Hemorrhagic Ovarian Cyst: What Does Bleeding Into a Cyst Mean?

A hemorrhagic ovarian cyst is a functional ovarian cyst that has bled into itself. Functional cysts form as part of the normal menstrual cycle. Bleeding inside one can cause sudden pelvic pain, but these cysts usually resolve on their own.

The two main functional cysts are follicular cysts, which form when a follicle does not release its egg, and corpus luteum cysts, which form after ovulation. MedlinePlus notes that a corpus luteum cyst may contain a small amount of blood. Healthdirect describes haemorrhagic cysts as functional cysts that bleed internally.

This guide is for people reading a scan report that uses the words hemorrhagic or haemorrhagic cyst. It explains the term and the warning signs. It cannot interpret your scan or tell you what your result means for you.

Most of the time, bleeding stays inside the cyst. But a cyst can burst (rupture) and bleed into the pelvis, or the ovary can twist (torsion) and lose its blood supply. Both can be medical emergencies.

Call local emergency services or go to an emergency department straight away if you have:

• Sudden, severe pain in the lower tummy or pelvis, especially with nausea or vomiting.
• Feeling very dizzy, light-headed or faint, fast breathing, or cold, clammy skin.
• Severe vaginal bleeding with pelvic pain or feeling faint.
• Severe pain with fever.
• Tummy pain or shoulder-tip pain if you are or might be pregnant. Ectopic pregnancy can cause similar symptoms, and the NHS says shoulder-tip pain can be a sign of internal bleeding.

Ask for an urgent appointment, or contact your local urgent advice line, if pelvic pain is getting worse, keeps going, or comes back after it had settled. Healthdirect also advises emergency care for new pain when you already know you have a cyst, or mild pain with nausea or vomiting.

A routine follow-up scan date is not a reason to wait if your symptoms change. Tell the team you have been told you have a hemorrhagic cyst so they can compare scans.

Bleeding can happen inside a functional cyst as part of the normal cycle. MedlinePlus notes that a corpus luteum cyst, which forms after ovulation, may contain a small amount of blood. Cysts are more likely to cause pain if they bleed, grow large or rupture.

Many people with a hemorrhagic cyst have no symptoms, and it is found by chance on a scan. Others have one-sided pelvic pain that starts suddenly. Pain from a cyst can be dull or sharp, and some people notice bloating or pain during sex.

Usually, yes. Healthdirect says haemorrhagic cysts usually resolve on their own and mild cases may be monitored. MedlinePlus says functional cysts typically go away within 8 to 12 weeks, and the NHS says most cysts disappear within a few months.

Severe cases are different. Healthdirect notes that some cause internal bleeding and may need urgent surgery. That decision is made in hospital, based on your symptoms, examination, blood tests and scan.

Pelvic ultrasound is the usual test. A transvaginal scan, using a thin probe in the vagina, gives a closer view of the ovaries. Doppler, a setting that shows blood flow, can show blood flow to the ovary.

The report may describe the cyst's size and what is inside it. If a cyst has ruptured, the scan may also show fluid or blood in the pelvis. Our guide to free fluid in the pelvis explains that wording. A pregnancy test is commonly part of the check-up for pelvic pain, because ectopic pregnancy can cause similar symptoms.

A follow-up ultrasound helps confirm that the cyst has gone. Blood inside a cyst can look like other kinds of ovarian lumps on a scan. Seeing the cyst shrink or disappear on a later scan supports the view that it was a functional cyst that bled.

MedlinePlus describes a recheck after 6 to 8 weeks. The NHS describes another scan in a few weeks. Your team will choose the date based on your symptoms and scan. If the cyst has not changed or looks different, further imaging or a gynaecology referral may be suggested.

Some cysts with old blood inside are not functional cysts. An endometrioma, linked with endometriosis, is one example. Our endometrioma guide and our ovarian cyst ultrasound guide explain how these terms differ.

Most hemorrhagic cysts need no treatment beyond pain relief advice and a follow-up scan. Healthdirect lists situations where removing a cyst may be suggested, including a cyst that lasts beyond 3 months, is larger than 6 cm, keeps growing, causes pain, or may be cancerous. MedlinePlus similarly mentions persistent complex cysts and cysts that are growing or causing symptoms.

Some people get functional cysts often. MedlinePlus notes that birth control pills may lower the chance of new cysts in this group, but they do not shrink a cyst that is already there. Do not start or stop any medicine because of a scan report without talking to your prescriber.

Take the full scan report with you and write down the answers.

• What makes you think this is a hemorrhagic functional cyst rather than another type of cyst?
• Was there any sign of rupture, free fluid or bleeding outside the cyst?
• When should my follow-up scan be, and who will arrange it?
• What would you expect the next scan to show if this is settling as usual?
• Which symptoms mean I should call emergency services before that scan?
• If cysts like this keep coming back, what options would we discuss?

On SameCase, patients and verified doctors share de-identified cases. Seeing how others with a hemorrhagic ovarian cyst described their symptoms, scan wording and follow-up plans can help you prepare clearer questions for your appointment. Another person's case cannot tell you what your scan shows or how your cyst will behave. Your own care team makes those decisions, and sudden severe pain always needs urgent medical help, not an online search.