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Pelvic pain after intercourse, had lump in labia, fatigue. Ultrasound showed hemorrhagic cyst in ovary. Should I be concerned?

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Abnormal pap in 2007, colposcopy, biposies (atypical cells and high-risk HPV). Normal paps followed. Recent changes in menstration. Two months ago had very light 3 day period that was 5-8 days late. Not pregnant. This month period was at 21 days, lasted 9 days with 6 very heavy with huge clots that sounded like I was having a bowel movement when I went to the restroom. Until recently, my cycles have always been 28 day cycles, 5 day period with 3 days heavy and 2 light. Like clockwork. Also this month I have had continuous pelvic pain, especially with intercourse. It's not cramping. It feels more like my uterus is bruised, sore, and swollen. In addition, I had a lump on my inner labia that appears to have been a very large pimple. It was about the size of a pea, not painful, but came to a head and popped and then went away. I have NEVER had anything like that before. I was also recently severely anemic. Supplements have brought it up from a 9 to 11 in a month, but the severe fatigue I was feeling before still persists. Sometimes to the point were its difficult to drive.

I should mention that I had a transvaginal ultrasound 6 weeks ago showing a 3.7cm hemorrhagic cyst on the left ovary. Because I have digestive problems, my GI doctor ordered a pelvic and abdominal CT scan with contrast and nothing was seen. I have my follow up ultrasound for the cyst next week. In the meantime, I am very worried about these changes. I reported them to my gyno's nurse so that we could discuss when I went in for my ultrasound, but it's not until the 24th. I also felt a strange lump/knot about half the size of a pea on my cervix. I have been off my period for 5 days now and, because my cervix is very low and tilted, I can feel the entire cervix quite easily. The entire cervix is smooth and soft and open, but there is a very hard knot on the outter edge that I have never felt before. There was also brown blood on my finger when I felt it. Anyway, I'm concerned. Should I be?
Posted Mon, 21 May 2012 in Women's Health
Answered by Dr. Minoo Bhagia 5 hours later

Thanks for writing to us.

Your current changes in menstruation, the lump and the abdominal pain are concerning. You need to be evaluated and treated. After going through your medical history, I suggest you the following options:

1. You should go for hysterectomy as you are having abnormal pap's and contact bleeding which can turn into cervical cancer. As you have completed your family, this would be a good option.
2. Other options are cervical biopsy and cryocauterisation of cervix with regular follow ups and vaccines for the prevention of cervical cancer like "garadsil" or "cervarix".
3. Hemorrhagic cyst which can be an endometriotic cyst may be removed during the operation.

These days hysterectomy is done laparoscopically (Total Laparoscopic hysterectomy) but as you said you are having cervical descent so vaginal hysterctomy can also be done

Discuss about these options with your gynecologist when you get to visit them.

Hope this answers your query. Let me know if you have any other query.

Best wishes
Take care
Above answer was peer-reviewed by
Follow-up: Pelvic pain after intercourse, had lump in labia, fatigue. Ultrasound showed hemorrhagic cyst in ovary. Should I be concerned? 13 hours later
Thank you so much for your quick reply. So, even though my Pap smear was abnormal in 2007 and has been normal since then, you are still concerned? Also, I had a recent CT scan of my abdomen and pelvis and nothing was seen, could cervical cancer have been missed? It was only a month ago that I had it. And the lump is still there; but I have read about a common cyst that sometimes happens on the cervix. I think they called it a Nabothian cyst (sp?). I had intercourse last night and there was no blood. However, I should mention that I have had a lot (depending on what one considers "a lot," in the past couple months. It's almost like clear water, no smell or foul odor. Anyway, I have let my doctor know about the persistent pain and strange changes in my period, anemia (she's the one that ordered the blood test and found it), and the huge clots and prolonged period.) But she doesn't know about the lump/knot, as I only noticed it yesterday. It's firm/hard, seems to be underneath the skin rather than on the surface, and is about the size of a small pea, if not smaller. The rest of the cervix is smooth and there are no lumps or bumps, although there is one place that seems to be indented. And the tenderness is still there. I feel like a hypochondriac.
Answered by Dr. Minoo Bhagia 9 hours later

Thanks for your feedback.

CIN or cervical intraepithelial neoplasia cannot be detected with CT scan. Colposcopy and biopsy can detect it. I suggest all my patients to get repeat pap smear and biopsy if previous pap smear was positive. I am happy you are doing them and all the tests are negative.

Pea sized nodule can be an inflammatory lesion, but it should be evaluated properly with biopsy.

As you have had heavy periods and new symptoms have developed, I feel taking care of it would be the best option. Hence my suggestion to you was to consider hysterectomy.

There is nothing very serious; but prevention is better than cure.
Discuss about these options with your gynecologist.

Hope I have addressed all your concerns. Should you have any more queries, I will be glad to assist you with it.
If all your queries are answered, do not forget to close this discussion.

Wish you good health.

Take care
Above answer was peer-reviewed by
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