Can Ovarian Cysts Cause Menstrual-Like Bleeding? Symptoms

Can an ovarian cyst cause bleeding similar to menstruation?

Hello, doctor.
Can an ovarian cyst cause bleeding similar to a menstrual period? Two weeks ago, I noticed a slight pinkish blood when urinating, which gradually became darker, and I also experienced abdominal cramping.
On April 14, I went to the gynecologist, who said there was a 4.35 x 4.25 cm cyst on my right ovary and that medication would suffice.
However, during the course of taking the medication, I experienced daily bleeding similar to a menstrual period until my second follow-up on April 21.
The doctor adjusted my medication, and it improved slightly (the ultrasound showed the cyst had not decreased in size).
But after taking the first pack of the new medication at home, I felt extremely unwell and stopped taking it after three days, at which point the bleeding ceased, but I had severe uterine pain, occasional dizziness, nausea, and bloating.
On April 24, unable to tolerate it any longer, I switched hospitals, and another ultrasound revealed that the cyst had grown to 6 x 6.25 cm.
The doctor mentioned two possibilities: one is a potential pregnancy, and the other is concern about the cyst possibly being malignant, which would require surgery for confirmation.
But can pregnancy present this way? I'm confused about whether it's an ovarian cyst or a pregnancy.

Xiao Qing, 20~29 year old female. Ask Date: 2016/04/24

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, based on your symptom description, it is necessary to have a physician confirm that you are not pregnant before determining the type of cyst and the appropriate treatment or follow-up.
Thank you! Wishing you peace and health.
Dr.
Chang

Reply Date: 2016/04/24

More Info

Ovarian cysts can indeed cause symptoms that may resemble menstrual bleeding, and understanding these symptoms is crucial for proper diagnosis and management. Ovarian cysts are fluid-filled sacs that can develop on the ovaries, and they are relatively common among women of reproductive age. While many cysts are benign and may resolve on their own, they can sometimes lead to complications or symptoms that warrant medical attention.

In your case, the presence of a cyst measuring 4.35 cm on the right ovary, as noted in your ultrasound, could potentially explain the bleeding and abdominal discomfort you are experiencing. It is not uncommon for women with ovarian cysts to experience irregular bleeding, which can sometimes be mistaken for menstrual bleeding. This is particularly true if the cyst is hormonally active, meaning it produces hormones that can affect the menstrual cycle.

The symptoms you described, including the initial light pink bleeding that progressed to a deeper red, along with abdominal pain, are consistent with what some women experience when they have an ovarian cyst. The bleeding can occur due to several reasons, such as:
1. Rupture of the Cyst: If a cyst ruptures, it can lead to internal bleeding, which may present as vaginal bleeding. This can also cause significant abdominal pain and discomfort.

2. Hormonal Fluctuations: Some cysts, particularly functional cysts (like follicular or corpus luteum cysts), can produce hormones that may lead to irregular bleeding patterns.

3. Associated Conditions: Conditions such as endometriosis or polycystic ovary syndrome (PCOS) can also lead to abnormal bleeding and may coexist with ovarian cysts.

Regarding your experience with medication, it is not uncommon for hormonal treatments to cause side effects, including changes in bleeding patterns, abdominal discomfort, or gastrointestinal symptoms like nausea and bloating. If the medication did not alleviate your symptoms and instead caused significant discomfort, it is essential to communicate this with your healthcare provider.

The increase in the size of the cyst to 6 cm and the mention of potential pregnancy raises important considerations. While pregnancy can cause similar symptoms, such as bleeding and abdominal pain, it is crucial to rule out other possibilities, including the risk of a growing cyst or other complications. If there is any suspicion of pregnancy, a pregnancy test (either urine or blood) should be conducted to confirm or rule it out.

In conclusion, while ovarian cysts can cause menstrual-like bleeding, it is essential to monitor your symptoms closely. If you experience severe pain, heavy bleeding, or any signs of complications (such as fever or dizziness), you should seek immediate medical attention. Your healthcare provider may recommend further imaging studies or even surgical intervention if necessary, especially if there is a concern about the nature of the cyst or if it is causing significant symptoms. Always keep an open line of communication with your healthcare provider regarding your symptoms and any changes you experience.

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