Hemorrhagic Cysts and Severe Back Pain

[Hurting Momma]

I am a 30 yr old woman that has a hemorrhagic cyst on my right ovary.  I have had two sonos, one two weeks ago, that showed free fluid in the clu-de-sac, and one last week that still showed the cyst but no free fluid.  I have been having severe lower back pain (into my butt bone area) and lower cramping in the pelvic area down into my leg and inner thigh.  They have told me to wait and see and to continue my BCP's.  They also told me to rotate Vicodin and 800mg Ibpropen for pain and to stay off of my feet.  (Which is very hard since I stay home with my two children ages 4 and 3)  Last night I had SEVERE back pain, with little cramping and nothing relieved the pressure and pain.  This morning I was marginally bettter when I awoke, but now it is getting unbearable again.  I had surgery in December 2004 for a hemorrhagic cyst of my left ovary that had already ruptured with free blood in the clu-de-sac, that showed free "fluid" for months.  I was told then to wait and see also that I would not be able to walk if it was blood, but I don't have a choice because of my young children, but I was in extreme pain.  I don't know what I should be looking for again with this one, or if the severe back pain is something that I should call the Dr. about once again.  I have also had functional cysts that have ruptured or just desolved on their own, but did cause some pain.  I can't live with this back pain, it hurts to stand, lie down, or sit for any period of time.  Any advice?

[Annekathryn Goodman, M.D.]

Hi There,
In general, the recommendation that you have received is reasonable. Most cysts will resolve. A hemorrhagic cyst means that a cyst has some blood in it. This usually happens after ovulation. Occasionally the cyst leaks and the cyst fluid is irritating and that is the cause of pain. If your pain is not improving you should definitely see your doctor again. pain from a leaking cyst or hemorrhagic cyst should really resolved in 2 to 3 days
best wishes

[Hurting Momma]

Thank you for your response.  I did finally go into the ER on 15th, with pain in the lower back, put also becoming worse in the lower abdo again.  I found out that I am pregnant.  They said approx. 3 1/2 to 4 weeks along, but still have the left hemorrhagic ovarian cyst, with the normal pregnancy cyst on that ovary too.  I repeated the serum blood test today again to make sure the levels are doubling, so they can rule out ectopic pregnancy.  Is there anything that I should continue to look for other than my pain increasing or becoming more severe?  How long should I do the serum tests to rule out the ectopic pregnancy, or what time frame should they be able to rule it out with a sono?  Thank you for your help.