Corpus Luteum Cysts

A corpus luteum cyst is a type of ovarian cyst. The corpus luteum is a very small natural mass that forms from the remnants of follicular cells in the ovary every month after ovulation. This small cell mass begins to produce progesterone after ovulation. If pregnancy does not occur, the corpus luteum dies nine days later, and if pregnancy occurs, it will continue to produce hormones until the end of the third month.

What is the corpus luteum?

During ovulation, an egg is released from the dominant follicle. After the egg is released and fertilized, it seals itself to form what is known as the corpus luteum. This cell mass helps produce the hormone progesterone in early pregnancy. The corpus luteum continues to produce progesterone until the fetus produces enough levels to maintain pregnancy, which usually occurs between 7 and 9 weeks of pregnancy. Progesterone is essential in early pregnancy because:

Allows the uterus to grow without contractions
Supports the growth of the lining of the uterus
Improves blood flow and oxygen supply

The corpus luteum is supported and maintained by the human pregnancy hormone chorionic gonadotropin or HCG. The corpus luteum size begins to decrease around the 10th week of pregnancy. When fertilization or implantation does not occur, the corpus luteum begins to decompose. This lowers estrogen and progesterone levels and leads to the onset of another menstrual cycle.

Corpus luteum and the menstrual cycle

Hormones play an important role in the normal regulation of menstruation in women. In addition to progesterone and estrogen, other essential hormones for ovulation include luteinizing and follicle-stimulating hormone. These hormones are responsible for ovulation and preparing the uterus for fertilized egg implantation. A normal menstrual cycle occurs every 25-36 days, during which time the body prepares for ovulation and pregnancy. There are three stages in the menstrual cycle.

Follicular phase

The follicular phase of the menstrual cycle begins on the first day of a woman’s period, continues at the onset of menstrual bleeding, and continues until ovulation. This stage usually lasts between 13-14 days. In the follicle stage, the body secretes follicle-stimulating hormone to induce the production of ovarian follicles containing eggs. One of these follicles becomes an adult follicle that is fertile and is known as the dominant follicle. The dominant follicle secretes estrogen, which breaks down the non-dominant follicles and stimulates the uterus to thicken its lining for implantation. It also increases the luteinizing hormone that is responsible for ovulation.

Ovulatory phase

The ovulation phase begins around day 14 of a woman’s menstrual cycle. During this time, the luteinizing hormone increases and stimulates the ovary to release the egg from the dominant follicle. Typically, this stage lasts between 16 and 32 hours and leads to ovulation.

Luteal phase

The luteal phase of the menstrual cycle is when the body prepares to implant a fertilized egg. When the follicle releases the egg at the ovulation stage, the opened follicle closes and forms a corpus luteum. The corpus luteum is responsible for producing the hormone progesterone, which stimulates the uterus to thicken further in preparation for the implantation of a fertilized egg. Estrogen also rises during this time to prepare the uterus for implantation.

If there are no fertile eggs for implantation in the thick membrane of the uterus, the body sheds the cover during menstrual bleeding due to low levels of estrogen and progesterone, and the cycle begins again.

Symptom of corpus luteum cysts

In most cases, corpus luteum cysts go away on their own without treatment. Corpus luteum cysts may disappear in a few weeks, or it may take up to three menstrual periods to completely disappear. Some women with these cysts may experience symptoms, such as:

Pelvic pain, which may present as dull or sharp aching
Abdominal fullness or heaviness
Bloating
Aching in the lower back and thighs
Painful intercourse
Weight gain
Painful menstrual bleeding
Breast tenderness
Need to urinate more frequently
Difficulty emptying the bladder
Difficulty emptying bowels completely
Abnormal vaginal bleeding

Some women may experience cyst rupture, which can cause severe pain and possibly internal bleeding. Larger cysts can cause Ovarian torsion.

How big is a corpus luteum?

Their size can vary; corpus luteum cysts are usually between 2 and 6 cm. Although these types of ovarian cysts are not usually a cause for concern, they can sometimes lead to complications such as lower abdominal pain.

Causes of corpus luteum cysts

There are several causes for corpus luteum cysts. They usually consist of ruptured follicles after ovulation. But there may be other underlying causes, such as:

Hormonal imbalance: There may be a greater chance of developing a corpus luteum cyst if there is a hormonal imbalance. This can be due to ongoing fertility treatments or other underlying issues.
Pregnancy: Pregnant women sometimes maintain a corpus luteum cyst from their last ovulation throughout their pregnancy. Often, cysts go away on their own during or after pregnancy but should be controlled as a whole.
Endometriosis: Endometriosis is a disorder in which tissue similar to the tissue lining the inner surface of the uterus grows outside the uterine cavity. This tissue sometimes attaches to the ovaries and causes cysts, making women with endometriosis more likely to develop corpus luteum cysts.
Pelvic infection: If a pelvic infection reaches the ovary, it can lead to cyst formation.
Previous cysts: Women who have had a corpus luteum cyst before are more likely to get it several times.

Diagnosis

While some ovarian cysts can be felt during a pelvic exam, others cannot. The ob-gyn may perform some diagnostic tests to evaluate and diagnose ovarian cysts, including:

Pregnancy test, which may be a sign of a corpus luteum cyst
Hormone testing
Pelvic ultrasound

Surgical procedures, such as laparoscopy, in which a doctor inserts a device into a woman’s uterus through a small incision in the abdomen. Some doctors may perform tests to check the levels of certain substances in the blood used to diagnose ovarian cancer, such as the CA 125 antigen test. If the cyst is solid and the person is thought to be at higher risk for ovarian cancer, these tests are likely to be requested. However, it also increases CA 125 levels in noncancerous conditions such as endometriosis.

Treatment

Often, corpus luteum cysts go away without treatment. However, there are times when treatment is necessary. Treatment options for ovarian cysts include:

Preventive medications such as hormonal contraceptives
Surgery to remove a large or persistent cyst

The doctor will treat based on the size of the cyst, the symptoms it may cause, and the person’s age. If the cyst does not cause any symptoms, the doctor will often wait to see how it progresses before starting any treatment.

When to see the doctor

See your doctor if you notice any painful symptoms associated with corpus luteum cysts. If you notice any of the following, you should seek treatment:

Sudden onset of sharp pain
Vomiting
Dizziness
Loss of consciousness
Fever

These symptoms may be a sign of a ruptured cyst or ovarian torsion, which can be life-threatening if left untreated.

Corpus luteum cyst rupture during pregnancy

Although it is uncommon for a corpus luteum cyst to rupture, it can explode independently or due to an external factor such as a pelvic exam, sex, or exercise. In these cases, the biggest concern is not the effect on the baby but the effect on the mother. The amount of bleeding is usually small, but a ruptured cyst can cause internal bleeding that requires surgery in rare cases.

The bottom line

In the second half of the menstrual cycle, immediately after ovulation, the empty ovarian follicle forms a mass called the corpus luteum. The corpus luteum releases the hormones estrogen and progesterone, which prepares the uterus for sperm implantation.

If pregnancy occurs, the placenta will take over the production of progesterone for about the first 12 weeks of pregnancy, after which the corpus luteum will die. Sometimes, instead of disappearing, a small sac filled with fluid known as a corpus luteum cyst can form on the ovary during the first trimester of pregnancy. These cysts are a type of functional cyst, they can cause painful symptoms, but in most cases, they go away without treatment.

Arjang Naim MD thoroughly examines the condition of the fetus and mother during the pregnancy examinations and takes the necessary treatment measures if any symptoms are harmful to the health of the mother and the fetus.

Additional questions

How long do corpus luteal cysts last?

In most cases, corpus luteum cysts go away on their own without treatment. Corpus luteum cysts may disappear within a few weeks or take up to three menstrual cycles to disappear altogether.

Does corpus luteum cyst affect fertility?

These types of ovarian cysts usually do not affect fertility.

What is the normal size of a corpus luteum cyst?

Most functional cysts are 2 to 5 cm. Ovulation occurs when the size of these cysts is about 2 to 3 cm. However, some may reach sizes of 8 to 12 cm.

Can a corpus luteum cyst rupture?

Rupture of the corpus luteum is a common disease in women of reproductive age. Accompanied by acute or chronic pain of variable intensity and intra-abdominal blood loss of variable amounts.