Most ovarian cysts do not cause abdominal pain, especially when they are small and benign. However, some patients with ovarian cysts may experience abdominal pain symptoms. For example, endometriotic cysts, also known as chocolate cysts, can cause severe lower abdominal pain, particularly manifesting as menstrual-like abdominal pain. When these pain symptoms occur, the primary reason patients initially visit local hospitals is to undergo medical examination for the condition.