Post-Sexual Abdominal Pain and Ovarian Cysts in Women

Abdominal discomfort after intercourse?

Hello Doctor: Before my marriage, I underwent a transvaginal ultrasound, which showed a normal endometrium but a cyst on the left ovary.
A few months later, it disappeared upon follow-up.
A year later, due to persistent infertility and an extension of my previously 25-day menstrual cycle to 28-33 days, I sought medical attention and discovered a serous cyst on the left ovary and elevated prolactin levels.
After three months of medication, follow-up showed the cyst had disappeared and hormone levels returned to normal.
However, three months after stopping the medication, the left ovary again presented with a cyst and elevated prolactin levels.
The doctor prescribed medication again and advised follow-up.
I would like to ask: 1.
What are the possible factors for frequent cysts, and can they cause infertility? 2.
I experience cramping and dull pain in the lower left abdomen the day after intercourse, but it improves significantly after resting for half a day.
Could this be due to a ruptured cyst? 3.
During my medical visits, only ultrasounds and transvaginal ultrasounds were performed.
Is this insufficient to detect elevated prolactin levels and the underlying cause of the cysts? I appreciate your assistance and suggestions.
Thank you.

Lai Xiaojie, 30~39 year old female. Ask Date: 2020/05/24

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, there could be several reasons for infertility.
Generally, it should not rupture.
The physician should have conducted appropriate examinations.
If you still have questions, you can consult your obstetrician-gynecologist.
Wishing you good health.

Reply Date: 2020/05/24

More Info

Understanding post-sexual abdominal pain and ovarian cysts in women can be complex, as it involves various physiological and pathological factors. Based on the information provided, it seems that you have experienced recurrent ovarian cysts, hormonal imbalances, and post-coital abdominal pain. Let’s break down your concerns systematically.

1. Frequent Ovarian Cysts and Infertility: Ovarian cysts are fluid-filled sacs that can develop on the ovaries. They are common and often benign, especially in women of reproductive age. However, frequent cyst formation can be linked to conditions such as polycystic ovary syndrome (PCOS), hormonal imbalances, or other underlying issues. In your case, the presence of elevated prolactin levels could indicate a hormonal imbalance that may contribute to the development of cysts. While many women with ovarian cysts can conceive without issues, persistent or large cysts can sometimes interfere with ovulation and fertility. Therefore, it is essential to monitor these cysts and address any hormonal imbalances with your healthcare provider.

2. Post-Sexual Pain: Experiencing abdominal pain or cramping after sexual intercourse can be concerning. This pain may be related to several factors, including the presence of ovarian cysts, pelvic inflammatory disease, or even endometriosis. The pain you describe, particularly on the left side, could suggest that the cyst is exerting pressure on surrounding structures or that it may have ruptured. A ruptured cyst can cause sharp, sudden pain, but it often resolves quickly. If the pain persists or is accompanied by other symptoms like heavy bleeding, fever, or severe discomfort, it is crucial to seek medical attention.

3. Diagnostic Approaches: You mentioned that your healthcare provider has primarily used ultrasound to monitor your condition. While ultrasound is a valuable tool for visualizing ovarian cysts and assessing their characteristics, it may not always provide a complete picture of hormonal levels or other underlying conditions. Blood tests to measure hormone levels, including prolactin, estrogen, and progesterone, can provide additional insights into your reproductive health. If hormonal imbalances are suspected, further evaluation may be warranted, including tests for thyroid function or other endocrine disorders.

In summary, your situation involves a combination of hormonal issues and the presence of ovarian cysts, which can contribute to both fertility challenges and post-coital pain. It is essential to maintain open communication with your healthcare provider, who can guide you through appropriate diagnostic tests and treatment options. Regular monitoring of your condition, along with lifestyle modifications such as maintaining a healthy weight, managing stress, and ensuring proper nutrition, can also play a significant role in managing symptoms and improving overall reproductive health.

If you experience any sudden changes in your symptoms, such as increased pain, changes in menstrual cycles, or any new symptoms, do not hesitate to seek immediate medical attention. Your health and well-being are paramount, and proactive management is key to addressing these concerns effectively.

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