Understanding Why Cysts Can Bleed
A cyst is a sac-like pocket of tissue filled with fluid, gas, or other material. The reasons for bleeding depend heavily on the type and location of the cyst. For women of reproductive age, ovarian cysts are a common culprit. When small blood vessels rupture and bleed into a functional ovarian cyst, it forms what is known as a hemorrhagic cyst. Outside of the reproductive system, other types of cysts can also bleed, particularly if they are inflamed, infected, or damaged. Rupture is one of the most common reasons for blood to be released, whether internally or externally.
Causes and Symptoms of Bleeding Cysts
Bleeding from a cyst can be caused by various factors, with the symptoms ranging from mild to severe, depending on the cause and extent of the bleeding.
- Rupture: A ruptured cyst, especially a large one, can release its contents, including blood, into the surrounding area, such as the abdominal cavity. This can cause sudden, sharp pain. For ovarian cysts, this can lead to severe pelvic pain and internal bleeding.
- Torsion: Ovarian torsion occurs when a cyst grows large enough to cause the ovary to twist on its ligaments, cutting off its blood supply. This is a gynecological emergency that can cause intense, sudden pain, nausea, and vomiting, and can lead to internal bleeding.
- Internal Hemorrhage: In cases like hemorrhagic ovarian cysts, blood simply accumulates inside the cyst itself. If the cyst is small, this may go unnoticed or cause only mild discomfort. However, if the cyst fills with a significant amount of blood, it can put pressure on the surrounding tissues, causing pain.
- Inflammation or Infection: Some cysts can become inflamed or infected. While many cysts are sterile, an abscessed cyst can cause surrounding inflammation and may release blood if it bursts. Pilonidal cysts, which form in the skin near the tailbone, are known to become infected and can bleed and drain pus.
- Endometriomas: For individuals with endometriosis, a type of ovarian cyst called an endometrioma can form from endometrial tissue. These cysts can fill with blood and, if they rupture, can cause internal bleeding and severe pain.
Different Types of Cysts That Can Cause Bleeding
While ovarian cysts are a common cause of bleeding, other types of cysts can also involve blood. A table comparing the characteristics of common bleeding cysts helps clarify the differences.
| Cyst Type | Location | Common Characteristics | Potential for Bleeding | When to Seek Medical Attention |
|---|---|---|---|---|
| Hemorrhagic Ovarian Cyst | Ovary | A functional cyst (follicular or corpus luteum) that fills with blood. Can be asymptomatic or cause pain. | High, especially if it ruptures or fills with a large amount of blood. | Severe, sudden abdominal pain, heavy bleeding, signs of shock (dizziness, weakness). |
| Endometrioma | Ovary (associated with endometriosis) | Formed from endometrial-like tissue, often called a "chocolate cyst" due to its dark, blood-filled contents. | High risk of rupture and internal bleeding, causing severe pain. | Intense pelvic pain, particularly around menstruation; bleeding between periods; symptoms of rupture. |
| Pilonidal Cyst | Near the tailbone | Develops around an ingrown hair and often becomes infected, forming an abscess. | Can bleed and drain pus when inflamed or ruptured. | Pain, swelling, and drainage that worsens; signs of infection (fever, redness). |
| Sebaceous Cyst | Skin (face, neck, back, scalp) | Filled with sebum and keratin. A central opening, or punctum, may be visible. | Can bleed if squeezed, inflamed, or ruptured, but usually minor. | Signs of infection or significant pain. |
When to Seek Medical Help
It is important to understand that while some minor bleeding from a skin cyst might not be an emergency, internal bleeding from a ruptured ovarian cyst is a serious medical issue. You should seek immediate medical attention by calling emergency services if you experience any of the following symptoms:
- Sudden and severe abdominal or pelvic pain
- Dizziness, lightheadedness, or fainting
- Rapid breathing or heart rate
- Weakness or feeling unwell
- Unusual or heavy vaginal bleeding, especially outside your period
- Signs of shock, such as pale, clammy skin
- Vomiting and fever along with severe pain
For less severe symptoms, such as persistent pelvic pain, unexplained bloating, or changes in your menstrual cycle, it is best to make an appointment with your healthcare provider. They can perform an ultrasound to properly diagnose the cause of your symptoms and determine if the cyst is problematic.
What to Expect at the Doctor's Office
If you report symptoms of a bleeding cyst, a healthcare provider will perform an evaluation that may include a physical examination, particularly a pelvic exam if an ovarian cyst is suspected. Diagnostic tests commonly used include:
- Ultrasound: This is often the first and most effective tool for visualizing the cyst, its size, and whether it contains blood.
- Blood tests: These can check for signs of bleeding (like anemia) or infection, and can also measure specific markers, such as CA-125, to assess for potential cancer risk, though this is rare.
- CT Scan: In more complex cases or emergencies, a CT scan may be used for a more detailed look.
Treatment for a Bleeding Cyst
Treatment depends on the type, size, and symptoms of the cyst.
- Conservative Management: For small, asymptomatic hemorrhagic cysts, doctors may recommend watchful waiting. The body often reabsorbs the blood on its own within a few menstrual cycles. Pain medication may be prescribed to manage discomfort.
- Emergency Surgery: In cases of severe rupture, torsion, or significant internal bleeding, emergency surgery is necessary. This can be performed laparoscopically (minimally invasive) or through an open incision.
- Surgical Removal: If a cyst is large, complex, or does not resolve on its own, a doctor may recommend elective surgery to remove it and prevent future complications.
Conclusion: Navigating Concerns about Bleeding Cysts
While some minor bleeding from a surface cyst might be a temporary issue, the presence of blood from a cyst, especially when accompanied by other symptoms like severe pain, should never be ignored. Bleeding can indicate a more serious underlying issue, such as a ruptured hemorrhagic ovarian cyst or torsion, which can become medical emergencies. Consulting with a healthcare provider is the safest course of action for diagnosis and appropriate treatment. By being aware of your body and recognizing the signs of a problematic cyst, you can ensure prompt and effective medical care when it is most needed.
