Because ovarian cysts do not cause symptoms, they are usually found during routine gynecological exams. This usually begins with a complete medical history, including menstrual history and a list of current medications. A pelvic exam will be performed, during which a physician may be able to feel the swelling of the cyst on an ovary.

If abnormalities are detected, other tests may be performed, including:

• Ultrasound. Uses sound waves to make “pictures” of organs in the body. An ultrasound can be performed either through the abdomen or vagina (called transvaginal ultrasound) and lasts about 30 minutes. With an ultrasound, a physician can see how the cyst is shaped, its size and location and whether it is fluid-filled, solid or mixed.
  
  
• Pregnancy test. A blood or urine test conducted to rule out pregnancy. Hormone levels (such as LH, FSH, estradiol and testosterone) are tested to evaluate for associated hormonal conditions.
  
  
• CA-125 test. A blood test to determine whether a cyst may be cancerous by measuring a protein called CA-125. A normal CA-125 level is less than 21. The amount of this protein may be higher if a woman has ovarian cancer.
  
  However, the CA-125 is not always an accurate way to determine whether a woman has ovarian cancer. Some ovarian cancers do not make enough CA-125 to be detected by the test. Also, there are noncancerous diseases, such as endometriosis and uterine fibroids that increase CA-125 levels. These tests are usually done only on women over age 35 that are at a high risk for cancer and have a cyst that is partially solid. Because this test is not always accurate, it is currently not recommended as a screening test for ovarian cancer.

Surgical removal of the cyst is sometimes necessary. If this occurs, a biopsy of the cyst tissue is often performed to determine whether it is cancerous.