Pelvic Pain, Bleeding, Low Sex Drive, and More

You just never seem to be in the mood these days. Or the last few times you had sex, it hurt. Maybe you have some discharge that’s different from the norm.

But how do you know which signs might signal a bigger problem with your health? Jennifer Lang, MD, a gynecologic oncologist in Los Angeles, says knowing that involves paying attention to your body on a regular basis.

“How can you know what abnormal is if you don’t know what normal is?” she asks.

Lang says it’s a good idea for a woman to examine her vagina with a mirror and light each month, just as you do a regular check of your breasts.

If something just doesn’t seem right or it’s bothering you, don’t feel embarrassed to bring it up with your doctor. “You deserve to have a healthy sex life,” Lang says. “And your doctor is there to help you realize that.”

Here are the top symptoms that doctors say you should bring up when they happen.

Low Desire

By far the most common sexual health issue for women is low desire, says Maureen Whelihan, MD. She has a private practice in gynecology in Palm Beach County, FL.

If low desire doesn’t bother you, it’s not a problem, Whelihan says. But if it’s causing you distress (and it’s lasted for at least 6 months), you can talk to your doctor to find out what may be going on.

Hypoactive sexual desire disorder, the medical term for a low sex drive, can have many different causes — physical, emotional, cultural, or a combination of those, Whelihan says. It could come from a hormone problem, such as estrogen or your thyroid hormone. It could happen because of other health conditions you have, like diabetes, anxiety, depression, or sleep disorders. It may be a side effect of a medication you take, like antidepressants or birth control pills. Even smoking and alcohol can affect desire. Or it may have to do with the quality of your relationship with a sexual partner.

Your doctor or another health professional in the office may ask you some questions to figure out what’s going on. You can also find screening tools online to help you decide if you need more help with low desire. Figuring out what may be causing the problem can help you and your doctor come up with the best solution.

Pain and Discomfort

You’re not alone if sex hurts. Nearly three out of four women will have pain during intercourse at some point. It could be in the vagina and the area just outside of it, called the vulva. But some women feel pain inside their pelvis, too.

Sometimes sex is uncomfortable when you’re not aroused enough, or you have a vaginal infection or a skin condition, like allergies or psoriasis. But pain during sex can also be a sign of serious conditions like pelvic inflammatory disease, endometriosis, fibroids, ovarian cysts, or cancer. So if it happens often or is severe, see your doctor — they’ll want to rule out any serious health issues that could be causing it.

If you’ve reached menopause, painful sex may be caused by vaginal atrophy. That’s when the tissues around your vagina and vulva dry up because of the loss of estrogen. To treat it, your doctor may prescribe a cream with estrogen that you apply directly to the skin in that area.

If you feel a bulging sensation around your vagina and have trouble peeing, it could be a sign that your bladder or other organs in your pelvis have dropped from their normal place and are pushing against your vagina. That’s called a pelvic organ prolapse, a problem that becomes more common with age. Treatments include Kegel exercises, physical therapy, and surgery.

Irregular Bleeding

If you’re past menopause and you have bleeding from your vagina, see your doctor as soon as possible. They’ll need to make sure you don’t have a serious problem, like an infection, uterine fibroids, or cancer.

If you’re still having periods, watch for any spotting, bleeding between periods, bleeding after sex, or periods that are heavier or last longer than usual.

Call your doctor if you have these symptoms. They’ll check you for a few different conditions, including ectopic pregnancy, infection, fibroids, polycystic ovary syndrome, and some cancers.

Unusual Discharge

Is there a change in the color, amount, or smell of your discharge that lasts more than a few days? Let your doctor know.

You may have something that’s simple to treat, like a bacterial or yeast infection. But some discharges may be a sign of sexually transmitted diseases like gonorrhea or chlamydia. Watery or bloody discharges may be due to cancer.

Lumps and Bumps, Rashes and Sores

If you notice any changes in your skin below your beltline, like a mole that looks different or is new, or a bump that itches or hurts, tell your doctor.

These spots can have many different causes, from an ingrown hair to an STD like genital warts or herpes. More serious is vulvar cancer, a rare condition that can show up as a lump, bump, or sore. It may cause itching or tenderness.

No matter what symptoms you’ve noticed, when something doesn’t feel or look right to you, don’t worry that you’re making a big deal out of nothing. “Run it by your doctor just to get a reassuring word,” Lang says. “So you don’t have to worry.”

Dyspareunia (Pain Having Sex). Medical Information

What is dyspareunia?

Pain felt in the genital or pelvic area during (or after having) vaginal sex is called dyspareunia.

It can be divided into either superficial or deep dyspareunia. Superficial means it is felt on the surface of the genital region. Deep dyspareunia is felt deep in the pelvis. They have different causes and treatments and, although it’s possible to experience both at the same time, most women find that their dyspareunia is predominantly one or the other type.

Superficial dyspareunia

This is pain felt in the lips of the vagina (labia), at the vaginal entrance (introitus) and the lower part of the vagina. It typically begins with penetration or very early on after intercourse has begun. It is sore and instant. It is usually quickly relieved by stopping penetration, although you may be sore to the touch afterwards for a little while. The causes of superficial dyspareunia are usually local problems of the labial, vaginal and perineal skin (the perineum is the area of skin between the vaginal opening and the back passage).

Deep dyspareunia

This is the term for pain felt deeper in the pelvis during or after intercourse. It can also spread to involve the fronts of the thighs. It may be sharp or dull, may stop when penetration stops or can continue for minutes or even hours. The causes of this type of pain usually lie rather deeper in the pelvis.

Causes of superficial dyspareunia

Skin bridge

Formation of a little bridge of scar tissue at the very back of the vaginal entrance (introitus) is common after childbirth, particularly if you have had a cut between the vagina and back passage (anus) – a procedure called episiotomy. The scar tissue contains nerve endings and is very sensitive, and so it causes pain on penetration. The pain tends to become worse as having sex (intercourse) continues, as the skin bridge becomes rubbed by the continuing rubbing of penetration.

Intact hymen

The hymen is a membrane that lines the vaginal opening. Early in your sex life the hymen is broken down by the act of having sex. In many young women it will already have been stretched by use of tampons. The name ‘intact hymen’ is misleading, as the hymen does in fact have a small hole in it from birth. This hole becomes larger little by little as girls grow older. However, the hymen can be quite thick and the hole not quite large enough. This can mean that early in her sexual life a woman may feel pain from the hymen as it is forced open the first time she has intercourse. The pain is superficial, is felt at the entrance to the vagina as soon as penetration is attempted and may prevent it from taking place.

Vaginismus

Vaginismus causes a powerful and often painful contraction of the muscles around the entrance to the vagina, which makes penetration painful or impossible. It may also prevent the use of tampons and any sort of gynaecological examination. The spasm of vaginismus is not something you can cause deliberately; it’s completely outside your control. It may seem to begin for no reason but can also result from a painful or worrying experience of sex, when it becomes a kind of protective reflex. However, vaginismus is upsetting and dispiriting for both halves of a couple, as it can prevent the enjoyment of sex for many years and can prevent sex completely. Once it has begun, fear of failure and nervousness about not being able to have sex make it worse. It’s important to seek help to break the cycle of anxiety and pain. Vaginismus is not difficult to treat but your doctor may need to refer you to a psychologist or a specialist physiotherapist.

Bartholinitis

Bartholin’s glands are a pair of glands on either side of the vagina, in the tissues of the wall. They can become inflamed and tender causing Bartholinitis and this will lead to pain during sex. Occasionally, the glands swell during sex, so that it starts off as painless but then becomes painful as it continues.

See the separate leaflet called Bartholin’s Cyst and Abscess for more details.

Vulvodynia

This is a very troublesome condition where the vulval area becomes painful and extremely sensitive to pressure and touch. It can be accompanied by severe pain on attempted penetration. It can also cause the vulval area to be painful when touched and during activities of everyday living. It can lead to frustration and depression, as symptoms can be very long-standing. The causes are uncertain but may involve the nerves in the area becoming much more sensitive than normal and the way the brain communicates with these nerves changing in some way. Treatment includes the use of emollient soap substitutes, creams that numb the area, medicines that lessen pain, physiotherapy and cognitive behavioural therapy.

Lichen sclerosus

This is a scarring skin condition which may affect women of any age, including children. It can affect men too. It results in thinning of the skin of the genital area, together with formation of white patches. It may be caused by the immune system. It causes itching and pain, which can last for a very long time. It’s often mistaken for thrush as it can be very itchy and sometimes slightly sore. Lichen sclerosus carries a small risk risk of cancer of the genital skin. For this reason it should be diagnosed and treated – treatment is usually with regular application of creams.

See the separate leaflet called Lichen Sclerosus for more details.

Female genital mutilation

Female genital mutilation (which used to be known as female circumcision) involves varying degrees of mutilating surgery to the genitals of a girl. In the more extreme forms, the vagina is stitched shut. Following genital mutilation there is usually permanent scarring, which may lead to damaged nerves and pain. Any of these issues can cause pain on penetration and may make sex impossible.

Vaginal abnormalities

Very rarely, abnormalities of the vagina itself make sex painful or even impossible. These include pieces of extra tissue inside the vagina which are present at birth (vaginal septa).

Causes of superficial and deep dyspareunia

Vaginal trauma

The vagina is pretty flexible and strong and usually recovers well from the stretch and (sometimes) small tears of childbirth. However, more significant injury to the vagina – for example, from difficult childbirth or mutilation – can lead to scarring and then to pain and difficulty during sex (intercourse).

Vaginal or genital infection

Infections of the vagina and the area around it cause inflammation of the tissues and so commonly cause pain on having sex. Infection may be with thrush (candida – a yeast that often lives in the bowel), with viruses such as herpes and with germs (bacteria). A wide range of bacterial infections can infect the vagina. Some (but by no means all) are sexually transmitted. The vagina is not always sore and itchy before sex but becomes so afterwards. There is often a coloured discharge and you may notice an offensive smell.

See the separate leaflets called Vaginal Thrush (Yeast Infection), Genital Herpes and Bacterial Vaginosis for more details.

Vaginal dryness

Sometimes pain during sex is due to lack of lubrication, meaning that the vagina is too dry. Normally, the vagina produces secretions which keep it moist and these increase when you become sexually aroused. If there isn’t enough foreplay, or you are not aroused enough, you may not produce enough secretions to make penetration comfortable.

However, it isn’t always as simple as that. There may be reasons why you don’t produce the secretions that you should. These can include psychological reasons such as nervousness because sex has previously been uncomfortable; anxiety around becoming pregnant; or anxiety around waking your sleeping children. Dryness can also be for physical reasons – the vagina tends to be drier after the menopause (see below). Some medicines can cause vaginal dryness, including some contraceptive methods. Vaginal dryness is also associated with a condition called Sjögren’s syndrome, in which the body’s secretions are generally rather reduced. Finally, pregnancy itself can make the vagina dry during intercourse (although it can also have the opposite effect).

Vaginal atrophy

After the menopause the levels of hormones in your body fall – particularly the level of oestrogen. Oestrogen is the hormone that keeps the vaginal wall strong and resistant. It increases the blood supply and the level of secretions and makes the wall softer and more stretchy. Therefore, when oestrogen levels fall after the menopause, the tissues become thinner, less stretchy and less well lubricated. Sometimes they can become as fragile and delicate as the vaginal tissues of young girls (who have not yet reached puberty and started their periods). There are lots of very effective treatments for this problem.

See the separate leaflet called Vaginal Dryness (Atrophic Vaginitis) for more details. 

Causes of deep dyspareunia

Deep dyspareunia can be caused by the genital organs themselves but may also be caused by other structures in the tummy (abdomen) that can be easily knocked during sex (intercourse). There are therefore many possible causes of deep pain in the tummy during sex.

Cervical pain

The neck of the womb (cervix) should not normally be painful. However, if can become infected by many of the organisms which can infect the vagina – particularly herpes. If the cervix becomes inflamed then knocking it with the penis during sex may cause deep pain in the pelvis and sometimes across the fronts of the thighs. The cervix may also become tender and sensitive if you have an intrauterine contraceptive device, particularly if it is sitting a little too low or falling out. This can cause sudden sharp pains in the cervix during sex. (Fortunately cervical cancer is very rare and does not usually cause painful sex.)

Endometriosis

Endometriosis is a condition in which little bits of womb (uterine) lining become embedded in other parts of the body. Most usually this is in the ovaries, the Fallopian tubes that link the womb to the ovaries, and the cervix. These bits of tissue bleed whenever you have a period. This blood tends to cause scar tissue formation with sticking of organs to one another, and the whole pelvis can become painful.

Endometriosis is typically found in young women, and may only become apparent when they come off the contraceptive pill if they have been taking it for a while. This is because ‘the pill’ suppresses it and is, in fact, a treatment for endometriosis. Endometriosis causes pain on sex, typically pain that comes on with deep penetration and continues for some time after penetration is over. It also causes painful periods, and women with endometriosis can find it difficult to get pregnant.

See the separate leaflet called Endometriosis for more details.

Ovarian cysts

The presence of cysts on the ovaries can cause pain during sex (intercourse). This is because the ovaries can be knocked by the penis during intercourse and this can cause the cysts to leak fluid. It’s not unusual to have cysts on the ovaries, as cyst formation is a normal part of the period (menstrual) cycle. However, these ‘physiological cysts’ are typically very small. Larger cysts are more likely to leak and cause pain, and can be a sign of endometriosis, especially in younger women. In women who have passed their menopause, ovarian cysts are worrying, as they can be a sign of ovarian cancer. See the separate leaflet called Ovarian Cyst.

Another, harmless form of pain from the ovary is called ‘Mittelschmerz’. This is pain when an egg is released from the ovary. Pain from Mittelschmerz may not be related to sex at all, and typically lasts for two or three days in the middle of the month – but sex may make it worse when it’s there.

Fibroids and growths in the womb

Fibroids are non-cancerous (benign) growths in the muscle of the womb, which can cause the womb itself to become quite bulky. This is not always painful but it can lead to discomfort during sex. See the separate leaflet called Fibroids.

Causes related to womb position

In some women the womb tilts backwards, rather than forwards; the ovaries then tend to fall backwards too. This can lead to them being knocked in positions involving deep penetration. This can result in deep pain in the pelvis that is more noticeable with deep penetration and which settles slowly when penetration stops or when you change your position.

Bowel pain

During intercourse the bowel is also knocked and moved. If the bowel is sensitive or tender then this can be the origin of pain during sex. This is particularly likely in women who have Crohn’s disease, ulcerative colitis or irritable bowel syndrome, all of which are conditions that cause the bowel to be painful.

See the separate leaflets called Irritable Bowel Syndrome, Crohn’s Disease and Ulcerative Colitis.

Pelvic inflammatory disease

This is a condition of the Fallopian tubes, the womb and, sometimes, the ovaries. It is caused by infection and makes these organs inflamed. As they tend to move during sex, this is painful. The pain is typically felt deep in the pelvis, is worse with deep penetration and settles slowly when penetration stops. Pelvic inflammatory disease also tends to make you feel unwell, and may cause a temperature and a vaginal discharge. See the separate leaflet called Pelvic Inflammatory Disease.

Bladder pain

The bladder sits on top of your womb, just behind and above your pubic bone. Like the womb, the bladder moves and gets pressed on during intercourse. So, if the bladder is inflamed, this may hurt. Typical causes include urine infections and interstitial cystitis. This is a condition in which the bladder becomes sensitive and painful. It behaves like a urine infection but no infection is present. 

Summary

Symptoms of dyspareunia (pain felt in the pelvis during or after sex) are distressing and depressing. They can affect your sex life, your fertility and even your relationship. Many of the causes have a very simple solution and it is important to seek help if you are experiencing problems.

Why Does Intercourse Hurt?: BostonUrogyn: Urogynecologists

Pain during intercourse for women is fairly common, with nearly 3 out of 4 women experiencing it at some point. This affects both your relationships and your own personal happiness. It can also indicate a serious underlying health problem. Painful intercourse can affect women of all ages.

If you’re experiencing pain during sex, Dr. Neeraj Kohli and Boston Urogyn can diagnose any underlying problems and provide treatments and therapies that relieve your pain and help you enjoy sex.

Some of the reasons sex may hurt:

Endometriosis

Endometriosis is a condition where tissue similar to your uterine lining starts growing outside your uterus. Normally, your body breaks down and sheds your uterine lining when you have your period. However, when you have endometriosis, this abnormal tissue becomes trapped inside your body. It may also spread to your fallopian tubes and ovaries. In addition to painful intercourse, endometriosis can cause pain when your urinate or have your period, as well as diarrhea, bloating, and nausea.

Adenomyosis

Adenomyosis occurs when the tissue that normally lines your uterus grows into the muscular walls of your uterus. The tissue doesn’t break down as it’s supposed to during your menstrual cycle, resulting in an enlarged uterus. This can cause painful, heavy periods, severe cramping, and chronic pelvic pain, which making sex difficult and painful. Adenomyosis can also lead to complications like chronic fatigue and anemia.

Pelvic inflammatory disease

Pelvic inflammatory disease, or PID, is an infection that spreads throughout the female reproductive system. PID often follows a bacterial sexually transmitted infection, such as gonorrhea or chlamydia, but it may occur even if you’ve never had an STD. PID doesn’t always cause symptoms, so you may not know you have it. However, PID may cause pelvic pain, heavy and foul-smelling discharge, bleeding between periods, and painful urination.

Vulvodynia

Vulvodynia is a chronic condition that causes pain, burning, and irritation around your vaginal opening. The pain may be constant or come and go, and it could affect your entire vulva or only a specific area. You may only experience symptoms in response to pressure or touch, but they may happen without any apparent cause. Symptoms can make sex, or even sitting for long periods, just about impossible. Unlike some other causes of genital pain, vulvodynia doesn’t have visible signs.

Ovarian cysts

Ovarian cysts are fluid filled sacs located either in or on an ovary. Though ovarian cysts are quite common, and can come and go on their own without causing any problems, they may rupture (break) or cause your ovary to twist, known as an ovarian torsion. These complications cause severe pelvic pain and bleeding, among other symptoms that interfere with sex.

Uterine fibroids

Uterine fibroids are common noncancerous growths that you may develop at any point during your childbearing years. They can vary in size, and you may have one or several. The smallest fibroids usually don’t cause symptoms. However, a large fibroid, or multiple fibroids can enlarge your uterus, causing symptoms that include pelvic pain and heavy, prolonged periods.

Note that painful sex is not always the result of a serious condition. It’s normal to experience difficulties with intercourse after childbirth or menopause because of changes to hormone levels, and plenty of medications can affect your sexual response and desire. No matter your age and other medical issues, you may simply need to use more lubrication.

You deserve to have pleasurable, pain-free sex. Don’t worry that you may not have a serious enough medical condition to report it to Dr. Kohli. He’s happy to find out what’s causing your problems and help you find a solution. Make an appointment with Dr. Kohli at Boston Urogyn online or over the phone.

9 Causes of Vaginal Bleeding After Sex, Menopause & Periods

Ovulation pain (mittelschmerz) or midcycle spotting

Mittelschmerz is a German word that translates as “middle pain.” It refers to the normal discomfort sometimes felt by women during ovulation, which is at the midpoint of the menstrual cycle.

Each month, one of the two ovaries forms a follicle that holds an egg cell. The pain occurs when the follicle ruptures and releases the egg.

This is a dull, cramping sensation that may begin suddenly in only one side of the lower abdomen. In a few cases, there may be vaginal spotting. Mittelschmerz occurs about 14 days before the start of the next menstrual period.

Actual Mittelschmerz is not associated with nausea, vomiting, fever, or severe pelvic pain. These symptoms should be evaluated by a medical provider since they can indicate a more serious condition.

Diagnosis is made through patient history.

Treatment requires only over-the-counter, nonsteroidal anti-inflammatory drugs to relieve the pain. An oral contraceptive will stop the symptoms, since it also stops ovulation.

Rarity: Common

Top Symptoms: abdominal pain (stomach ache), last period approximately 2 weeks ago, vaginal bleeding, bloody vaginal discharge, pelvis pain

Symptoms that always occur with ovulation pain (mittelschmerz) or midcycle spotting: last period approximately 2 weeks ago

Urgency: Self-treatment

Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a hormonal condition very common in women of reproductive age, resulting in menstrual abnormalities as well as an excess of the androgen testosterone. PCOS can affect a woman’s overall health and appearance and often has a si…

Ectopic pregnancy

Ectopic pregnancy is a fairly common condition (one to two percent of all pregnancies). An ectopic pregnancy is one that occurs outside the uterus, which is the normal site of fetal development.

The hallmark symptoms of an ectopic pregnancy include severe abdominal pain, vaginal bleed…

Uterine fibroids

Uterine fibroids are benign growths in the wall of the uterus and most often appear during childbearing years. Fibroids are almost never associated with cancer.

Those at higher risk include black women and women who started their periods at a young age. Other risk factors are vitamin D deficiency, poor diet, obesity, drinking alcohol, and family history of fibroids.

Fibroids can cause pelvic pressure and pain, severe menstrual cramping, and heavy menstrual bleeding that leads to anemia. Quality of life is diminished due to the chronic pain and discomfort. Though fibroids don’t always make it impossible to become pregnant, infertility and pregnancy loss may occur as well as pre-term delivery.

Fibroids can be diagnosed through a routine pelvic exam or ultrasound in a doctor’s office.

A gynecologist can prescribe various medications to ease the symptoms and regulate the menstrual cycle. There are also a number of surgical techniques, some minimally invasive, to shrink or remove the fibroids while leaving the uterus in place. Hysterectomy, or removal of the uterus, is an option in some cases.

Rarity: Common

Top Symptoms: vaginal bleeding, pelvis pain, abdominal cramps (stomach cramps), painful periods, irregular period

Urgency: Primary care doctor

Endometriosis

Endometriosis is a condition where the tissue that normally forms the lining of the uterus – the endometrium – also begins growing on the outside of the ovaries and fallopian tubes. This out-of-place endometrium still thickens and bleeds each month, causing pain, scar tissue, and adhesions.

Risk factors include short menstrual cycles that begin at a young age, with menopause at an older age; never giving birth; uterine abnormalities; family history; and alcohol use.

Symptoms include severe pelvic pain, cramping, and excessive bleeding during menstruation. There may be pain during sexual intercourse and sometimes during bowel movements and urination. Diarrhea, constipation, nausea, and bloating are also common, as is difficulty becoming pregnant.

Endometriosis can be confused with other conditions, such as pelvic inflammatory disease or irritable bowel syndrome. Permanent infertility can occur with untreated endometriosis.

Diagnosis is made by pelvic examination, ultrasound, and sometimes laparoscopy.

Treatment involves over-the-counter pain relievers and hormone therapy, including contraceptives. Surgery may be done to remove endometriosis tissue. As a last resort, removal of the ovaries and the uterus may be recommended.

Rarity: Uncommon

Top Symptoms: vaginal discharge, abdominal pain (stomach ache), vaginal bleeding, pelvis pain, painful periods

Urgency: Primary care doctor

Cervical polyp

A cervical polyp is a growth that develops on the surface of the cervix. The cervix is the gynecological structure of the female reproductive system that connects the uterus to the vagina.

Symptoms are often absent with cervical polyps. However, in some cases, you may experience bleeding betw…

Pelvic inflammatory disease

Pelvic inflammatory disease, or PID, is the general term for a bacterial infection of a woman’s reproductive organs.

PID is most often a complication of a sexually transmitted disease (STD) such as gonorrhea or chlamydia. However, it is possible to get PID from other causes.

Any woman can be affected. It is most often found in sexually active women under age 25, especially those who have had PID before, have multiple partners, and/or douche frequently.

Symptoms include fever, lower abdominal pain, foul-smelling vaginal discharge, pain and/or bleeding during sex, and pain on urination.

Untreated PID can cause infertility due to damaged tissue in the reproductive tract, as well as chronic pelvic and abdominal pain. Unprotected sex partners will be infected as well.

Diagnosis is made through symptoms, pelvic examination, vaginal and cervical swabs, and urine tests.

Treatment is with a course of antibiotics. Be sure to finish all of the medication as directed, even when you begin feeling better.

To prevent PID, have all partners (male or female) tested for STDs and avoid unprotected sexual contact.

Rarity: Common

Top Symptoms: fever, abdominal pain or unusual vaginal discharge, vaginal discharge, nausea or vomiting, vaginal bleeding, pelvis pain

Symptoms that always occur with pelvic inflammatory disease:fever, abdominal pain or unusual vaginal discharge

Urgency: In-person visit

Endometrial polyp

Endometrial polyps are growths or masses that occur in the lining of the inner wall of the uterus and often grow large enough to extend into the uterine cavity. They attach to the uterine wall by a large base (these are called sessile polyps) or a thin stalk (these are called peduncul. ..

Why am I bleeding after intercourse?

Written by:

Mr Ashfaq Khan

Published: 20/04/2020
| Updated: 21/04/2020

Edited by: Cameron Gibson-Watt

The medical name for vaginal bleeding after sex is post-coital bleeding and there are many reasons why it can occur. Any woman of any age can experience it and, in fact, it’s quite a common occurrence. It is believed that most women will experience vaginal bleeding or spotting either during or after sex at least once in their life.

Mr Ashfaq Khan is a leading gynaecologist and obstetrician based in London, who has over 20 years of experience in dealing with this vaginal condition. He describes the more common and rarer causes of vaginal bleeding and when might be a good idea to see a specialist about it.

Is it normal to bleed after sex?

No. It is very important to consult a doctor if you notice bleeding either during and after sexual intercourse. However, a single episode of bleeding following intercourse before menopause may not be serious but should be carefully observed.

If you have already passed through menopause, then bleeding necessitates a visit to the doctor.

Why do I bleed after sex?

There are various reasons why you may bleed after sex. Most of the time, it is can be caused by one of the following:

• trauma, such as tears in the vagina caused by dryness or too much friction
• inflammation, which might be present due to cervical ectropion in which there is an inflamed area of the cervix
• an infection, such as pelvic inflammatory disease or an STI
• polyps, these are non-cancerous growths either in the womb or lining of the cervix

More suspicious causes could be pre-cancer or cancer of the cervix, vagina, or endometrium (lining of the womb). Rarely, auto-immune diseases like lichen sclerosis, Lichen Planus and psoriasis can cause such bleeding.

I’m bleeding after sex but it’s not painful: should I see a doctor?

Pain is not usually accompanied with post-coital bleeding. Most of the time, bleeding after intercourse without pain is more related to some pathology. It is important not to ignore bleeding after sex.

I’m bleeding after sex and it is painful: should I see a doctor?

Yes. Mainly for two reasons:

Firstly, if the bleeding is trauma-related than you may need to either repair the trauma or get treatment for it. Otherwise, the bleeding is very likely to continue.

Secondly, this condition can lead to dyspareunia (painful sex) and chronic pain which can significantly affect your sexual life.

I’m bleeding after sex and I’m pregnant: what does it mean?

It is not unusual to experience vaginal bleeding during pregnancy, but for many couples, it can cause significant distress. Though the risk of miscarriage or premature labour is not so common, it is strongly advised to see a doctor to exclude those causes.

Most of the time the source of bleeding is the cervix or vagina rather than from inside the womb. It is better to see a colposcopist (gynaecologist with colposcopy experience) who is more experienced to assess the cervix and vagina.

When should you see your gynaecologist about vaginal bleeding?

It is especially important to see a gynaecologist if there is any bleeding after menopause (over 50 years of age), during pregnancy or in anyone who has had a previous abnormal cervical smear result. Otherwise, if the bleeding is sporadic and minimal then you can wait for a couple of months to see if it clears up on its own.

That being said, it is always better to see a gynaecologist who is in a much better position to assess the condition and provide appropriate management.

If you are experiencing any of the symptoms mentioned in this article, do not hesitate to contact Mr Khan by visiting his Top Doctors profile and booking a consultation.

Obstetrics & gynaecology
in London

Cervical Cancer: Symptoms and Signs

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. Use the menu to see other pages.

Precancer often does not cause any signs or symptoms. Symptoms do typically appear with early-stage cervical cancer. With advanced cancer or cancer that has spread to other parts of the body, the symptoms may be more severe depending on the tissues and organs to which the disease has spread. The cause of a symptom may also be a different medical condition that is not cancer, which is why people need to seek medical care if they have a new symptom that does not go away.

Any of the following could be signs or symptoms of cervical cancer:

• Blood spots or light bleeding between or following periods

• Menstrual bleeding that is longer and heavier than usual

• Bleeding after intercourse, douching, or a pelvic examination

• Increased vaginal discharge

• Pain during sexual intercourse

• Bleeding after menopause

• Unexplained, persistent pelvic and/or back pain

Any of these symptoms should be reported to your doctor. If these symptoms appear, it is important to talk with your doctor about them even if they appear to be symptoms of other, less serious conditions. The earlier precancerous cells or cancer is found and treated, the better the chance that the cancer can be prevented or cured.

If you are concerned about any changes you experience, please talk with your doctor. Your doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help figure out the cause of the problem, called a diagnosis.

If cervical cancer is diagnosed, relieving symptoms remains an important part of cancer care and treatment. This may be called palliative care or supportive care. It is often started soon after diagnosis and continued throughout treatment. Be sure to talk with your health care team about the symptoms you experience, including any new symptoms or a change in symptoms.

The next section in this guide is Diagnosis. It explains what tests may be needed to learn more about the cause of the symptoms. Use the menu to choose a different section to read in this guide.

Pelvic Pain Brisbane | Pelvic Inflammatory Disease

Period Pain

Period pain or dysmenorrhea is a condition of painful menstrual periods. Menstrual cramps or pain is felt in the abdominal areas and can occur before the menstrual cycle begins and can continue for 2 to 3 days.

Primary dysmenorrhea is the common painful condition in women with no abnormalities in pelvic region. Women may experience severe pain before or at the onset of menstrual periods and the pain persists for 2–3 days. Primary dysmenorrhea is caused by the elevated levels of hormone prostaglandin produced by the tissues lining the uterus (womb). Prostaglandin triggers the uterine muscles to contract and push the uterus lining (endometrium) out of the body through vagina. Women who have high level of prostaglandin will experience intense pain and contractions.

Secondary dysmenorrhea is the painful condition that may be caused because of other gynaecological problems. This kind of pain begins early in menstrual cycle and lasts longer than primary dysmenorrhea. Conditions that may cause secondary dysmenorrhea includes endometriosis, fibroids, infection, ovarian cysts, narrow cervix, abnormal pregnancy, and intrauterine device for birth control.

Some of the commonly observed symptoms are back pain, leg pain, nausea, vomiting, diarrhoea, headache, irritability, weakness, and fainting. Your doctor will perform a pelvic examination to identify if there are any other problems associated with menstrual cramps. Blood tests and cervical cultures will confirm if there is any sign of infection. Other diagnostic tests may be required which include MRI scan and ultrasound scan.

If the menstrual cramps are because of the underlying medical conditions, then treating the underlying medical conditions will help to relieve pain. The conservative approach includes non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain and contraceptive pills which decrease the production of prostaglandins by preventing ovulation. However, these medicines are taken before the menstruation begins.

NSAIDs are contraindicated if you have a history of kidney and stomach problems. The other home remedies such as a heating pad to the pelvic area, regular exercises, massage to the back and abdomen, low-fat diet, and intake of calcium and thiamine tablets may help to treat period pain.

Surgery is very rarely conducted for patients with dysmenorrhea. It is done only if the other conservative treatments are not successful. Some of the procedures carried out are

• Endometrial Ablation – In this procedure, the superficial tissue layer lining the uterus is destroyed. The extra tissue is destroyed by several ablation techniques such as laser beam, freezing, or heating. It is recommended in patients who have heavy uterine bleeding.
• Endometrial Resection – It is the procedure of removal of the endometrium by surgical method. It is done in patients who have heavy menstrual bleeding and who do not have uterine problems such as polyps or cancer. Surgical removal is not advisable for women who want to have children, as it removes part of the uterus.
• Hysterectomy – It is the surgical removal of entire uterus. It is recommended if you have fibroids, uterine prolapse, cancer in the uterus, and vaginal bleeding. This procedure will stop periods and this procedure is not recommended in women who want to have children.

Endometriosis

(This information should serve as a general guide only. It is recommended you discuss your specific concerns with Dr Burrows)

Endometriosis

A common cause of cyclic and non-cyclic pelvic pain in women in the reproductive years is the gynaecologic condition called Endometriosis.

The word “Endometriosis” refers to the lining of the uterus (womb) that sheds every month as a period. Endometriosis is a medical condition where cells that look like the endometrium grow in other places, mostly the pelvis. These cells can bleed every month and cause pain, scarring, and damage to other organs.

Common symptoms include

• Dysmenorrhoea – a condition of pain during the menses (period) that does not respond to the usual treatments (pain relief, the oral contraceptive pill etc.), pain that is disabling and causes work, studies, or social activity to suffer, and pain that is prolonged
• Dyspareunia – is a common symptom of endometriosis, and refers to deep pelvic pain after sexual intercourse
• Menorrhagia – heavy menses (periods) due to a type of endometriosis called adenomyosis where the endometriosis spots invade deep into the uterine wall
• Chronic pelvic pain – can be caused by adhesions or scar tissue in the pelvis or abdomen – as the endometriosis patches bleed they can damage the peritoneum (lining of the body cavity), ovaries, bowel, bladder, and rectum.
• Infertility – treatment of endometriosis can improve the fecundity (pregnancy rate),although mild degrees of endometriosis is not a main cause of infertility.

Whist there are many other causes for pelvic pain in women (see”Laparoscopy”), endometriosis is a diagnosis that needs to be considered, even if the initial investigations, such as an ultrasound scan, are normal.

There are very effective hormonal treatments the doctor will discuss with you, including pain relief, the oral contraceptive pill, progesterone releasing devices, hormonal rod, daily tablets, an injection every 12 weeks, or a progesterone hormone releasing intra-uterine device.

If these treatments are unsuccessful, a laparoscopy should be considered.

Ovarian Cyst

Cysts are non-cancerous sacs filled with fluid that develop in women’s ovaries. Cysts are formed when the follicle that contains egg fails to break and release the egg out of the ovary, resulting in accumulation of fluid in the follicle.

Some of risk factors for cyst formation include heredity, early menstruation, irregular menstrual cycles, excessive upper body fat distribution, and hormonal imbalance. If there is more than one cyst present inside the ovary, the condition is called as polycystic ovary syndrome (PCOS).

Ovarian cysts usually do not cause any symptoms, but you must visit your doctor if you observe swelling or bloating of the abdomen, pain during bowel movements, pelvic pain, severe pain leading to nausea and vomiting, and pain in the pelvis region before or after the menstrual period begins.

Some cysts will disappear by themselves and some cysts that are large will require treatment. Treatment options include non-surgical and surgical treatment. The nonsurgical treatment includes

• Birth control pills help to decrease formation of new cysts and prevent the formation of eggs that will become cysts
• Non-steroidal anti-inflammatory drugs such as ibuprofen and acetaminophen helps to relieve pain

Surgery will be recommended to remove the cyst or ovary if the medications do not help or cysts that are 5 to 10 cm in diameter. Different types of surgeries to remove the cysts include laparotomy and pelvic laparoscopy surgery.

Laparoscopy to Investigate Pain

Laparoscopy is a procedure performed in the hospital operating theatre, where is small telescope is inserted via an incision beneath the navel, and other instruments are used to perform “keyhole” or “minimally invasive” surgery.

Conditions treated include:

• Endometriosis
• Removal of an ovarian cyst (an abnormal sac of fluid or tissue on the ovary)
• Removal of ovary or fallopian tube
• Investigation of pelvic pain (diagnostic)
• Treatment of pelvic inflammatory disease
• Laparoscopic assisted vaginal hysterectomy

Please discuss your symptoms and concerns with Dr Burrows, and she will give you detailed advice regarding your own health care.

Pelvic Inflammatory Disease

What is pelvic inflammatory disease?

Pelvic inflammatory disease (PID) is infection of the reproductive organs of women. This may include infection of

• The Uterus (womb)
• The Cervix (the opening of the womb into the vagina)
• The fallopian tubes (these are the tiny tubes between the ovary and the womb – eggs released by the ovary pass through these tubes)
• The ovaries The infections that can cause PID include
• Gonorrhoea
• Chlamydia
• Other bacteria

PID can cause severe illness in a woman, requiring treatment in hospital. However, sometimes PID can occur without causing any signs or symptoms. That is, the woman may not feel sick and may not notice any change in her body. PID is a very serious disease because it can lead to long term problems.

PID is one of the leading causes of infertility in women. Women who have had PID may have difficulty becoming pregnant and if they do become pregnant, there may be problems with the pregnancy.

Risk factors

The primary risk factor for PID is infection with a sexually transmitted infection (STI) –in particular, Chlamydia and gonorrhoea.

Risk factors for these STIs include

• Engaging in unsafe sex
• Having sex with more than one partner
• Being in a sexual relationship with someone who has multiple sex partners

Symptoms

Women can have PID without any signs or symptoms. Women may notice

• Pain low in the abdomen
• Pain during sex
• Abnormal periods (women on the pill may notice this too)
• Bleeding after sex
• Abnormal discharge
• Fevers
• Some women become very sick and have severe pain

If you have symptoms suggestive of an STI or think you may have been exposed to one, you should seek medical attention immediately.

Prevention

Infection with PID can be prevented by avoiding risky sexual behaviours.

To reduce your risk

• Use latex or polyurethane condoms during sex
• Limit your number of sex partners

If you have recently been treated or are being treated for an STI, you must make sure your sex partner(s) also receives treatment in order to prevent getting infected again. Sex partners should receive treatment even if they do not have any symptoms.

• Practise Safe Sex – Always using condoms when you have vaginal or anal sex is the best way to avoid getting PID. Using water-based lubricant with condoms is recommended. This reduces the risk of the condom breaking and increases both partners’ enjoyment of sex. Oil based lubricants (such as Vaseline) should not be used. They weaken the condom and may cause it to break. If you are giving a man oral sex (his penis in your mouth) then he will need to wear a condom. It does not matter whether you are male or female, if you put your mouth in contact with your partner’s anus or vulva while having sex you will need to use a dental dam
• If you are having unprotected sex, talk to your sexual partner about the risks involved (while some sexually transmitted infections can be cured, others cannot – don’t forget that by having unprotected sex you are at risk of being exposed to HIV). From a good discussion with your partner you may be able to come to a clear agreement about using condoms
• There are lots of ways to enjoy physical intimacy with your partner. Explore other ways to be intimate, which do not put you at risk of sexually transmitted infections or an unintended pregnancy
• If you tend not to use condoms after drinking alcohol or taking other drugs it may be time to have a think about this and the risks involved. While for some it may be unrealistic to think of not enjoying a drink, there are many ways of cutting down so that you stay in control and can make more rational choices about your sexual contact
• Remember that using condoms not only protects you from STIs, it also is an effective form of contraception. If you do use other forms of contraception (like the pill, diaphragm and IUCD etc.), use condoms as well

If you or your partner has more than one sexual partner and do not use condoms, have regular sexual health check-ups.

If you think you may have been at risk of getting a sexually transmissible infection, you may be at risk of having PID. Have a sexual health check to be sure.

Diagnoses

The doctor can test for PID by

• Examining and taking swabs from your vagina and cervix
• Testing urine for Chlamydia and Gonorrhoea
• Feeling the cervix, uterus and ovaries for any sign of tenderness or pain
• Doing blood tests

If you find out that you do have PID, anyone you have had sex with in the past few months will need to be tested and treated also. This is to make sure that they are cleared of the infection and to prevent you from getting the infection again and needing treatment all over again. If you feel uncomfortable or embarrassed about telling your partner or partners, the doctor or nurse can contact them. This is a confidential process and your name will not be mentioned. This is very important for your health, for your partner’s health, and the health of other people they have sex with.

How can you be treated for pelvic inflammatory disease?

PID is treated with antibiotics. Sometimes three different antibiotics are given.

To ensure the infection has been cured

• It is important to take all the tablets – otherwise the infection may not be properly cured
• You will be asked to return to Dr. Anna Burrows or clinic for follow-up appointments – this will include checking that signs of infection are settling. After you have finished the treatment there will be tests to check the infection is cured
• It is best not to have sex until the tablets are finished and you have been tested to check the infection is cured (even if you feel better)

Sexual partners who have the infection should be treated at the same time – otherwise you may get the infection again.

If a woman is very sick with PID, she may need to be admitted to hospital for treatment.

Management Strategies

90,000 Ovarian cyst – treatment and symptoms, diagnosis of ovarian cysts in Moscow, Clinical Hospital on Yauza

11/01/2021

The article was checked by an obstetrician-gynecologist, Ph.D. Sazonova Yu.M. is for general informational purposes only and does not replace specialist advice.
For recommendations on diagnosis and treatment, a doctor’s consultation is required.

– Doctors of the Clinical Hospital on Yauza can diagnose ovarian cysts at a gynecological examination with the help of a competent history taking, an ultrasound of the pelvic organs with color Doppler mapping, and a clinical examination.
– In some cases, it is necessary to apply additional research methods, such as CT or MRI and tests for sex hormones.
– In most cases, functional ovarian cysts disappear on their own after a while. Otherwise, our specialists will prescribe treatment – conservative or surgical.

Ovarian cyst – a benign formation filled with any content. According to statistics, an ovarian cyst occurs during life in 30-50% of women of reproductive age.

Make an appointment with a gynecologist

Types of ovarian cysts

The most common type of ovarian cysts is functional, which are subdivided into follicular and corpus luteum cysts. The reasons for their development in most cases are hormonal disorders caused by ovarian dysfunction. The presence of chronic inflammatory diseases and hereditary predisposition also increase the risk of their occurrence.

Follicular cyst arises from a follicle in which ovulation has not occurred and is a fluid formation with thin walls.The size of this type of cyst usually does not exceed 5-6 cm.

Cyst of the corpus luteum. After the ovum leaves the follicle, it is reborn into the corpus luteum. If pregnancy does not occur, the corpus luteum is destroyed. In some cases, it may fill with blood or fluid and remain in the ovary for a while. This is how the cyst of the corpus luteum is formed. The size of the cyst is usually no more than 6-8 cm.

Most often, functional cysts disappear naturally and require dynamic monitoring and minimal treatment.But complications associated with their twisting, rupture and, as a result, possible bleeding are also possible.

Paraovarian cysts develop from the tissues surrounding the ovary and are filled with serous fluid. This is a single-chamber thin-walled benign formation. They are located next to the ovary or fallopian tube, do not dissolve and can reach 20 cm in diameter.

Dermoid cysts are formed from the remnants of embryonic tissue. May include teeth and hair, fat cells, bone and cartilage.

Endometrioid cysts develop from foci of endometriosis in the ovaries. During menstruation, a small amount of blood is secreted, which fills the cyst with a thick, dark fluid.

Serous and mucinous cysts can arise from ovarian epithelial cells.

All cysts can grow large, impairing reproductive function, causing pain.

Ovarian cyst symptoms

Most often, the disease is asymptomatic, sometimes it can disturb:

• pain in the lower abdomen, which can be given to the rectum,
• menstrual irregularities, uterine bleeding associated with ovarian dysfunction, delayed menstruation,
• painful sensations during intercourse,
• sometimes – an increase in the abdomen (with a large cyst),
• An ovarian cyst, especially an endometrioid cyst, can cause infertility.

Why is this disease dangerous?

A cyst can be complicated by torsion of its legs, rupture of education, spread of endometriosis. These situations require urgent hospitalization in a hospital for surgery. Malignancy (malignancy) of some types of long-standing cysts is also possible.

Make an appointment

Diagnostics

Doctors of the Clinical Hospital on Yauza diagnose an ovarian cyst at a gynecological examination using an ultrasound scan.In some cases, to clarify the diagnosis, to clarify the causes of cyst formation, it is necessary to perform CT or MRI of the pelvic organs, tests for CA-125 tumor markers, tests for sex hormones.

Any formations on the ovaries require differential diagnosis with an oncological process.

Treatment

Most often, functional ovarian cysts disappear on their own within 2-3 months, but if this does not happen, our specialists prescribe treatment.

Conservative therapy

In most cases, the doctor prescribes conservative anti-inflammatory therapy and, if necessary, taking oral contraceptives, after which the patient’s condition is monitored using ultrasound.

If surgery is required, the woman is sent for laparoscopy – an effective and low-traumatic method of removing cysts. After the operation, in order to successfully restore the body and prevent the reappearance of the ovarian cyst, our specialists prescribe a special pharmacotherapy.

Laparoscopic ovarian cyst surgery

If an ovarian cyst (endometrioid, serous, mucinous, dermoid or paraovarian) reaches a significant size (more than 4–5 cm), causes pain and destroys healthy ovarian tissue or disrupts its function and functions of adjacent organs, it must be removed.This is done using laparoscopic surgery.

Timely detection and treatment of ovarian cysts allows patients to return to their normal life as quickly as possible.

Our advantages

• Our medical center is attended by doctors with a wealth of practical experience.
• We have a special innovative design of operating theaters: infection-resistant seamless monolithic units, 5 levels of sterility, thanks to a sophisticated ventilation system.
• The Department of Gynecology is equipped with the latest generation of equipment – surgical techniques from renowned world manufacturers of medical equipment – Karl Storz, Covidien, Erbe, etc.
• All procedures are carried out in the most comfortable conditions for the patient.

You can look at the prices for services in the price list or check the phone number indicated on the website.

Reviews

Julia

I would like to express my gratitude to your doctors.It is always scary to decide on an operation. I, like hundreds of other people, tried to give it up. It’s good that the doctor explained the consequences of the refusal in my case in an accessible way. The operation was quick and easy; I spent the postoperative period with you. I’m happy with everything, got rid of the problem, and again I can live a full life.

Igor

The fact that the work of the clinic is organized at a high level is noticeable already at the entrance. Reception, diagnostics, doctor’s consultation also left the most pleasant impression.The treatment was chosen very competently. The cyst disappeared, and with it the painful sensations.

Ekaterina

The clinic is equipped with an excellent modern apparatus for ultrasound diagnostics, doctors identified a cyst, were able to choose a treatment until complications appeared. Almost immediately after the therapy I was able to get pregnant, for which I am sincerely grateful to the doctors of the hospital.

Vlada

Thanks to Igor Anatolyevich for the wonderful operation.I felt neither pain nor fear. But after the operation, I felt much better. The attitude towards patients in the clinic is simply wonderful. They know how to calm and cheer.

Olga

Excellent specialists work in the clinic. the most modern gentle methods are applied. This became the main criterion for me when choosing a clinic.

Literature:

3. Khokhlova S.V., Davydova I.Yu., Novikova E.G., Teletaeva G.M., Tryakin A.A., Urmancheeva A.F. Practical recommendations for drug treatment of non-epithelial ovarian tumors // Practical recommendations RUSSCO 2016.2016.

4. Shu C. A., Pike M. C., Jotwani A. R., Friebel T. M., Soslow R. A., Levine D. A., et al. Uterine cancer after risk-reducing salpingo-oophorectomy without hysterectomy in women with BRCA mutations // JAMA Oncol.2016.

90,000 diagnostics and treatment in Kaliningrad – Nadezhda Medical Center

Ovarian apoplexy is a rather dangerous disease characterized by a rapid increase in symptoms and their vivid manifestation. However, the clinical picture is often blurred, which leads to difficult diagnosis and incorrect diagnosis, as a result of which the woman is in mortal danger.

Description

Apoplexy is a rupture of the ovary, or rather, its tissues, followed by hemorrhage inside the organ and abdominal cavity. The disease is typical for women of reproductive age (20-35 years). Most often occurs during ovulation (middle of the cycle) and maturation of the corpus luteum. Apoplexy of the ovary ICD 10 can be a consequence of the pathological process of maturation of cysts, inside which a hematoma is formed. The likelihood of illness during pregnancy is not excluded.

Symptoms

As a rule, ovarian apoplexy symptoms are bright, which cannot be missed:

• sudden severe pain in the lower abdomen or side;
• pulling severe pain in the middle of the cycle or after a delay in menstruation, uncommon for signs of ovulation or PMS;
• pain can radiate to the navel and rectum;
• minor bleeding in the middle of the cycle;
• lowering blood pressure, blurred eyes, deterioration in general health;
• increase in body temperature;
• chills, dry mouth, vomiting, thirst.

It is difficult for the patient to stay upright, she can lose consciousness with hemorrhage into the abdominal cavity.

Reasons

Apoplexy of the left ovary or right occurs for a number of reasons:

• inflammatory and infectious diseases of the ovaries;
• mutation of the corpus luteum;
• changes in blood vessels;
• violent intercourse;
• weight lifting, active physical labor.

Diagnostics

To diagnose an ovarian rupture, the symptoms will become a reliable way.However, pain syndrome is also typical for other diseases (ectopic pregnancy, miscarriage, malignant tumor, appendicitis), so the woman is sent to a hospital, where several specialists are examined at once. In most cases, blood, urine, ultrasound, and abdominal palpation do not determine the exact cause of the disease. The most reliable diagnostic method is laparoscopy.

Treatment

Ovarian rupture, the causes of which do not affect the course of the disease, amenable to conservative treatment only in an uncomplicated form, in the absence of bleeding into the abdominal cavity.The patient is prescribed rest and rehabilitation therapy. This treatment is suitable only for women who have given birth who do not plan to have children in the future. So far, ovarian apoplexy can only be treated with surgery. A woman undergoes laparoscopy with the most gentle approach in order to preserve the reproductive organ.

Prevention

Timely diagnosis and treatment of diseases of the female genital area will prevent apoplexy. You can not lift weights, engage in heavy physical labor and violent sex, especially during ovulation.We offer you to undergo a comprehensive examination and treatment of any diseases of the reproductive system. Our gynecologists know what apoplexy is, symptoms and methods for diagnosing pathology. Patients of the medical center always receive competent assistance from doctors of the highest category.

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A repeated consultation is considered to be a consultation of one specialist within 30 days from the date of the previous appointment.On the 31st day from the previous visit to a specialist of this profile, the consultation will be primary.

90,000 Take care of the ovaries | Medical house Odrex

Ovarian cysts – “bubbles” on the female reproductive gland – are unsafe: they can put pressure on neighboring organs, negatively affect reproductive function and lead to emergency conditions.So task number 1 is to identify pathology in time and choose the right strategy.

Gynecologist-endocrinologist on ovarian cysts

Consults Irina Vasilievna Tsyganenko , obstetrician-gynecologist, gynecologist-endocrinologist

Sensitive organ

Changes in ovarian tissues can occur under the influence of a number of factors:

• Hormone imbalance,
• Diseases of the genitourinary system,
• Decreased immunity,
• A sharp decrease in body weight,
• Overweight,
• Injury to the abdomen,
• Regular stress,
• Heredity,
• Concomitant diseases of the kidneys and liver.

In focus

The presence of a cyst may be indicated by irregularity and soreness of menstruation, pain in the lower abdomen during physical exertion, an increase in body temperature to 38-39 degrees. In such cases, it is necessary to do an ultrasound of the pelvic organs.

But it should be remembered: very often the appearance of cysts occurs asymptomatically, therefore it is important to regularly undergo professional examinations by a gynecologist. The fact is that cysts, depending on their nature, can behave very differently.

Will it disappear or not?

Thus, the formations that appear as a result of an imbalance of hormones – both sexual and “stressful” – usually dissolve on their own or with the help of drugs. In most cases, this process does not take more than 3 months.

Another thing is when it comes to cysts caused by endometriosis (growth under the influence of hormonal imbalance of endometrial cells beyond the “intended place”, the inner layer of the uterus). Such cysts are called “chocolate” because the cells produce menstrual blood, and it accumulates in the form of dark brown clots.Over time, such formations increase and contribute to the development of infertility. Endometrioid cysts, as well as neoplasms due to inflammatory diseases of the pelvic organs or abnormal development of germ cells, rarely disappear without surgical treatment.

Emergency

During intercourse, playing sports and other physical activity, ovarian cyst rupture may occur. In this case, the woman feels severe pain, sometimes accompanied by intra-abdominal bleeding and loss of consciousness.In this case, an urgent surgical intervention is required.

Pediatric gynecologist about ovarian cysts

Consults Larisa Dmitrievna Lyubomirskaya , pediatric gynecologist

Small to large

Ovarian cysts can occur at any age, starting from infancy – in some cases, education is found even in newborn girls. However, more often they develop at 10-14 years old, with the onset of puberty. The first sign of a deviation is irregular menstruation.And since cycle problems are not uncommon at a young age, it is very easy to miss the onset of the disease.

Don’t Ignore

As in adult women, functional ovarian cysts in girls often do not manifest themselves for a long time and are found by chance – during a gynecological examination or during an ultrasound of the pelvic organs. If the formation exceeds 10-15 cm in size, pain occurs, and the body temperature rises.

With endometrioid cysts, there is a prolonged brown discharge before and after menstruation, the patients complain of soreness or discomfort in the lower abdomen.Explain to your daughter that these symptoms should never be hidden. If they appear, it is important to see a pediatric gynecologist as soon as possible.

Supervised

Hormonal anti-inflammatory therapy and control of the dynamics of cyst development are the first steps that a doctor should take. If there are no positive changes, it’s time to think about the operation.

Timely assistance

No one is immune from the appearance of an ovarian cyst. The gynecologist can identify it at any age.Therefore, parents should be attentive to the health of their daughter and explain to her that uncomfortable conditions cannot be tolerated – it is better to immediately seek medical help.

Gynecologist on ovarian cysts

Consults Olga Nikolaevna Kulish , obstetrician-gynecologist, gynecologist-surgeon, oncogynecologist

When an operation is indispensable

If conservative treatment is ineffective, the cyst causes severe pain, grows and reaches a large size, appears in menopause, has signs of a dermoid, endometrioid, cystadenoma, is suspicious of oncology, or has signs of malignancy – surgical treatment is necessary.Emergency care is required for a condition when there is a twisting of the cyst or appendages, suppuration or rupture of the cyst, accompanied by bleeding.

Effective and safe

We perform 99% of operations laparoscopically. After three micro-incisions, the surgeon finds and removes the cyst, while the ovarian tissue does not suffer, as does the reproductive function of the female body. Education is sent for histological examination to a world-class laboratory to find out if there is a need for additional therapy.If necessary, histology is performed directly during the operation.

Return to Form

Unlike traditional surgery, which involves a 6-7-day hospital stay at Odrex, the patient’s stay in the clinic is limited to one day. It takes 2-3 times less time to heal wounds: 5-7 days, not 2-3 weeks. After the operation, there is an excellent cosmetic effect, there is no pain in the postoperative period and the patient can quickly return to her usual lifestyle.

Fast Recovery

The operation does not always mean the removal of an organ – the techniques used in Odrex allow to preserve the ovarian tissue as much as possible.

Functional ovarian cysts

What is an ovarian cyst?

This is a round formation on the ovary, has a capsule and is filled with contents, mainly liquid. The sizes of cysts are usually from 2 to 7 cm in diameter, sometimes even more.They develop more often in women with impaired ovulation processes (maturation of the follicle and release of the egg). This pathology develops more often in women of childbearing age. By themselves, cysts do not pose a threat to a woman’s health and can disappear on their own without any treatment. Doctors call such cysts – functional . There are also organic ovarian cysts, they consist of tumor tissue (for example, dermoid, serous, mucinous) and require surgical treatment, since they do not disappear by themselves.

Functional cysts, they are also temporary, are follicular , as well as corpus luteum cysts .

Why and how are functional cysts formed?

Ovarian cysts can develop against the background of an imbalance of sex hormones, due to disruption of the work of other endocrine organs, such as the thyroid gland or adrenal glands, due to infections of the genitourinary organs, after very severe stress, after abortion. As a result of these factors, the processes of maturation of follicles in the ovaries are disrupted.Normally, the follicle should rupture when it reaches a size of about 20 mm (dominant follicle), but in this case this does not happen, its walls stretch and become a capsule of the cyst, and fluid accumulates inside, so a follicular cyst arises. Sometimes ovulation of the follicle still occurs, but it is filled not with the cells of the corpus luteum, but with the bloody-fluid contents and a cyst of the corpus luteum is already formed.

How does a functional ovarian cyst manifest?

Small cysts often do not bother a woman in any way, she may not even know about their existence in her body, since such cysts disappear by themselves after one or two menstrual cycles.Larger cysts, from 5 cm in diameter, can cause pain and discomfort during physical exertion, for example, pulling sensations on one or both sides of the lower abdomen when walking fast; they are often accompanied by a violation of the menstrual cycle, menstruation irregular, abundant; with very large cysts, there is discomfort when urinating, during or after intercourse.

When a rupture or torsion of the cyst leg occurs, there may be severe cramping pain in the suprapubic and inguinal region, weakness, dizziness, up to loss of consciousness, nausea.These symptoms are dangerous because they can lead to blood loss (intra-abdominal bleeding) and peritonitis (inflammation of the peritoneum). If such symptoms appear, an urgent need to contact a gynecological hospital.

How are functional ovarian cysts diagnosed?

To make the correct diagnosis, the gynecologist first asks the complaints (when, how did the above symptoms appear, how long does it last, is there a worsening of the condition) and clarifies information about your menstrual function, about concomitant diseases, especially the reproductive and endocrine system.Next, the doctor will conduct a general and gynecological examination, during which an increase in the appendages can be determined by palpation. From additional studies, ultrasound is carried out, an effective and painless method for detecting cysts, a pregnancy test is performed for women who are sexually active in order to exclude an ectopic, since it gives a similar clinic. A very good diagnostic and treatment method today is laparoscopy, it allows you to directly examine the ovaries in order to detect a tumor and conduct surgical treatment.However, in the case of uncomplicated functional cysts, laparoscopy is most likely not needed. If cysts rupture, a puncture of the posterior vaginal fornix may be performed to determine if there is blood in the abdominal cavity. However, this approach is outdated when it comes to laparoscopy.

Treatment of functional ovarian cysts

During the selection of treatment, the age of the woman and the need to preserve the reproductive function are taken into account, the size of the cyst, the duration of its occurrence, it is important to clarify whether it is a relapse or a primary case.Also, special attention is paid to the risk of cyst malignancy.

If the cyst is small, there are no complications, then 2-3 menstrual cycles are observed for it, most often the cyst disappears on its own. It is advisable to limit stress and physical activity so that there is no torsion of the leg or rupture of the cyst, if cystic changes are accompanied by severe pain, pain relievers are prescribed (only after an in-person consultation with a doctor).

If after 8-12 weeks, that is, 2-3 cycles, signs of a cyst remain on the ultrasound, objectively the woman feels symptoms, then COCs (combined oral contraceptives) are prescribed for at least 6 months.

If this does not bring an effect, the cyst recurs, then they resort to surgical treatment, since it is most likely not a functional cyst.

Method of choice – laparoscopy. It is preferable to remove the cyst without injuring the ovarian tissue itself (cystectomy or cystectomy). In postmenopausal women, removal of the ovaries (ovariectomy), removal of the appendages (adnexectomy), sometimes in combination with removal of the uterus (hysterectomy) are recommended.

Complications and prognosis

Complications include torsion of the cyst pedicle, rupture of the cyst.But in general, the prognosis of this disease is favorable. Functional cysts practically do not affect the ability to have children, on the contrary, with the onset of pregnancy, they decrease in size and may disappear. Cancer degeneration of a cyst is possible only with organic cysts that are not functional.

Preventive measures

There are no special measures and methods. But in order not to start the process, it is better to regularly visit a gynecologist and monitor the condition of your reproductive system, timely treat diseases of the endocrine system, hormonal abnormalities, infectious and inflammatory processes.Limit stress, give up bad habits. Proper nutrition and a healthy lifestyle will help reduce the risk of not only reproductive diseases, but also strengthen your body.

Find out all our news and a lot of useful information on Telegram Public Accaunt: https://t.me/klinika_medvedev

90,000 Treatment of ovarian cysts at the Lymphatic Surgery Center

Ovarian cyst

The ovaries are two small organs located on either side of the uterus.It is normal for small cysts to form in the ovaries (follicular cysts). These cysts are not harmful and usually go away on their own. Others require treatment and can become a problem.

Types of ovarian cysts
Ovarian cysts are a common pathology for women of childbearing age. Most cysts are the result of hormonal changes that occur during the menstrual cycle. Ovarian cysts vary in size from as small as a nut to as large as a grapefruit.There are many types of cysts and each type has a different origin. In most cases, ovarian cysts have no clinical manifestations. At the same time, in the presence of ovarian cysts, symptoms such as menstrual irregularities and pain are possible. The cause of clinical manifestations can be hemorrhages in the lumen of the cyst, torsion, rupture. Most cysts are benign, but some types of cysts are at risk of malignant transformation. That is why, for any cysts, a woman should be examined by a gynecologist.

Functional cyst
This is one of the most common types of cysts. It is formed from tissue that is altered by the normal ovulation process. In the process of maturation of the follicle and the formation of the corpus luteum, in some cases, the regulation of ovulation is disrupted and follicular or luteal cysts can form. Follicular cysts form at the site of a follicle that has ruptured. Luteal – in place of the corpus luteum. Functional cysts cannot be treated with surgery.Most of these cysts are asymptomatic. They disappear on the background of taking hormonal drugs, after a few months.

Dermoid cyst (teratomas)
This is a cyst that consists of different types of tissues: hair, fat and teeth. They develop from embryonic primordia. Usually, dermoid cysts can be of different sizes and have no symptoms. Clinical symptoms appear as a result of ovarian torsion or pressure from large cysts. Such cysts are only subject to surgical treatment.

Serous ovarian cystadenoma (benign ovarian tumor)
This is a cyst that forms from cells of the outer surface of the ovary. They are usually benign, but they can cause problems associated with their malignant transformation. The cystadenoma can become large and press on other pelvic organs, causing pain. Treatment is only surgical, is the prevention of ovarian cancer.

Endometrioid cysts
Cysts of this type are formations filled with “chocolate-like” content.The inner surface of the endometrioid cyst is similar in structure and functional properties to the inner lining of the uterus – the endometrium. This tissue changes under the influence of hormones. The cells of the inner wall of the cyst react to the action of sex hormones (estrogen and progesterone), as a result of which a reaction develops with epithelial rejection and menstrual-like bleeding. Such processes take place monthly. The so-called “chocolate” cyst is gradually formed. For a long time, endometriomas may be asymptomatic.Pain is disturbing when microperforation occurs with the release of aggressive cyst contents into the abdominal cavity. Most often, it causes pain during the menstrual period or during intercourse. Endometriomas often run under the guise of chronic adnexitis. Gradually, the size of the cysts increases. The release of the “chocolate” content leads to the adhesion of the pelvic organs. In case of untimely treatment, infertility develops. Treatment consists of laparoscopic surgery and postoperative hormone therapy.The success of treatment depends primarily on the timely detection of this pathology.

Unfortunately, some cysts can develop into cancer. The risk of developing ovarian cancer increases with age. Ovarian cancer is asymptomatic in its early stages. but if you feel such clinical manifestations as: discomfort, enlargement or swelling in the pelvic part, nausea or heartburn that does not disappear, loss of appetite, pain in the lower abdomen, be sure to consult a doctor. A cyst that is found on time is easy to cure and thereby avoid further complications.

Diagnostics
The gold standard in the diagnosis of ovarian cysts is ultrasound. This is a simple and reliable diagnostic method. Very often, ovarian cysts are found during a routine examination, when the gynecologist detects an increase in the ovaries. Sometimes doctors order blood tests for tumor markers to confirm or rule out ovarian cancer.

Treatment
If the cyst is functional, your doctor will monitor the condition.Most of these cysts disappear on their own after 1–2 months (menstrual cycles). If the cyst does not disappear, it has the character of a benign tumor, the doctor will suggest surgical treatment.

The type of treatment depends on:
• Size and type of cyst
• Your age
• Symptoms
• Your desire to have children

Hormone therapy
Your doctor may prescribe hormonal contraceptives to treat a functional cyst. Hormonal contraceptives stop the ovulation process.They stop the development of the follicle, thereby preventing cysts from forming. But this treatment is not suitable for everyone – especially if you are over 35 years old. Your doctor can help you decide if this is the right therapy for you.

Surgery
Your doctor may suggest surgery to remove the cyst. The type of surgery depends on the type of cyst. It is possible to remove only the cyst (cystectomy), and it is possible to remove the cyst together with the ovary. In our clinic, most of the operations are performed laparoscopically – without large incisions.The patient is discharged home on the second day after the operation, an excellent cosmetic result is provided.

Most ovarian cysts occur in women of childbearing age. For their timely identification and selection of the correct treatment path, it is necessary to regularly visit a gynecologist. If you know that you have cystic ovarian formation, immediately consult a qualified doctor – he will help you make the right decision regarding treatment!

Our Center is attended by qualified gynecologists.