Can a luteal (corpus luteum) cyst cause pelvic pain?

From the Guidelines

A luteal cyst can cause pelvic pain, and the pain can range from mild discomfort to sharp, severe pain, especially if the cyst ruptures or causes ovarian torsion. The pain associated with a luteal cyst is thought to occur because the cyst stretches the ovarian tissue or irritates surrounding structures in the pelvis 1. According to the O-RADS US risk stratification and management system, a corpus luteum cyst is defined as a thick-walled cyst less than 3 cm that may have crenulated inner margins, internal echoes, and intense peripheral color Doppler flow 1.

Key Characteristics of Luteal Cysts

• Form when the corpus luteum fills with blood or fluid instead of dissolving naturally
• Can cause pelvic or abdominal pain, particularly on one side of the lower abdomen
• Pain can range from mild discomfort to sharp, severe pain
• Most luteal cysts resolve on their own within a few menstrual cycles without treatment

Management of Luteal Cysts

• Over-the-counter pain medications like ibuprofen or acetaminophen can help manage discomfort
• If pain is severe or persistent, medical evaluation is recommended
• Hormonal birth control might be prescribed to prevent new cysts from forming 1

Importance of Accurate Diagnosis

• Accurate diagnosis of a luteal cyst is crucial to determine the best course of treatment
• The O-RADS US risk stratification and management system provides a framework for categorizing and managing adnexal lesions, including luteal cysts 1
• A thorough medical evaluation is necessary to rule out other potential causes of pelvic pain and to determine the best treatment options.

From the Research

Luteal Cyst-Related Pelvic Pain

• Luteal cysts, also known as corpus luteum cysts, can cause pelvic pain due to various mechanisms, including rupture, torsion, and bleeding 2, 3, 4, 5.
• The rupture of a luteal cyst can lead to hemoperitoneum, a condition characterized by the presence of blood in the peritoneal cavity, which can cause severe pelvic pain 2, 3, 4, 5.
• Torsion of a luteal cyst can also cause pelvic pain, as seen in a case report of a woman with a hemorrhagic corpus luteum cyst torsion during term pregnancy 3.
• Bleeding from a luteal cyst can cause pelvic pain, and this condition can be life-threatening if not promptly recognized and treated 2, 5.
• Large ovarian cysts, including luteal cysts, can cause significant morbidity, including severe pelvic pain and urinary tract obstruction, as seen in patients with cloacal exstrophy 6.

Diagnosis and Treatment

• Ultrasound study (USS) and contrast-enhanced computed tomography (CT) are commonly used imaging modalities to diagnose luteal cyst-related pelvic pain 5.
• Magnetic resonance imaging (MRI) can also be used to study the pelvis, but its low availability and long acquisition time limit its usefulness in characterizing acute gynecological complications 5.
• Treatment of luteal cyst-related pelvic pain depends on the underlying cause and may involve surgical intervention, such as exploratory laparotomy or bilateral salpingo-oophorectomy 3, 6.