendocrine Metabolic Ovarian Syndrome (PMOS)

• PMOS, formerly known as Polycystic Ovary Syndrome (PCOS), was officially renamed in 2026 in part because the original name was misleading. Not every woman with PMOS has the characteristic “polycystic” appearance on her ovaries, and what we once commonly referred to as “cysts” are actually an increased number of small, immature follicles whose development has stalled. 

• Endometriosis

• Endometriosis happens when tissue similar to the lining of the uterus grows outside of the uterus. When this tissue grows on the ovary, it can form a cyst called an endometrioma, also known as a “chocolate cyst” because it can fill with old, dark blood over time giving it a chocolate brown appearance.

• Hypothyroidism

• Your thyroid and reproductive hormones are more connected than you might think. In cases of severe or untreated hypothyroidism, changes in pituitary hormones can overstimulate the ovaries and interfere with normal ovulation, potentially contributing to the development of ovarian cysts.

• Low Vitamin D 

• Though there is no direct link between low vitamin D and ovarian cysts research has shown vitamin D plays a role in ovarian function, inflammation, and hormone regulation, making adequate levels an important piece of overall reproductive health.

• Pelvic infections

• Infections of the reproductive tract  can sometimes travel up to one or both ovaries, fallopian tubes or uterus causing an infection, in a condition known as pelvic inflammatory disease (PID). The type of cyst seen here is not hormonally driven, but can contribute to the formation of pus-filled pockets or cyst-like fluid collections on or near the ovaries and therefore, is worth noting. 

Natural Treatment Plan For Ovarian Cysts: 

A suspected ovarian cyst rupture or ovarian torsion requires prompt medical attention and should be evaluated in the emergency department, especially when symptoms are sudden or severe. However, for individuals dealing with recurrent or uncomplicated ovarian cysts, there are several considerations that may help address underlying contributing factors, support healthy ovarian function, and potentially reduce the likelihood of certain types of cysts recurring.

Diet:

While there isn’t one specific diet proven to eliminate ovarian cysts, focusing on a fiber-rich, nutrient-dense, plant-forward diet may help support healthy hormone metabolism, inflammation, and overall ovarian health.

Some foods to emphasize include:

• Fiber-rich foods: vegetables, berries, beans, lentils, whole grains, nuts, and seeds. Fiber also supports regular bowel movements and the elimination of metabolized hormones.
• Cruciferous vegetables: broccoli, cauliflower, Brussels sprouts, cabbage, kale, and arugula provide compounds involved in normal estrogen metabolism.
• Foods that support normal liver function: beets, carrots, artichokes, leafy greens, watercress, and citrus. These foods provide nutrients and phytochemicals that support the liver's normal detoxification processes.
• Magnesium-rich foods: pumpkin seeds, chia seeds, almonds, cashews, avocado, leafy greens, beans, and dark chocolate.
• Omega-3-rich foods: salmon, sardines, mackerel, herring, chia seeds, flaxseeds, hemp seeds, and walnuts.
• Citrus fruits: lemons, oranges, and grapefruit provide vitamin C and flavonoids. Citrus peel also contains concentrated flavonoids, although evidence that citrus peel specifically affects ovarian cysts is limited.
• Hydration: plenty of water throughout the day. Adding fresh lemon is perfectly fine if it makes water more enjoyable, but lemon water itself hasn't been shown to shrink ovarian cysts.

Supplements:

• Vitamin D3: If your vitamin D levels are low (anything below 60), supplementation may be worth discussing with your healthcare provider. It’s worth noting there is not universally accepted number for vitamin D. Some functional health providers like vitamin D to be between 60-80, while the other camp supports 80-100. 
• Omega 3 Fatty Acids: Omega-3s help support a healthy inflammatory response and can be obtained through as we discussed above or supplementation for women who need a bigger punch. I suggest patients aim for at least 2400 mg per day to mitigate inflammation.
• Zinc: Zinc plays an important role in reproductive health, hormone production, antioxidant defenses and thyroid health. Just make sure you pulse zinc so it doesn’t offset the Zinc:Copper ratio. 
• DIM: DIM is a compound derived from cruciferous vegetables like broccoli, cauliflower, cabbage, and Brussels sprouts. It’s commonly used to support estrogen metabolism in cases where estrogen dominance is seen. 
• Chastetree. Vitex: Vitex is traditionally used to support progesterone signaling and can influence the balance between progesterone and estrogen. However, Vitex isn’t appropriate for every hormonal pattern and can sometimes do more harm than good especially if it lowers estradiol in someone whose estrogen levels didn’t need to come down in the first place. Always test, don’t guess before bringing this supplement into your routine.