Ovarian apoplexy

Clinical symptoms of apoplexy associated with the basic mechanism of this disease:

1. Pain, which occurs primarily mid-cycle or after a minor delay in menstruation (at the time of the rupture of a corpus luteum cyst, for example). Pain is most often localized in the lower abdomen. Sometimes the pain may radiate to the rectum or to the lumbar or the umbilical region.^[1]
2. Bleeding into the abdominal cavity, which may be accompanied by:

• low blood pressure
• increase in heart rate
• weakness and dizziness ^[2]
• syncope
• chills
• fever up to 38°C
• vomiting
• dry mouth

Sometimes there may be inter-menstrual bleeding or spotting after menstruation. Quite often, ovarian apoplexy occurs after intercourse or training in the gym, when pressure in the abdomen has increased or ovarian tissue has experienced some stress. However, rupture of ovarian tissue can occur in conjunction with other diseases.^{[citation needed]}

During a normal ovarian cycle (which accompanies the menstrual cycle) of a sexually mature woman, one or more follicles grow in the ovaries. The oocyte in the follicle matures to prepare for potential fertilisation. As the cycle progresses, a smaller number of dominant follicles (typically only one) begin to stand out, and reach a maximum size of about 20mm around the middle point of cycle. By this stage, the oocyte has finished maturing into an ovum (an egg), and ovulation occurs - the follicle ruptures and releases the ovum. A ruptured follicle forms a temporary cyst - a corpus luteum - which produces hormones to continue the cycle and mature the uterine lining.^{[citation needed]}

In cases of dystrophic and sclerotic changes in ovarian tissue, acute and chronic inflammatory processes in the uterus, or in polycystic ovary syndrome and some other diseases, as well as the result of medication that stimulate ovulation, certain irregularities in ovulation process and corpus luteum formation occur. As a result, blood vessels in the ovary contract, become dilated, and increase intra-ovarian bleeding. A hemorrhage can then occur in the corpus luteum due to the fragility of blood vessels, causing a hematoma. This is accompanied by pain, weakness, dizziness, nausea, vomiting, pale skin, and/or fainting. If left untreated, internal bleeding may increase and become a threat to the individual's health and life. Other possible causes of ovarian rupture include abdominal trauma, excessive physical stress, vigorous sexual intercourse, horseback riding, etc.^{[citation needed]}