Can a cyst cause bleeding? What to do if there is bleeding from an ovarian cyst

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Bleeding from an ovarian cyst occurs quite often. Various reasons contribute to this, including hormonal imbalances caused by the growth of this tumor. A cyst is a cavity filled with liquid contents. An examination is performed to identify the cause of bleeding. Conservative and surgical methods are used for treatment.

Can a cyst bleed?

With an ovarian cyst, bleeding may occur:

When the integrity of the membranes of the neoplasm is violated. This is a dangerous complication in which the contents of the tumor spill into the abdominal cavity. This leads to the development of peritonitis, so the patient needs medical attention.
With a rapid increase in the size of the cystic formation. In this case, bloody vaginal discharge appears. They do not depend on the phase of the menstrual cycle. Bleeding and ovarian dysfunction caused by cyst growth are inextricably linked. Discharge in polycystic ovary syndrome often becomes profuse, turning into follicular bleeding.
If the cyst is hemorrhagic in nature. This tumor begins to bleed when malignant cells appear in its composition. Endometriotic formations are no less dangerous. They have a complex structure and are characterized by a tendency to spontaneous rupture.

How to stop

To stop bleeding from an ovarian cyst, the following conservative methods are used:

Administration of hemostatic agents. Dicynone or aminocaproic acid quickly stops bleeding. This method is a temporary measure used in preparation for surgery.
The use of drugs that increase blood clotting. Medicines are used for prolonged intermenstrual bleeding. They are prescribed after a coagulogram. Frequent use of such tablets increases the risk of thrombosis.
Introduction of plasma components. Used in case of severe blood loss to stabilize the patient's condition.
Administration of hormones that cause uterine contractions. Droppers with oxytocin are used for heavy menstruation and acyclic bleeding caused by cyst growth.
Taking iron supplements. Frequent bleeding is accompanied by the development of anemia. Iron-containing products (Fenuls, Ferrumlek) help increase hemoglobin levels.
Hormonal therapy. Hormones are used to slow down the development of cystic formation and reduce the volume of bleeding (gestagens, androgens). The drug is selected depending on the type of cyst, the age of the patient and the general condition of the body.

When a tumor ruptures, laparoscopic surgery is used. The procedure for performing the intervention includes the following steps:

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Bleeding from an ovarian cyst is a rather serious and dangerous pathological condition. Internal bleeding occurs when the cyst ruptures and there is a high probability of consequences such as peritonitis. Clearly, in such situations, the patient urgently requires qualified medical assistance. Also, in some cases, women experience vaginal bleeding; this occurs if the tumor grows. Bleeding of varying severity may occur if a woman has a hemorrhagic cyst. Such a cyst begins to bleed only after it enters the oncological stage. Another type of cyst is considered dangerous; it is an endometrioid cyst. It is quite complex in its structure and a rupture can take the patient by surprise at any moment.

Causes of ovarian cyst rupture and its symptoms

Bleeding due to rupture of a formation can be caused by:

1. Disturbed hormonal levels.
2. Injuries in the abdominal area.
3. Lifting heavy objects.
4. If you have hemophilia.
5. Frequent and active sexual intercourse.

Internal bleeding can be determined by certain symptoms, for example, if there is acute pain in the lower abdomen, and after a short period of time the appearance of an uncontrollable high temperature. In addition, you should pay attention to such symptoms as:

1. Vaginal discharge that looks like blood.
2. Difficulty urinating.
3. Pale skin.
4. Increased heart rate.
5. Weakness.
6. Tachycardia.

What other pains may indicate a rupture of a pathological formation on the ovarian wall:

1. If the left ovarian cyst ruptures, pain may be felt in the liver area or very similar to pain with appendicitis.
2. Rupture of the right ovarian cyst, characterized by pain similar to pain in diseases of the pancreas.

Diagnosis of a rupturing ovary

In case of ovarian rupture, immediate qualified intervention is required, diagnosis is carried out as soon as possible. Medical professionals must carry out the following procedures and studies:

1. Puncture. If there is still a rupture, then there is guaranteed to be blood in the syringe.
2. Computed tomography, this study will help clarify the size of the ruptured cyst and how much fluid has accumulated in the abdominal cavity.
3. Ultrasound of the pelvic organs to determine whether fluid is accumulating in the abdominal cavity.
4. Laparoscopy is also used as a diagnostic method. Having carried it out, it is possible to make an accurate diagnosis.

Treatment of cyst rupture or surgery

Many doctors are in no hurry to send the patient straight to the operating room; to begin with, if the initial stage of the disease is diagnosed, it is carried out with drugs. The patient is prescribed special medications, as well as cold compresses. They are applied to the lower abdomen to speed up the woman’s recovery. You should not think that even at such a mild stage of the disease, you will be allowed to go home immediately. Most likely you will have to stay in the clinic.

There is a chance of going to the operating table if complications arise, or the patient is diagnosed with a moderate or severe form of the disease. In such cases, laparoscopy or, quite rarely, laparotomy is often performed.

Prevention of ovarian cyst rupture

By taking preventive measures to prevent cyst rupture, these unpleasant consequences can be avoided altogether. To do this, it is worth undergoing an ultrasound scan of the abdominal organs approximately once a month and taking medications prescribed by your doctor. If these measures still do not help and the cyst grows and progresses, then it is worth removing it without allowing it to rupture.

Bleeding from an ovarian cyst occurs as a result of rupture of the formation. Each type of tumor has a special bleeding pattern. In order to understand why a cyst ruptures and what it entails, let’s figure out what types of formation there are.

A follicular ovarian cyst appears when a hormonal disorder occurs in the female body. The size of this formation reaches from 1 to 13 centimeters in diameter. This type of formation tends to disappear on its own as soon as the woman’s hormonal levels return to normal. If a follicular cyst forms repeatedly in a patient, this can be regarded as the cause and consequence of a hormone imbalance. Those formations that do not disappear on their own within two menstrual cycles are called persistent.

Cyst rupture is characterized by severe and sharp pain in the lower abdomen. The pain is so acute that the patient is forced to lie down. This may cause nausea, vomiting, general weakness, or a slight increase in body temperature. If a rupture occurs in an ovarian vessel, then hemorrhage will occur in the ovary, peritoneal area or pelvic organs. A sudden rupture breaks the integrity of the ovarian tissue.

Important! The woman may feel weak, lethargic, or in shock, depending on the extent of the rupture and the amount of blood lost. If bleeding occurs inside the abdominal cavity, the patient’s skin and mucous membranes rapidly turn pale, the heartbeat quickens, and blood pressure drops.

A ruptured right ovarian cyst occurs as a result of rapid follicle growth. It is not uncommon for patients to provoke bleeding themselves. This occurs during violent intimacy, high physical activity and a sudden change in body position (for example, somersault or fall).

Important! The growth of a tumor does not always provoke rupture of an ovarian tumor. Sometimes the bleeding is “hidden” in nature. Such hemorrhage does not have pronounced symptoms. The woman does not even suspect that the cyst has ruptured, because over time it goes away on its own.

In case of hemorrhage of a focal tumor, doctors prescribe conservative or surgical treatment. The choice of therapy depends on the intensity of bleeding, its severity, blood clotting and the patient’s well-being.

Hemorrhage due to endometriotic formation

The cause of endometrioid cysts is endometriosis. This formation appears as a result of the growth of tissue into which endometrial cells were introduced. Once in the ovary, the endometrium remains there throughout the entire menstrual cycle and then comes out during menstruation. If an abnormal development of the formation occurs (the contents of the cyst leak into the abdominal cavity), adhesions appear on it, connecting the ovary with the peritoneal tissue and nearby organs.

At first, endometriotic tumors are not a cause for concern. In most cases, they develop slowly, without any special manifestations. If adhesions occur on the formation, the woman may experience discomfort in the lower abdomen. The pain is acute and gradually moves to the rectum or perineum.

When the size of the endometrioid cyst reaches 10 centimeters in diameter, it forms a cavity with thick, dark-colored blood. Menstrual bleeding with an endometrioid tumor is most often heavy and prolonged. Before and after menstruation, spotting may appear. Their duration varies from two to five days. Some patients complain of uterine bleeding that occurs in the middle of the menstrual cycle.

When a cystic formation ruptures, its chocolate-colored contents enter the peritoneal area. The woman notes an increase in temperature, general weakness, pale skin, drowsiness and fatigue. An endometrioid tumor of the ovary and its rupture are accompanied by high body temperature, low blood pressure and acute pain in the lower abdomen.

Hemorrhage due to paraovarian tumor

The paraovarian cyst has an oval shape and smooth walls, the thickness of which does not exceed a couple of millimeters. Inside the formation there is a lining of epithelium. The contents of the cyst are transparent and contain protein and mucin. The blood supply to the tumor is carried out through the fallopian tubes and vessels of the cyst wall.

Rupture of the right ovarian cyst occurs as a result of excessive physical activity or a sudden change in body position. The capsule of the paraovarian formation often bursts randomly. At the same time, pus or lymph accumulates in it. When the contents of the tumor are poured into the peritoneum, the patient’s body temperature rises to 39ºC, intoxication of the body occurs, and sharp pain appears in the lower abdomen. Internal bleeding manifests itself in a woman in the form of stupor, sharp pain and shock.

Bleeding from dermoid tumor

A dermoid cyst is a congenital formation. This tumor is a benign tumor. It consists mainly of the patient’s tissues: fat, muscle, nervous. Sometimes cyst fragments are sebum, hair or teeth.

Although the dermoid cyst grows slowly, the process is stable. The formation increases in size during the process of constant cell division. This type of tumor in most cases can degenerate into a malignant formation. Therefore, doctors insist on surgical intervention.

Bleeding of a dermoid cyst occurs as a result of torsion of its pedicle. This anomaly leads to rupture of the capsule, during which the contents of the tumor enter the peritoneal area. This phenomenon is rare, since this type of formation usually develops into malignant rather than bursting. If the torsion of the tumor does not provoke rupture of the follicle, an inflammatory process may appear in it - peritonitis.

Emergency measures for bleeding

Sometimes bleeding begins after a formation ruptures, so timely medical intervention will help avoid consequences. When doctors suspect a tumor rupture, the patient is immediately hospitalized. At the hospital, she is given an accurate diagnosis, the level of blood loss is determined, and then an individual treatment plan is selected.

If a mild form of the tumor can be treated conservatively, if there is bleeding, doctors resort to surgery. Most often, bleeding can be stopped using laparoscopy. This operation involves partial dissection of the follicle and ovary. If there is a risk of the tumor degenerating into a malignant one, and the amount of blood lost is assessed as high, doctors resort to laparotomy. This type of operation helps to bring a woman out of a state of shock, and also restores the body’s ability to maintain dynamic balance. Laparoscopy is a more delicate operation than laparotomy. In the first case, the damaged part of the ovary is cut off from the patient, and in the second, the organ is completely removed.

Note: In addition to surgical intervention, doctors prescribe a set of additional procedures. In order to prevent the occurrence of adhesions after laparoscopy, the patient is prescribed physiotherapeutic procedures.

If peritonitis develops as a result of hemorrhage, the woman is prescribed anti-inflammatory drugs. In some cases, hormonal treatment is prescribed. If significant blood loss has occurred, the patient may receive a transfusion or homeostatic procedures.

Prevention

In order to avoid rupture of the formation, patients who have been diagnosed with the disease must take preventive measures:

Mandatory visits to the gynecologist (if the doctor has already prescribed treatment, he himself determines when the patient should come for an examination).
A woman should pay attention to inflammations of the genitourinary system in order to cure them in time.
Strictly follow all the instructions given by the gynecologist.
The patient should avoid heavy physical exertion and active lovemaking.
If a woman is planning a pregnancy, she should consult a doctor. It is possible to conceive a child if there is a tumor, but the patient must be registered with the attending physician.

Content

Among female diseases, ovarian cysts are very common. Benign formations bring a lot of trouble to their owner in the form of menstrual irregularities, pain, and discomfort. Knowing the main signs of the onset of this disease, a woman will be able to seek medical help in a timely manner.

Types of ovarian cysts and their characteristic features

Why does inflammation of an ovarian cyst occur, how does it appear and how do the types differ? First you need to understand what a neoplasm is, which often appears in women of childbearing age. A cyst is a cavity shaped like a sac filled with fluid that appears on the surface or inside the ovary. The dimensions, structure, reasons for which it appeared, and detection method may be different.

Functional

The most common type is functional, and can appear on both the left and right ovary. It is formed due to a hormonal disorder, if the overripe follicle could not rupture in time before the onset of the next menstruation. The main signs of a functional ovarian cyst are that it disappears on its own in one or more menstrual cycles and does not require surgical intervention, although the size sometimes reaches several centimeters in diameter.

Follicular

A woman's egg matures in a small sac attached to the wall of the ovary called a follicle. If there is a hormonal imbalance in the body or in the presence of inflammatory processes in the pelvis, ovulation may not occur. In this case, the follicle does not burst, but becomes increasingly filled with liquid, forming a voluminous capsule. Over a period of time, the reverse process occurs, the cavity with fluid decreases in size, and signs of cystosis are not visible.

Corpus luteum cyst

A similar process can occur in the corpus luteum, which is formed on the basis of a ruptured follicle. The expansion of the walls of the cavity where the egg has matured is provoked by the presence of endocrine diseases and the malfunction of the ovaries during inflammation. With insufficient production of the necessary hormone progesterone, a compaction appears with liquid contents inside. Discomfort will be felt when the formation grows to a large size (8-10 cm in diameter). The corpus luteum cyst resolves on its own.

Mucinous

A very dangerous form is mucinous. The structure has a multi-chambered tuberous surface. According to the characteristics of an ovarian cyst, it is distinguished by the presence of internal partitions; the chambers are filled with mucous secretion. Very often, the mucinous type is diagnosed in women before menopause. Severe nagging pain appears, the cystic formation quickly reaches enormous sizes, sometimes the diameter reaches 30-35 cm. Urgent surgical care is able to stop the process, which can degenerate into a malignant tumor.

Dermoid

The reasons why the dermoid appearance occurs are not fully understood. This often happens in the presence of abdominal injuries. Due to the large accumulation of fluid in the abdominal cavity, the capsule reaches a size of about 12-18 cm in diameter. Often, during ultrasound diagnostics, torsion of the pedicle of the dermoid cyst, which contains nerves and blood vessels, is detected. This causes sudden sharp pain. It is possible to get rid of the tumor only by performing surgery, with further rehabilitation treatment.

Endometrioid

The endometrioid ovarian cyst received its name for the similarity in its tissue composition with the mucous membrane inside the uterus. Small dense capsules that appear on the surface of the ovary are filled with a dark, thick liquid consisting of the remains of blood released during menstruation and lymph. Depending on the stage of development of the formation, treatment is surgical or hormonal therapy is prescribed.

Hemorrhagic

Gynecologists classify the hemorrhagic type as functional. It differs from others in that blood vessels rupture inside the corpus luteum or follicle. Signs of a hemorrhagic cyst are hemorrhage with severe pain in the lower abdomen. It is impossible to do without surgical intervention. The removed ovary or part of it, together with the unwanted formation, undergoes histological examination to exclude the diagnosis of a cancerous tumor.

General symptoms of cystosis

It often happens that a woman learns about the presence of the disease in the gynecologist’s office during an examination or during an ultrasound, where changes in the ovaries are recorded in the photo. At the initial stage, the formation of formations at the physical level does not manifest themselves in any way and does not bother the patient, but all types have similar signs of the appearance of a cystic formation, which should not be ignored. Get tested if you notice any of the following symptoms:

heaviness in the lower abdomen;
increased frequency of aching, nagging pain, with aggravation;
uncharacteristic discharge;
erratic menstrual cycle with frequent periods or absence of them;
discomfort during sexual intercourse;
increased abdominal volume;
low but persistent temperature;
unexplained constipation;
pressure on the bladder with increased urination.

How does an ovarian cyst hurt?

The leg of the neoplasm has nerve endings, so when it is compressed or twisted, pain occurs, often very strong and sharp. The same symptoms of acute pain occur when the capsule ruptures. In other cases, it is an aching pain that is protracted and not associated with the menstrual cycle. Pain appears in the groin of the abdomen on the left or right side, depending on where the tumor is located. Without treatment, pain in the ovaries can spread to the legs and lumbar region.

What is the discharge from an ovarian cyst?

During the growth of a cystic formation in the ovary, one of the signs is small spotting that does not coincide with menstruation. The color ranges from dark brown to red. Scanty discharge may appear when pressure is applied to the abdomen during a gynecological examination in the presence of an endometrioid ovarian cyst.

Can there be bleeding with an ovarian cyst?

Bleeding, varying in intensity, occurs when diagnosing a hemorrhagic type of cyst, left or right ovary. Bursted blood vessels, accompanied by acute sharp pain, allow blood to leak into the abdominal cavity or through the vagina. There are cases when uterine bleeding is provoked by a corpus luteum cyst, resulting from uneven exfoliation of the endometrium. Bleeding can occur during the most terrible course of the disease - the transition to the oncological stage.

What are the symptoms of an ovarian cyst in women when it ruptures?

Signs of an ovarian cyst during rupture are characterized by intense pain that blocks the woman’s independent movement. Calling an ambulance is necessary if a woman has the following symptoms:

sharp, paralyzing pain in the lower abdomen;
nausea, vomiting;
bleeding, both internal with swelling of the abdomen, and external;
a sharp decrease in pressure;
dizziness, in some cases loss of consciousness;
increase in body temperature, which is not affected by antipyretic medications;
blue lips, pale skin.

Possible complications and consequences of the disease

If a cystic disease of any type is detected, treatment should not be ignored, even if it is a functional type that does not require special intervention and resolves on its own. The processes occurring inside the body do not always signal a failure of any system in a timely manner. In order not to miss the important time allotted for starting treatment and blocking the development of the disease, you need to undergo regular examination by a gynecologist in a timely manner.

In some cases, the disease progresses very intensively, which leads to the degeneration of the formation into a cancerous tumor, which is rarely treatable and leads to death. Rupture of the seals and the entry of cystic fluid into the abdominal cavity in a short period of time leads to an inflammatory process, peritonitis and, as a result, blood poisoning. This often occurs in the presence of a serous, dermoid cyst.

Failure to promptly seek medical help out of ignorance or under other circumstances during bleeding will lead to critical blood loss, which can lead to the death of the patient. In the best case, a woman is predetermined by long-term recovery treatment after removal of the female internal pelvic organs, which were affected by an irreversible inflammatory process due to bleeding.

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Cysts of a functional nature are relatively common and in more than 50% of cases are combined with some form of menstrual dysfunction. The most typical pathology is menorrhagia and irregular menstruation, accompanied by hypermenorrhea, amenorrhea and oligomenorrhea.

Follicular cysts can exceed 8-10 cm in diameter and cause pain in the corresponding lower quadrant of the abdomen. When examining the pelvic organs, they are palpated as elastic tumor-like structures that can rupture with strong compression. At first, patients with such cysts should be managed conservatively, because these formations may disappear spontaneously.

We usually prescribe OPS to young patients to suppress the stimulating effect of pituitary gonadotropins on the ovaries and conduct a repeat examination of the pelvic organs after 6-8 weeks. During this time, the tumor-like formation should resolve, unless it is a true malignant tumor. The absence of changes is an indication for surgical treatment.

The occurrence of corpus luteum cysts can be the result of several factors. They appear as a result of excessive enlargement of the corpus luteum during a normal menstrual cycle or are formed due to hemorrhage into its cavity, as well as after hormonal stimulation during early pregnancy. Corpus luteum cysts can easily “simulate” an ectopic pregnancy; they are usually observed against a background of short-term amenorrhea that occurs after irregular bleeding; they can be palpated and poorly sensitive, and also cause bleeding into the abdominal cavity, accompanied by abdominal pain and symptoms of peritoneal irritation.

Endometrial biopsy does not contribute to differential diagnosis, since progestogenic changes in the endometrium are observed in these diseases. A cyst can be determined by palpation as a formation more rounded than a tubal pregnancy, but this is not always a reliable diagnostic sign.

The results of measuring hCG levels in blood serum and urine may be erroneous, since luteal cysts often accompany early intrauterine pregnancy. In many cases, they resolve spontaneously, so observation of such patients is often quite sufficient.

Treatment should always be conservative. If profuse bleeding from the ovary is detected, it is necessary to perform transection and excision of the cyst while preserving the ovary.

J.P. Balmaceda

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