Cysts causing severe pain
Dear Dr Mitchell,
I write this to you very shattered. My sister has been deeply in pain and she has not seen her periods since November 2017. So she went to see her doctor and he discovered that she has a cyst. He gave her some tablets to help heal the cyst but he said he is not sure if the pills will help, and if the pills don’t help they will have to operate. However, the pills are causing much more pain than before, so I am deeply concerned for her. With regards to the periods, they tested for pregnancy and it came back negative, and she doesn’t know what might be the problem. Can the cyst have something to do with her periods disappearing? Is there anything you’d recommend for her to use to decrease the pain?
The severe pelvic pain that your sister has been experiencing may be due to the fact that she has an ovarian cyst.
An ovarian cyst can cause pelvic pain from the weight of the cyst putting pressure on the organs in the pelvis and compressing the nerves in the pelvis. Pain from an ovarian cyst may also be due to rupture in the capsule of the cyst with the leaking of fluid from the cyst. If an ultrasound is done the fluid can be detected in the pelvis.
There may also be bleeding into the cavity of the cyst causing a haemorrhagic ovarian cyst which results in pelvic pain. There may also be torsion of the ovary if the ovary becomes heavy from an increase in the size of the cyst. This means that the ovary becomes twisted on its pedicle and the blood flow to the ovary becomes compromised and is sometimes completely cut off resulting in the ovary losing its function and becoming gangrenous in severe cases. This is a medical emergency and surgery has to be done to untwist the ovary and an attempt made to preserve the ovary or remove it completely if it has lost its function.
The absence of the menstrual period since November 2017 is significant. Some ovarian tumours produce hormones that can cause the menstrual period to be delayed for several months. Some of these tumours can be cancerous and definitely need to be removed by doing surgery. If the ovarian cyst has persisted and the pelvic pain is significant then further investigations to rule out ovarian cancer should be done and urgent surgery should be definitely considered.
Your sister should seek urgent medical advice and get the appropriate evaluation done to determine if surgery is needed to relieve her symptoms.
Consult your gynaecologist who will advise you further.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
DISCLAIMER:
The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.