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Possible Ruptured ovarian Cyst?
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Anon_232390 posted:
Ok so My last period was 09/18 brown bleed until 09/24 red bleed... 1st by Text-Enhance">yeast infection in 4 years 10/22. Neg preg tests/PCOS. My period finally decided to show itself last night on 11/4. My cycles have been around 33 days for the past few months. At first it looked like it was orange spotting and quickly turned pink. It is a pretty light flow but enough to wear a pad. Ok on to the point I woke up at 6:30 this morning in pain.. I had a constant pain in my right ovary area. No matter what I did, It hurt for 2 hours this way. I walked and sat and laid down nothing helped. Eventually the pain eased off and now it is just coming and going but nowhere near as bad. It is mainly when I get up and move alot now. The pain did spread out a bit but it is pretty much in the one spot. I have had cysts before and even had one burst ages ago but I havent felt pain like this in almost 10 years. My flow is still light with no bad clots or anything. Ive had maybe one or two small clots that looked slimy (like jelly) but not dark red or anything. Sorry it is a bit hard to describe. I am 26, married with no chance of STDS as we get tested and are only with each other. Does this sound like a possible ruptured cyst? My period was late and im not having any of the normal cramping with it. (I also had no cramping leading up to it) The ER is my only option right now and I am avoiding it unless I really feel like I need to go. Thanks for any and all input. My body is being a very weird lady these past couple of months
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Jane Harrison Hohner, RN, RNP responded:
Dear Anon: To review, you had a flow in late September ((the first in 4 years?), then a flow on 10/22, but the current pain and bleeding onset 11/4---hope I am tracking you correctly. This would mean that the pain and bleeding began about cycle day 14 (cycle day 1 being the first day of your last period). Given this specific timing the most likely cause would be bleeding/pain with ovulation. Right before ovulation there is a brief spike of estrogen. When this level drops back down to normal, the sharp decline can destabilize the lining of the uterus leading to spotting/bleeding. Some women have this sign of ovulation every month; others only rarely. Fortunately the amount is usually scant and brief in duration.

In your specific case, the abrupt onset of the severe abdominal pain that MIGHT indicate either a rupture of a large follicular cyst as the oocyte/egg is ejected,or even a bowel problem or ruptured appendix.

The best way to get a confirmed diagnosis is to have an ultrasound which can visualize either the evidence of a ruptured cyst (eg "free fluid in the pelvis"), or a large ovarian cyst which is twisting. If there is a large ovarian cyst (eg greater than 8 cm) the heavy cyst can prompt the ovary to twist on itself like a heavy flower on a too fragile stalk. This twisting ("ovarian torsion") causes intense pain as it cuts off the blood supply to the ovary.

Bottom line, if the pain persists or is escalating you should be seen. That might mean an ER visit if you cannot get in to a GYN or clinic promptly.

Yours,
Jane


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