Ovarian cysts

Pre- and post-menopausal women with cysts demonstrating low suspicion for malignancy may be managed expectantly with monitoring. It is reasonable to perform sonographic follow-up of cysts larger than 5-7 cm in pre-menopausal women and 3-5 cm in post-menopausal women.

Pre-menopausal women should be evaluated with transvaginal ultrasound, whereas post-menopausal women should be evaluated with cancer antigen (CA)-125 levels and transvaginal ultrasound. Pelvic examination should be included at each of these visits, with particular attention to the rectovaginal examination findings, but the rising prevalence of obesity often hinders its utility.