A hemorrhagic ovarian cyst is a common type of ovarian cyst that develops when blood vessels within a functional cyst rupture, leading to an accumulation of blood. These cysts form as a result of the normal menstrual cycle. While often benign and self-resolving, they can sometimes cause discomfort and, in rare instances, lead to complications.
Understanding Hemorrhagic Cysts
Hemorrhagic cysts originate from functional ovarian cysts, which are non-cancerous structures that form on the ovary during the menstrual cycle. One common type is a follicular cyst, which develops when an ovarian follicle fails to rupture and release an egg, continuing to grow and fill with fluid.
Another type is a corpus luteum cyst, which forms after the egg is released, and the remaining follicular sac seals off and accumulates fluid. These functional cysts become hemorrhagic when a small blood vessel on their inner lining ruptures, causing blood to leak into the cyst cavity.
The leakage of blood into the cyst can cause it to enlarge and potentially lead to symptoms. Most hemorrhagic cysts are self-limiting and resolve on their own within a few weeks to a few months as the body reabsorbs the fluid and blood.
Identifying the Symptoms
Symptoms associated with hemorrhagic ovarian cysts can vary significantly among individuals, with some people experiencing no noticeable signs at all. When symptoms do occur, they frequently include pelvic pain, which is often localized to one side of the lower abdomen, corresponding to the ovary containing the cyst. This pain can range from a dull ache to a sharper, more sudden discomfort.
Many individuals report a feeling of fullness or pressure in the abdomen, sometimes accompanied by bloating. Nausea and vomiting may also occur, particularly if the cyst is large or causing significant irritation. Pain during sexual intercourse (dyspareunia) can also be a symptom, especially with deep penetration. The intensity of these symptoms often depends on the cyst’s size and the extent of bleeding.
When to Seek Medical Care and Diagnosis
Certain symptoms warrant immediate medical attention, as they may indicate a complication of a hemorrhagic cyst or another serious condition. Sudden, severe pelvic pain, especially if accompanied by dizziness, lightheadedness, or fainting, could signal a ruptured cyst or ovarian torsion, where the ovary twists on its supporting ligaments. Fever, chills, or unusual vaginal bleeding alongside pain should also prompt evaluation, as these might suggest infection or other issues.
Diagnosis of a hemorrhagic ovarian cyst begins with a physical examination, including a pelvic exam. The primary diagnostic tool is a pelvic ultrasound, which uses sound waves to create images of the reproductive organs.
This imaging technique can confirm the presence of a cyst, determine its size, and identify characteristics suggestive of a hemorrhagic nature, such as internal echoes or a “reticular” pattern caused by clotted blood. In some cases, blood tests may be performed to rule out other conditions or assess for complications, but ultrasound remains the definitive diagnostic method.
Treatment Options
Management of hemorrhagic ovarian cysts often depends on the severity of symptoms, the cyst’s size, and whether complications are present. For many, “watchful waiting” is appropriate, as these cysts frequently resolve spontaneously. Pain relief can be managed with over-the-counter medications such as ibuprofen or acetaminophen to alleviate discomfort.
Hormonal therapy, often in the form of birth control pills, may be recommended to prevent the formation of new functional cysts and reduce the likelihood of future hemorrhagic cysts. These medications suppress ovulation, interrupting the cycle of cyst development.
Surgical intervention becomes necessary for a small percentage of cases, particularly if the cyst is large (typically over 5-10 cm), causes persistent or severe symptoms, or if complications like rupture with significant bleeding or ovarian torsion occur. Surgical options may include cystectomy, where only the cyst is removed, or in rare circumstances, oophorectomy, which involves removal of the entire ovary, especially if the ovary is severely damaged or the cyst is very large. The choice of treatment is individualized, considering the patient’s age, symptoms, and desire for future fertility.