What are the risks of leaving an endometrioma untreated?

Leaving an endometrioma in place can carry risks such as gradual growth with increasing pelvic pain and inflammation, and in rare cases acute complications like rupture or ovarian torsion. There is also a small increased lifetime risk of certain ovarian cancers compared with the general population, but the absolute risk remains low—especially when imaging shows features typical of an endometrioma.

Monitoring is usually done with repeat imaging, most often pelvic ultrasound at intervals (commonly every 6–12 months), along with symptom check-ins. We pay close attention to changes like rapid growth, new solid components, or internal blood flow, as these can prompt a different workup or a discussion about treatment. If symptoms escalate or the cyst begins to interfere with ovarian function or fertility planning, our team can review your options and help you decide whether continued observation or surgery makes the most sense for you.