A must-read for women! How terrible is “corpus luteum rupture”?

The following incident happened at the Asian Games a few days ago:

Yasmin (pseudonym) is a foreign canoeist. After completing the canoeing competition at the Asian Games, she suddenly began to suffer from severe abdominal pain, pale face, and sweating profusely. After further examination, it was confirmed that she had ovarian corpus luteum rupture and bleeding.

Image source: Weibo screenshot

Corpus luteum rupture is a term that often appears but you may still not know much about it. Many people only hear about this disease after their relatives, friends or themselves have experienced corpus luteum rupture. In fact, the corpus luteum is always there and is very important for women.

Today we will talk about the knowledge about "corpus luteum"~

What is the corpus luteum?

In a normal menstrual cycle, a woman's ovaries release an egg every month. The structure that nurtures this egg is called a follicle. After the egg is released, the remaining part of the follicle becomes the corpus luteum .

The development process of follicles in the ovary: 1 - ovary; 2 - mature follicle; 3 - mature follicle; 4 - ovulation; 5 - corpus luteum; 6 - degenerating corpus luteum. Image source: Wikipedia

The corpus luteum can be considered a temporary gland that can secrete estrogen and progesterone to maintain the growth and development of the endometrium. If a fertilized egg forms an early embryo, it can colonize and grow on the well-developed endometrium, and the corpus luteum will continue to secrete hormones to help the embryo develop until the placenta takes over its function. If there is no pregnancy, the corpus luteum will shrink and absorb, and the endometrium will also shed and bleed due to the loss of hormonal support from the corpus luteum, which is menstruation.

Why would a healthy corpus luteum rupture?

Women with normal menstruation will produce a corpus luteum every month, but most people only know about the disease of corpus luteum rupture through hearsay. Therefore, even without looking at the clinical data, you can judge by intuition that this is not a common phenomenon.

In fact, most corpora lutea do die according to normal procedures, so menstruation almost always arrives 14 days after ovulation. This is the time pattern indirectly formed by the life span of the corpus luteum.

As a temporary gland, the corpus luteum has a very rich supply of small blood vessels to provide nutrition and energy. If the corpus luteum grows too large or forms a cyst, the small blood vessels may rupture and bleed due to slight external force, or even rupture spontaneously without external force. If you have high blood pressure that causes excessive pressure in the small blood vessels, or have a bleeding disease with abnormal coagulation function, the risk of corpus luteum bleeding is even higher.

Based on this principle, corpus luteum rupture always occurs after the corpus luteum is fully developed and before it atrophies and collapses, which means that it only occurs in the middle and late stages of the menstrual cycle, that is, a few days after ovulation and before the next menstrual period. This stable time feature is an important basis for clinically identifying corpus luteum rupture.

Image source: pixabay

Is corpus luteum bleeding dangerous?

In real life, there are actually many cases of corpus luteum bleeding and corpus luteum rupture that go undetected.

The corpus luteum is wrapped in the ovary. If the ruptured blood vessels are small and the bleeding is not much, the bleeding can often stop on its own due to the body's powerful coagulation mechanism. The blood will not rush out of the ovary, but will only be confined to the corpus luteum and slowly absorbed together with the corpus luteum. In this case, most of us do not feel anything, or just have a slight soreness and dull pain in the lower abdomen.

If the bleeding is a little more and causes the corpus luteum to rupture, the bleeding can stop on its own in most cases. In this case, due to the stimulation of the blood, the lower abdominal pain will be more obvious. Depending on the severity, it is often necessary to observe on your own or be hospitalized for observation. In case of increased bleeding, surgery may still be required.

If the bleeding is heavy and conservative treatment is not expected to be safe, surgical treatment is necessary immediately.

If the corpus luteum ruptures and heavy bleeding occurs, it is still very dangerous. If the corpus luteum ruptures and causes heavy bleeding and is not treated in time, it may cause shock or even death. But in general, as long as you seek medical attention in time after severe abdominal pain occurs, corpus luteum rupture will not cause serious consequences in most cases.

Is it necessary to stop exercising to prevent corpus luteum rupture?

Whenever news about patients with corpus luteum rupture hits the hot search list on Weibo, it triggers various discussions, including stigmatization of the disease and some misunderstandings based on panic.

A common misconception is that sexual intercourse can lead to corpus luteum rupture. In fact, after reading the analysis in the previous article, you can find that external force is only one of the risk factors. Clinically, many corpus luteum ruptures occur during daily physical exercise. Some people even suddenly have corpus luteum ruptures when they just stand up, twist their waist, or even sit still.

Holding urine may also cause the corpus luteum to rupture. Image source: Weibo screenshot

Therefore, stigmatizing the morality of patients with corpus luteum rupture is not only immoral but also unscientific.

Since corpus luteum rupture can occur during daily physical exercise, is it necessary to prohibit exercise during the period when the corpus luteum is prone to rupture? In fact, most of the time, it is not necessary.

First of all, as mentioned earlier, the corpus luteum of most people can "die normally", so the absolute risk of corpus luteum rupture is not high, and there is no need to worry about it.

Secondly, the overall health benefits of exercise are very high. It not only has the function of relieving premenstrual discomfort and relieving dysmenorrhea, but also has many positive effects in maintaining physical and mental health. If you stop exercising because you are afraid of corpus luteum rupture, it is actually not cost-effective.

Therefore, if there are no discomfort symptoms, there is no need to stop exercising in the middle and late stages of menstruation. However, if there are discomforts such as abdominal distension and dull pain in the middle and late stages of menstruation, it is still prudent to reduce the intensity of exercise or stop exercising. In case of severe abdominal pain, do not endure it, go to the hospital as soon as possible.

Planning and production

Author: Doctor Feidao Duanyu

Review | Gao Hui, Chief Physician of Gynecology and Endocrinology, Tiantan Hospital

Planning｜Yang Yaping

Editor: Yang Yaping