Both before and after menopause, the indication for treating an ovarian mass is based on its symptoms: Is it causing pain with daily life? Is it causing pain with intercourse? How big is it?
Cysts, which are fluid-filled, are not usually worrisome, and usually resolve themselves without intervention—either before or after menopause. We are concerned if they continue to grow (anything less than 5 cm in size is not a worry).
Any solid mass requires investigation, because it is more likely to be a tumor or cancer. Again, the size and growth rate help us to determine a treatment route.