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Can a hemorrhagic cyst in the right ovary cause pain in the left pelvic area?

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Can a hemorrhagic cyst in the right ovary cause pain in the left pelvic area?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At June 7, 2018
Reviewed AtFebruary 12, 2024

Patient's Query

Hi doctor,

I have pain in my left pelvic area, which gets better after taking Meftal Spas. I got an ultrasound done, which revealed a 2 inches hemorrhagic cyst in my right ovary. My period is also delayed. Is this cyst regular or an endometriosis cyst? Is this pain related to the cyst? What should I do? I am attaching my scan reports.

Answered by Dr. Balakrishnan R

Hi,

Welcome to icliniq.com.

I have gone through your reports (attachment removed to protect patient identity), you are fine and only need very few changes. Let me tell you the problems one by one followed by what to do. Your cyst is just a hemorrhagic or corpus luteum cyst. After ovulation, the remains of the follicle may sometimes keep bleeding and form a cyst. It is not endometriosis because in that case, you would have regular painful periods every month, brownish discharge and severe pain during sex. Your cyst will resolve on its own. Just forget about it, you can have a repeat scan after four weeks to check the size. Your scan says polycystic ovaries. But, the criteria for PCO is at least ten cysts of 10 to 12 mm on both sides. So you do not have PCO. Pain is most probably due to some form of adhesions around the uterus.

It could be due to an infection around the uterus, which can be transmitted during sex. It needs evaluation by a gynecologist and a good course of antibiotics for you and your partner. Symptoms of this infection can be white or yellowish or greenish or grayish vaginal discharge, with or without itching, foul or fishy smell, pain at the end of sex, increased discharge after periods and sex, and feeling feverish during periods. Menstrual blood will be thick and dark or brownish. Most important problem is your weight, your expected weight is 160 to 165 lbs. Try to reduce 4 to 8 lbs per month. Do not hurry on weight reduction, as it will be difficult to maintain. As soon as you reduce at least 11 lbs, you will see changes in your health. The excess cholesterol will alter the hormonal balance and cause these cysts. I suggest you try the following to reduce your weight.

  1. Avoid fasting, junk food, fast food, and red meat.
  2. Reduce snacks in between meals.
  3. Have a low-calorie and high-protein diet.
  4. Try to exercise regularly.

Patient's Query

Hello doctor,

Thank you for the reply.

My stomach is always bloated. Is this cyst not a chocolate cyst or endometriosis cyst? My doctor told me to get a laparoscopy done, to remove the cyst, and said it could twist my ovary. Does my ultrasound prove that I do not have a chocolate cyst? I do not have any other symptoms except, pain on left side and cyst on the right.

Answered by Dr. Balakrishnan R

Hi,

Welcome back to icliniq.com.

There could be many other reasons for the pain like renal calculi or gastroenteritis. Endometriosis is caused due to blood collection in an ovarian cyst over few months. It will look no different from a hemorrhagic cyst, so definitive diagnosis can only be made after seeing it. But it can be ruled out by the absence of symptoms, as I had mentioned earlier. When you have pain on the opposite side of the cyst, then how will its removal relieve you of the pain? I would suggest you try taking tablet Doxycycline 100 mg, twice a day and painkiller for a week. You can also suppress the hormones by taking a packet of 21 pills from the first day of your next periods, it will not allow ovulation and also suppress the cyst. Repeat the scan and note the size of the cyst. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent.

Patient's Query

Hi doctor,

Thanks a lot for clearing my doubts. My only concern was endometriosis, but I do not have any other symptoms. But, can a right endometriosis cyst cause pain on the left side of the stomach?

Answered by Dr. Balakrishnan R

Hi,

Welcome back to icliniq.com.

I understand your concern.

Endometriosis is like an injury with blood collected around it, so you will have pain only if you touch that place. The features of inflammation like pain, adhesions, and swelling will be highest on the side of the cyst only. The other side may also have slight discomfort but not like the pain you are mentioning. Endometriosis cyst of that size cannot just appear. You would have a gradual increase in pain and other symptoms. If you still have doubt, get an ultrasound or an MRI done. MRI will delineate the cyst well and give a lot of details about the adhesions and any unseen cysts.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Balakrishnan R
Dr. Balakrishnan R

Obstetrics and Gynecology

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