Ovarian Cysts

Fluid-filled sacs on or in the ovaries — the vast majority are functional cysts that form as a normal part of the cycle and resolve on their own within one to three months. Recurrent cysts with irregular periods and androgen signs point toward PCOS, while a small minority of cysts need surgical attention.

Evidence synthesis: Large observational and trial data support expectant management: the majority of simple functional cysts resolve spontaneously within 8-12 weeks, and combined oral contraceptives prevent new functional cysts but do not shrink existing ones (Cochrane review). For the PCOS phenotype — polycystic ovaries with irregular cycles and hyperandrogenism — inositol has the strongest supplement evidence (multiple RCTs restoring ovulation), with berberine showing comparable effects to metformin on insulin resistance and cycle regularity in Chinese RCTs, though trial quality is moderate. There is no evidence any supplement resolves a structural cyst; complex, persistent, or solid-featured cysts require gynaecological assessment regardless of symptoms.