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Ovarian Cysts in Postmenopausal Women (Green-top Guideline No. 34)


Ovarian cysts are diagnosed with increasing frequency in postmenopausal women as more patients are undergoing imaging in connection with medical care. An ovarian cyst inevitably raises the question of its relevance to the woman’s symptoms and concerns for the possibility of ovarian cancer. The understandable fear of malignancy has driven many patients and their care providers to pursue further testing and surgical investigation.

This guideline aims to clarify when ovarian masses can be managed within a general gynaecological service or when referral to a specialist gynaecological oncology service is appropriate. This should help in determining whether surgical or expectant management is more appropriate, and help to avoid unnecessary surgery or invasive or costly testing in the vast majority of patients in whom simple cysts are benign.

A useful clinical algorithm for the management of postmenopausal women with ovarian cysts can be found on page 6 of this guideline.

The management of confirmed ovarian malignancy is outside the remit of this guideline. Further information can be sought from the National Institute for Health and Care Excellence and the Scottish Intercollegiate Guidelines Network.

COVID disclaimer

This guideline developed as part of the regular programme of Green-top Guidelines, as outlined in our document Developing a Green-top Guideline: Guidance for developers (PDF), and prior to the emergence of COVID-19.

Version history

This is the third edition of this guideline.

Please note that the RCOG Guidelines Committee regularly assesses the need to update the information provided in this publication. Further information on this review is available on request.

Developer declaration of interests

Dr MK Mehasseb: Dr Mehasseb has received payment for lectures at the University of Leicester for the RCOG Membership examination, and is a member of the Advisory Board for Ethicon Endo-Surgery.

Dr NA Siddiqui: None declared.

Dr F Bryden: None declared.

This page was last reviewed 19 July 2016.