Question :

Hemorrhagic cyst after five months

Dear Ask The Doctor:
I had an ultrasound done due to pain and excessive menstrual bleeding. They found a 1.6 hemorrhagic cyst and said to follow up with an ultrasound in three months. I followed up At 5 months (2 weeks ago) and they said I still have the cyst. That it is still pretty much the same. It is 1.8 now. She said it's no biggy and we will follow up with another ultrasound in 3 months. My question is, is this protocol normal? I am doing pretty ok. I have horrible pain when I ovulate up until - few days into my period. I also bleed tons the first few days. I have had nausea as well. She doesn't seem to understand this is painful. But my main concern is if she is missing something. Can these thing last this long? I know it isn't very large, so hopefully It is ok. I had one rupture 10 years ago and broke a blood vessel and it was beyond painful.


Answer :

Dear Patient: 
When a hemorrhagic cyst is small and there is no marked symptoms related to the cyst, an expectant management with periodic reassement by ultrasound every 3 months is normal management protocol. If the cyst does not resolve after 2-3 ultrasounds, further investigation may be required then. Usually a laproscopic cystectomy is performed if the cyst size is less than 6cm.


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