What Is a Hemorrhagic Ovarian Cyst?

A hemorrhagic cyst is formed when any tiny blood vessel present on the wall of an ovarian cyst gets ruptured. Blood and debris fills up the cyst cavity, forming a hemorrhagic cyst.

What Are Ovarian Cysts?

Ovary is a part of female reproductive system. It produces and stores eggs, the female gametes to be precise.

Each month, one of the egg matures and grows up. It is bound inside a sac or follicle during its maturation phase. After it has grown to its full size, it approaches the boundary of the ovary to ultimately be released inside the fallopian tube. The sac containing it is left behind and dissolves on its own.

There are two kinds of ovarian cysts.

Follicular Cyst

If any of the follicle/ sac containing the egg does not release it in the end,  it forms a follicular cyst. This is a fluid filled sac in side the ovary, still containing the egg.

Corpus Luteal Cyst

Routinely, the follicle containing the egg releases it after full maturation into the tube, and itself gets dissolved. Sometimes, the sac, after release of egg, does not get dissolved. It stays in the ovary like a fluid filled sac. This is called a corpus luteal cyst.

Such cysts are lined by thin blood vessels.

Out of the two, hemorrhage in commoner inside the corpus luteal cyst, since it is lined inside by many tiny blood vessels, that may potentially rupture.

Ovarian cysts occur commonly in women during her reproductive age. They may be symptom less. So, you may not notice their presence.

Many of them regress on their own with time to disappear. No medical intervention is required.

Ovarian Cyst And Pregnancy

You may have an ovarian cyst and get pregnant.

Since you are pregnant, doctor can’t manipulate or operate the cyst at this moment. You have to move on now with your pregnancy and the cyst together, very carefully.

Usually, such cysts don’t interfere with pregnancy. There are chances that it stays as such or even regress with time.

However, sometimes such cysts may complicate. So, you and your doctor need to monitor it closely.

Possible Complications

  • A hemorrhagic cyst may rupture, leaking out blood inside the pelvic cavity. This may be accompanied by acute pain lower down. This condition is a medical emergency, to be rushed to the ER immediately.
  • Such cysts may give you frequent painful episodes due to stretching of the ovarian wall.
  • May get infected. Infection has chances of spreading to other pelvic organs too. So, antibiotic treatment is mandatory.
  • May cause a crampy pain, suggesting  that it is slowly leaking out, such a situation may lead to preterm labor.
  • It may twist. This is another very painful condition. The patient needs to be taken to the hospital immediately.

In all above conditions, medical intervention would be required.

You have to be watchful for any of the above events. For that, monitor the cyst closely by U/S. Also, if you feel any pain, leaking blood from down there, or cramps, report to your doctor immediately.

Management During Pregnancy

  • Let the strategy be such that you complete your pregnancy weeks as many as possible without disturbing the cyst. For that, you need to take a lot of bed rest.
  • Do not lift any heavy object or strain yourself at work. This would stretch the ligaments and musculature of the pelvic area, giving chances for the cyst wall to break or twist.
  • Keep a close eye on the cyst. This is done by regular follow ups with ultrasound monitoring. If you get any alarming symptom, report to your doctor immediately.

Medical Advice (Q&As) on “Managing Hemorrhagic Ovarian Cyst During Pregnancy

  1. radhika

    I’m pregnant less than 5 weeks. I have got spotting 3-4 Times. But my HCG levels are increasing day by day. I’m getting all healthy symptoms of pregnancy. My recent TVS USG report say that I’ve intrauterine gestational sac of less than 5 weeks measuring around 8 mm but no embryonic pole. I’ve two ovarian hemorrhagic cysts also in my left ovary. I’m scared to see all this. This scene has turned up all my emotions into dark. Kindly guide me. What are consequences?

    Reply
    1. Buddy M.D. Post author

      As you can read above, these cysts don’t usually interfere with pregnancy. There are pretty good chances that they remain as such or even regress with time, as the pregnancy progresses. This is so because, these cysts are hormone sensitive.

      They grow during the initial phase of pregnancy, when there is a continuous hormonal supply from the ovaries. As the placenta takes over, as the supplier of hormones, the cysts start reducing in size. Placental hormones don’t support the growth of these cysts.

      However, it is advisable that your pregnancy be monitored closely. Repeated U/S to assess both, baby’s growth and the status of the two cysts is imperative.

      Reply
  2. Asmaah

    I am 30 yrs old and I’m married. I have done my pelvic ultrasound which says, there are two more obvious complicated cysts in the right ovary 2.8×2.5×1.7 and 2.1×1.9×1.4 cm. Appearances are suggestive of hemorrhagic cysts with a simple 2.7×2.4×1.4 cm query a follicle. No prominent free fluid.
    Opinion: There appears to be a couple of hemorrhagic cysts in the right ovary.
    This is what my ultrasound reports says I want to know how it happens and does it affect my health and how I can I treat it and does it affect my married life and I’m trying to conceive. Can it might be problem because of this cysts.

    Reply
    1. Buddy M.D. Post author

      Both the cysts are small in size and are likely to regress on their own with time. If you don’t have any symptom, nothing needs to be done.

      However, if you have pain in abdomen or any menstrual problem, medical intervention is required.

      Read more on the topic above.

      Reply
  3. Tani

    Hi,
    I am 8.5 weeks pregnant and in my Ultrasound report, it says that I have a thick walled unilocular cyst measuring 48x43x54mm in the right ovary with echogenic contents within peripheral solid area without vascularity noted along the wall. There is also a small cyst with fine internal septations measuring 20x12mm in the left ovary. The final impression says ‘complex cysts described as likely to be endometriotic/hemorrhagic in nature.
    Do I have cause for worry? I’ve had these cysts for a while now.

    Reply
    1. Buddy M.D. Post author

      Don’t worry, but get the cysts treated. They cannot be left as such. They may get infected or get twisted.

      Reply
    1. Buddy M.D. Post author

      As you may read above, we can’t treat the cyst now. Pregnancy is the first thing to be attended. Just keep a close watch over the cyst to watch for any complications.

      In most cases, the cyst stays like that and doesn’t interfere with pregnancy.

      Reply
  4. Shubham Garg

    Hi, can you explain my Wife Ultrasound report because there is no doc. Who can confirm my wife pregnancy due to only 18 days over.
    OPINION -F/S/O– Right ovarian cyst of size 59*55mm, Cyst shows echogenic focus of size 19*11mm, Diagnostic possibility-hemorrhagic cyst with clot retraction.
    There is no detection of pregnancy in urine test.

    Reply
    1. Buddy M.D. Post author

      Well, this ultrasound report shows no sign of pregnancy.

      She has a cyst in her ovarian region that needs to be treated. Conceiving would be difficult till the cyst is treated.

      Reply
  5. Ariana

    I am 5 weeks pregnant with a 5 cm hemorrhagic cyst on my right ovary. I get occasional crampy pain but nothing serious. Will this go away on its own??

    Reply
    1. Buddy M.D. Post author

      Such cyst usually do not interfere with pregnancy and there’s nothing to worry.

      However, you need to be watchful. Follow up with repeat ultrasounds is essential to see its status.

      Reply
  6. Suhani

    I m 6 weeks pregnant with the sac of 4mm. My cyst was of 86cc on first ultrasound it has doubled the size in 10 days. What is to be done.
    Please advise

    Reply
  7. Devika

    Recently my doctor advised follicular study.we submitted the report to the doctor. Doctor said u have hemorrhagic cyst with size 37×27mm .That time doctor gave the medicine.I am not getting pregnancy. After 3rd day of period I am getting abdominal pain .It does not stop it continue.Is it harmful to my health ? I have a doubt next egg also have that cyst or not?

    Reply
      1. Devika

        Doctor said egg contains hemorrhagic cyst with size of 37×27mm(report).I have a doubt if next cycle (period) come ,in the cycle an egg has that type of cyst or not?

        Reply
  8. Brianna C.

    I found out I was pregnant from an at home urine test. I was getting waves of pain in my lower stomach though and after intercourse noticed a very small amount of red blood (wiped twice and had 2 small streaks of it) I went to an ER because I was worried about an ectopic pregnancy. They did a transvaginal ultrasound but here’s where I’m confused: the doctor told me I have a hemorrhagic cyst in my uterus, not ovary but he clearly said uterus. He said it may have been the way the baby implanted into the uterine wall? However on the final report it says my gestational sac is present (9 mm) my yolk sac is present and there’s no free fluid in the cul de sac. The estimated gestational age is 5 weeks 5 days. My right ovary is within normal limits BUT there is a 2.6 x 2.3 x 2.5 cm left OVARIAN corpus luteum cyst and that there’s normal blood flow bilateral ovaries. The doctor was telling me I have a threatened miscarriage, but it seemed as if he thought I was bleeding heavier than I was. Since that small amount of blood there has been no more. So, is this cyst in my ovary or uterus?! What the dr. Said and what the paper says is so contradicting. If the cyst is in my uterus, is that why he said it’s a threatened miscarriage?

    Reply
  9. Brianna C.

    Also want to add I was told I had PCOS back in Sept. 2017. Never got my hormone levels checked, just got a transvaginal ultrasound and the dr found I had like 15 cysts in one ovary. I was put on the patch, and accidentally put another patch on the week I was supposed to have my period (lost track ooops) because of that I didn’t have another patch to put on after that period. PCP told me to just put another patch on after another period occurred. But now I’m pregnant magically (the Dr. told me I ovulated every once in a blue moon and it would be hard to naturally conceive) I’m only 19 years old, my grandma had PCOS and my mom had endometriosis (both had full hysterectomy) so I know I have issues in my family with fertility.

    Reply
    1. Buddy M.D. Post author

      It’s difficult to comment without seeing your ultrasound. All that can be said is- hemorrhagic cysts are usually in the ovary.

      Reply

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