Can Birth Control Pills Shrink an Ovarian Dermoid Cyst?

No, birth control pills will not dissolve or shrink an ovarian dermoid cyst. While hormonal contraceptives are sometimes discussed in the context of ovulation-related ovarian cysts, they are not a treatment for dermoids and no medication has been proven to shrink them.

Why Birth Control Doesn’t Shrink Dermoids

To understand why birth control pills cannot treat a dermoid cyst, it helps to distinguish a dermoid from a functional cyst:

• Dermoid cysts (medically known as mature cystic teratomas) are benign (non-cancerous) ovarian tumors. Hearing the word “tumor” can be frightening, but benign simply means it is not cancer. Dermoids develop from reproductive cells and typically contain a mixture of cystic fluid and mature tissues like fat, hair, or calcified parts. Because their growth is not driven by your monthly hormonal cycle, they do not resolve like functional cysts and do not shrink with hormonal medications.
• Functional cysts form as a normal part of your menstrual cycle. For example, a corpus luteum cyst is a structure that forms naturally after ovulation and can also be present in early pregnancy ^[1].

Combined birth control pills work by suppressing ovulation. While taking them may reduce your chances of developing some new ovulation-related cysts, they do not reliably prevent all functional cysts, nor do they speed up the healing of any existing functional cysts ^[2]. It is also worth noting that some progestin-only pills do not consistently stop ovulation, meaning they have even less impact on cyst formation. In either case, hormonal birth control will not treat an existing dermoid.

What Birth Control Can Do For You

Even though birth control will not treat your dermoid cyst, it may still be a good choice for other important reasons. Your doctor might prescribe or recommend it to:

• Prevent pregnancy
• Manage irregular, heavy, or painful menstrual bleeding

You should not start or stop taking hormonal birth control solely in an attempt to treat a dermoid cyst.

How Dermoid Cysts Are Managed

Because medications cannot dissolve a dermoid cyst, your doctor will generally recommend an individualized plan involving either watchful waiting (regular ultrasound monitoring at specific intervals) or surgery.

There is no single size cutoff that automatically requires surgery. The decision depends on your age, whether you have gone through menopause, your fertility goals, the specific ultrasound features of the cyst, and whether you are experiencing symptoms.

• Monitoring (Watchful Waiting): If your cyst is small, not growing, and not causing you any pain, your doctor may suggest monitoring it with follow-up imaging. This is appropriate when the clinician is confident in the ultrasound diagnosis and feels a follow-up plan is safe. Note that an ultrasound can strongly suggest a dermoid, but a definitive diagnosis is only confirmed if it is removed and examined in a lab.
• Surgical Removal: Surgery may be considered if a cyst is large, growing, causing symptoms, or poses a higher risk of complications.

Complications and Warning Signs

While monitoring a cyst or waiting for surgery, it is crucial to know the difference between routine symptoms and emergencies.

• Ovarian Torsion: Larger dermoids can cause the ovary to twist (torsion), cutting off its blood supply ^[3][4]. This is a medical emergency. Seek immediate emergency care if you experience sudden or severe one-sided pelvic or abdominal pain, especially if it is accompanied by nausea, vomiting, faintness, or fever. Sometimes this pain can come and go. Do not wait for your next scheduled ultrasound.
• Rupture: Rarely, a dermoid cyst can burst or leak its contents into the pelvis. Because the material inside a dermoid is highly irritating, this can cause chemical peritonitis—severe abdominal inflammation and pain that also requires urgent medical attention ^[5][6].
• Malignant Transformation: While dermoids are benign, older age and a larger tumor size can increase the index of suspicion for cancer (malignant transformation) ^[7][8]. Unusual or irregular features on an ultrasound can also be warning signs ^[9][10]. However, this complication is very rare. Keep in mind that having solid, fatty, or calcified parts is completely normal for a benign dermoid cyst; concern is based on the overall imaging pattern evaluated by an expert radiologist, not just the presence of solid material.