Hi, Thanks for the query. According to your description, there is rapid increase in the size of the ovarian cyst. If the increase slowed down after starting hormonal pills, possibly the size of the cyst will regress after few weeks. If the size persisted or increased even after taking the pills, you may need to undergo further evaluation. Free fluid in pouch of douglas can be seen in conditions like after ovulation, pelvic inflammatory disease. Usually ovulation will not occur while being on hormonal pills. So, if you are having symptoms like vaginal discharge, pain abdomen etc, get evaluated for pelvic infection. And take treatment accordingly. Take care.