Last checked September 2026 against 8 sources · Editorial policy

Ovarian cysts in perimenopause and after menopause

Ovarian cysts are fluid-filled sacs on an ovary. They're very common, usually cause no symptoms, and often go away within a few months without treatment. After menopause they're monitored more closely, but simple cysts rarely turn cancerous: in one study almost half disappeared on their own. Sudden severe pelvic pain, or bloating and pelvic pain on most days, needs prompt attention.

Most ovarian cysts are harmless, but cysts after menopause are monitored more closely. Symptoms, CA-125 and ultrasound, and when surgery is advised.

Find your stage · 2 min 8 sources

Ovarian cysts after menopause: expectation vs reality

What people often expect

“A cyst found after menopause means surgery”

What the evidence shows

In a study of postmenopausal women with simple cysts followed by ultrasound, 46.30% of cysts resolved on their own and 43.91% stayed unchanged. About 7.94% became complex, and only one patient later developed ovarian cancer. The authors concluded simple cysts after menopause can be watched, because the risk of them turning cancerous is low.

Why ovarian cysts happen in perimenopause and after menopause

Functional cysts come from the menstrual cycle

Before menopause, most cysts form as part of the normal cycle, when an egg follicle doesn't release its egg or doesn't reseal properly afterward. These functional cysts are the most common type, usually harmless and short-lived, and typically disappear on their own within a few months. In perimenopause, when ovulation is erratic and hormone levels swing, they can still form and come and go.

Pathological cysts and endometriosis

Less commonly, cysts form from abnormal cell growth; these are called pathological cysts. Some are linked to underlying conditions such as endometriosis. The vast majority of all ovarian cysts are non-cancerous, but because a small number are cancerous, doctors look closely at the size and appearance of any cyst on ultrasound. A scan usually shows which type a cyst is, and that guides whether it is watched or removed. Cysts linked to endometriosis often come with painful periods and pain during sex.

Why cysts after menopause get closer checks

After menopause the ovaries are quieter, so any cyst is checked more carefully with ultrasound and sometimes a CA125 blood test. Cancerous cysts are more common after menopause. Regular ultrasound scans and blood tests over about a year are usually recommended, even when a cyst looks simple on the first scan. Even then, most simple cysts resolve or stay unchanged.

What CA125 can and can't tell you

CA125 is a protein that's sometimes raised in ovarian cancer. But high levels can also come from non-cancerous conditions such as endometriosis, a pelvic infection, fibroids and even your period, which is why it's less reliable before menopause. A high CA125 means more tests, usually an ultrasound, not a diagnosis. Doctors combine it with the scan and your symptoms. A normal CA125 does not rule out every problem, so symptoms still matter.

Symptoms of an ovarian cyst

A cyst usually only causes symptoms if it bursts, grows very large, or twists and blocks the ovary's blood supply. Then you may have pelvic pain, from a dull, heavy feeling to sudden sharp pain, pain during sex, trouble emptying your bowels, needing to pee often, changes in your periods, bloating, and feeling full after eating only a little. These overlap with ovarian cancer symptoms, so they always need checking.

How common are ovarian cysts after menopause?

From the studies on this page

of simple postmenopausal cysts resolved on their own in one ultrasound follow-up study
46.30%
stayed unchanged on repeat scans in the same study
43.91%
turned into complex cysts, which get closer checks
7.94%

The NHS describes ovarian cysts as very common. Many are found by chance on scans done for other reasons.

Pelvic symptoms that aren’t an ovarian cyst

Most ovarian cysts cause no symptoms. When pelvic pain or bloating is the reason you're worried, these conditions are also on the list.

Ovarian cancer
Check →
Bloating, pelvic pain, feeling full quickly or needing to pee more on 12 or more days a month.
Test: CA125 blood test and ultrasound
Fibroids
Check →
Heavy periods, pelvic pressure, lower back pain.
Test: Ultrasound
Endometriosis
Painful periods, pain during sex, pain when peeing or pooing.
Test: Specialist referral
Ovulation pain
Check →
One-sided pain mid-cycle, about 14 days before a period, lasting minutes to 1 or 2 days.
Test: Symptom diary

Ovarian cyst treatment in perimenopause and after menopause

Watch and wait for simple cysts
Strong evidence
Most cysts go away within a few months, and a follow-up ultrasound may confirm that. Simple cysts after menopause are often followed with repeat scans, because the chance of a simple cyst turning cancerous is low: in one study nearly half resolved and most of the rest stayed the same.
Monitoring an ovarian cyst after menopause
Strong evidence
If you're postmenopausal, regular ultrasound scans and blood tests over about a year are usually recommended, because there's a slightly higher risk of ovarian cancer after menopause. Keep the follow-up appointments even if you feel fine, since most cysts don't cause symptoms. If a cyst changes or grows on repeat scans, your doctor will discuss the next step.
Surgery for ovarian cysts
If this is the cause
Surgery may be needed for cysts that are large, causing symptoms, or possibly cancerous. The decision depends on the ultrasound appearance, size, symptoms and blood tests. Surgeons may remove just the cyst, one ovary, or both ovaries, depending on the cyst and your age. Ask how the operation will affect your hormones.
Symptom review
First step
See a doctor for pelvic pain, pain during sex, bloating, needing to pee often, or feeling full quickly. A transvaginal ultrasound is the usual first test. Sudden severe pelvic pain, or pain with nausea or vomiting, needs urgent care in case a cyst has burst or twisted.

When an ovarian cyst needs urgent care

Urgent: Sudden, severe pelvic pain
Get an urgent doctor's appointment or go to urgent care. A cyst may have burst or twisted.
Urgent: Pelvic pain with nausea, vomiting or a high temperature
Get urgent help.
Bloating, pelvic pain or feeling full quickly on most days
See a doctor and ask about a CA125 blood test. You may get an urgent referral, usually within 2 weeks.
Urgent: Any bleeding after menopause
Always needs checking. You should see a specialist within 2 weeks.
More →

Ovarian cysts and menopause: questions women ask

Are ovarian cysts after menopause cancerous?

Usually not. Simple cysts rarely turn cancerous and often resolve: in one study, 46.30% disappeared and 43.91% stayed unchanged. Complex cysts get closer checks, and cancerous cysts are more common after menopause than before. The main thing is to keep your follow-up scans.

What are the symptoms of an ovarian cyst after menopause?

Often none. Large, burst or twisted cysts can cause pelvic pain, pain during sex, bloating, needing to pee often, trouble emptying your bowels and feeling full quickly. After menopause these symptoms always need checking. A transvaginal ultrasound is the usual test.

Can perimenopause cause ovarian cysts?

Yes. Most cysts form from the normal cycle, which becomes erratic in perimenopause. They're common and usually go away by themselves within a few months. A follow-up scan a few weeks later often shows it has gone. Cysts that persist, grow or look complex are looked at more closely.

Can you get ovarian cysts after menopause?

Yes. They're less common than before menopause because ovulation has stopped, but they still happen and are often found by chance on scans. Most simple ones are harmless, but they're monitored with scans and blood tests for about a year.

Are hot flashes a sign of ovarian cancer?

Hot flashes aren't among its listed symptoms. Watch for bloating, pelvic pain, feeling full quickly or needing to pee more on 12 or more days a month, and for unusual vaginal bleeding. See a doctor if you have any of these, whether or not you also have hot flashes.

What are the symptoms of ovarian cancer after menopause?

Frequent bloating or a swollen stomach, pelvic pain, feeling full quickly or losing your appetite, and needing to pee more often, on roughly 12 or more days a month. Other signs include indigestion, bowel changes, back pain, tiredness, weight loss and bleeding after menopause. See a doctor if you have any of these.

Do ovaries produce estrogen after menopause?

Very little. Menopause reflects the loss of ovarian hormone production as egg follicles run out. That's also why a new cyst after menopause, when the ovaries are quieter, gets a closer look. The small amount of hormone made after menopause comes mostly from other tissues.

Does a raised CA125 mean cancer?

Not necessarily. CA125 can be raised by endometriosis, pelvic infection, fibroids and periods. A high result leads to an ultrasound and possibly specialist referral, which clarifies what's going on. After menopause, when periods and most benign causes no longer apply, a raised CA125 is taken more seriously.

What causes ovarian cysts after menopause?

After menopause, cysts from ovulation are no longer the usual cause, so cysts are more often simple fluid-filled sacs that form for unclear reasons, or pathological cysts from abnormal cell growth. Most are harmless: in one study nearly half of simple postmenopausal cysts resolved on their own. Because cancer is more common after menopause, any cyst is monitored with scans and blood tests.

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