I had my ultrasound this past July 08 when I began having chronic menstrual cramps, which have since not gone away. The ultrasound was performed because in early Jan 2007 I was put on an anti-breast cancer drug called Megace, though I did not have breast cancer, I was put on this drug to increase my appetite as I was very thin. The dr didn't tell me Megace was a hormone.
Well when I took it I began having 2 to 3 periods a month for 6 months, doctors tried to stop the frequent bleeding with hormones and steroids, which induced Panic Attacks, horrific migraines, acne and then I stopped treatment and my periods just stopped altogether in August 07 clear up until January 08 where I had 2 normal periods. I thought my periods were getting back to normal until I did not menstruate again until this past July 08 where I had 2 more normal periods but then my menses disappeared again and have chronic cramps.
Anyway the ultrasound was very disturbing compared to past ultrasounds before 2007 which always appeared normal; (thin endometrial stripe, small ovaries, tiny follices, no cysts, lumps, lesions or anything._
This ultrasound is as follows:
Endometrial stripe: Heterogeneous and thickened to 1.3 cm
Fluid: small amount of fluid is present within the uterine canal; free pelvic fluid
Right ovary: Measures 4 x 3.6 x 3 cmand contains multiple cysts; the largest is 1.9 x 1.5 x 1.3 cm.
LEFT OVARY: Measures 2.9 x 2.7 x 2.6 cm and also contains multiple cysts; the largest is a SEPTATED LESION MEASURING 1.8 x 1.8 x 1.8 cm.
IMPRESSION FROM THE RADIOLOGIST:
Multiple bilateral ovarian cysts including a septated right-sided lesion; the pevlic cul-de-sac fluid may relate to a possible cyst rupture; Thickened hetereogeneous fluid containing endometrium.
My doctor told me that my cysts did not appear to him as the PCOS, he also told me that all of my hormonal labwork was normal, and that I do not fit the clinical representation of PCOS (No skin tags or discoloration, not overweight, I'm not insulin resistant, my lh:fsh ratio is normal, prolactin, tsh, and testosterone is also normal, my cortisol levels were only mildly elevated). His conclusion was that I screwed up my female hormonal balance like progesterone and estrogen, with all of the drugs in early 2007 and it left me with a hormonal imbalance and things of that nature.
He did NOT comment on any of these other things and I was not tested for cancer but I have been in pevlic pain ever since July which worsens during bowel movements and laying on my stomach..it also causes back pain... please help!
I am so sorry that you are having to deal with this. Has your doctor scheduled you for a follow up ultrasound ? Did the radiologist recommend a follow up ultrasound as well ?
The only concern you should have at the moment is the septated cyst and perhaps your thickened endometrial lining. The other cysts are of little concern and will probably be gone by the next ultrasound as they are quite small. It should be noted that the septated cyst is also quite small and depending upon the radiologist's impression of it, it may or may not have to come out.
Have you considered getting an internal ultrasound by a gynecologist ? This would get a slightly better look at the cyst and it would give you a second opinion as to what should be done now.
This hormone that they had you on, was it by any chance estrogen ? This would explain both the thickened endometrial lining and the larger than normal follicular cysts. Excess estrogen will often stimulate the ovaries and also cause the endometrium to thicken. If this is the case, have you thought about talking to your doctor about taking a bit of natural progesterone in order to balance things out ? An endocrinologist may be more helpful if your problem is due to a hormonal imbalance.
I would not freak out about ovarian cancer or anything like that. At your age, this is extremely unlikely. However, there is definitely something going on and you need to address it. Why not seek out another opinion from a gynecologist and also get a referral to an endocrinologist to see what these specialists have to say ? I also hope that your weight problem has been resolved in the meantime. Being too thin is definitely a good way to stop getting your period and to screw up your hormones. Try to help yourself by ensuring you get enough healthy calories in any given day.
No, the Megace was actually a very powerful synthetic progesterone. the doctors though I had estrogen dominance so they pumped me up with progestogens, and natural progesterone forms, and it left me with a progesterone intolerance. Estrogen actually makes me feel better. but it doesn't explain the cysts or thickened endometrium.
My weight, while small (I'm 5'0") was 93lbs, but it was normal for ME. I was healthy. My doctor just wanted me to be fat like the rest of the country. My father was very underweight. I didn't LIKE being that thin, I would have loved some curves; which is why I agreed to take that horrific drug he gave me. I gained a good 15lbs in a 2-month time frame when my hormones went haywire.
So I'm no longer underweight.
Is it worth this anguish? Mental, and physical?
I've seen an endo and she sent me to the gyno. But I'm going to have to get a second opinion from both kinds of doctors. I don't have much faith in the second opinion, however.
Wow that IS indeed strange as progesterone usually causes a thinner endometrial lining and not a thicker one. As for the cysts, this can be caused by either I think. Overstimulation of the ovaries is usually done in order to create more cysts on the ovaries during fertility treatments and my own ovarian cyst may have come about after I went off the pill and my ovaries became a bit overstimulated. However, early pregnancy also frequently results in ovarian cysts due to the progesterone that is being produced and I am still not convinced that my cyst was not the result of too much progesterone (which caused my endometrium to bleed and thus why I went off the pill). I have heard arguments for both.
I find it strange that they decided to give you such a drug in order to stimulate your appetite. This is very odd and I am not sure I would still be with the same doctor if it caused so much trouble. 93 lbs is extremely slim even for 5 feet in height but as you say, some people are wiry and others are not so it all depends upon how you are built. The important thing is that you are eating a healthy diet and that your body is in good shape.
Estrogen dominance usually results in a thicker endometrial lining and heavier & longer periods. A lot of estrogen dominant women also suffer from fibroids as these feed on estrogen. You do not seem to have any of these symptoms so I would see about getting that second opinion, ideally from a good university centre or a place with good specialists. Don't know why the endo sent you to the gynecologist. He or she should have done a complete work up to see what your hormone imbalance consists of.
Second opinions are very important because in any field there is a variety of opinions about certain issues and this even changes with time so there may be a difference between younger and older doctors. Having a variety of options will help you to make the best decision in light of what is available. For example, if you were a bit older when your doctor had wanted to put you on that drug in the first place, you may have sought out a second opinion and decided to take another course of action. I completely understand, however, that you trusted him to give you the best health care under the circumstances. I have also gotten into trouble following my doctor's advice on occasion (like going on the birth control pill, for example). I do not think that the trouble you are going through now is worth it (nor is mine) and there MUST have been either another option or even another way of measuring your health that took your body build into account. I understand this completely because according to many doctors I would be considered to have a small frame because I can encircle my fingers around my wrist. However, if you actually saw me you would see that I have a very large frame (and I am 5'10") despite my dainty wrists and ankles .. so I don't trust these methods of judging someone's health according to a "one size fits all" way.
I hope you will find a doctor who can give you some sensible advice under the circumstances and put your body back on track. At the very least, you need to have a follow up ultrasound and at the most, you may have to have the septated cyst removed. You most certainly need to find a good physician who can interpret the results and recommend a course of action that will take care of this.
All of my best for your speedy recovery. Hang in there.
Thanks so much for your words and explaining to me the role of progesterone in the lining of the uterus....it makes perfect sense now why I was having so many periods on that drug!
I only took it twice but I bled every time I took it, and I was having periods every 5 days for many months. They continued to pump me up on progestogens/progesterone thinking I had estrogen dominance, which only aggravated the problem!
Finally when I quit all the hormones my periods stopped too, for 4-8 months at a time, with horrible periods separated those months.
Ironically, my period in August, was induced (unknowingly) by drinking ginger root tea. I was feel very nauseous and PMS-y so my bf gave me some Ginger tea to calm my stomach and literally 2 hours later I started a period. I didn't immediately make the connection until I started going on an organic diet and read up on ginger and its properties that can induce a period.
So, I waited and waited for another one to start - I felt like I ovulated ealry this month - even my doctor told me it "looked" like I ovulated - cervix was very soft and there was a lot of mucus. I began PMSing severely about 2 weeks ago and got so fed up that I tried drinking the tea again to see if it would bring about a period or if the August ginger-induced period was just a coincidence.
So, tonight, I drank a half cup of 1.5 grams and...
Lo and behold, 2 hours after drinking it, my period started. I was astounded. I looked it up on the net and it says gigner can induce periods. But I often wonder - what would my body do if I didn't drink the ginger around my period time? It's very disheartening.
It truly seems like I have more progesterone than estrogen as my periods are very light and the contents are very thin. It's like my uterus is having a hard time shedding its contents because there aren't much contents to shed----------unless I go beyond 3 months without a period----then the lining becomes so entirely thick that I have a heavy, clotty, horrific "I feel anemic and look goth" kind of period.
Soon after I began having hormonal problems with the drug, the doctor discharged me as a patient, so I'm seriously wondering if I have a lawsuit. I was in perfect health! So I was underweight - I was only 20 years old....
Now I'm plagued with acne and bloating constantly. I feel like the 15-20lbs I gained is mostkly water retention.
Anyway, this is a wonderful conversation, I am very impressed by your knowledge. Apparently my ovaries have been very overstimulated last year. Sheesh. I hope this straightens out.
If you don't mind, what happened to you with the pill?
You may still be estrogen dominant and you will have to have your hormones checked in order to confirm this. Perhaps that drug was simply too strong and all you needed was a tiny bit of natural progesterone cream. The female body is all about hormonal balance. If you are starting to have regular periods again then this is certainly a good sign. I am not sure about the ginger but I know that some foods mimic certain hormones so it is possible.
As for me, I was on the birth control pill for about twenty years when I started to have irregular heavy bleeding. I too had the clots and this was terrifying, especially after twenty years of normal light "periods" (or rather withdrawal bleeding as while on the pill one does not have a real period). My doctor wanted me to switch pills but when I started to feel strange sensations in my pelvic area I freaked out and he sent me for an ultrasound which showed an 7.5 cm simple cyst on my left ovary. I also had an endometrial biopsy at that time and there was not enough tissue for a conclusive result (although the tissue that was there was normal). In the meantime I found out that progesterone in the pill can be quite harsh on the lining of the uterus, especially in the triphasic formulations. This can cause endometrial atrophy from long term use (by the way, there is nothing about this in the patient insert, despite the fact that evidently doctors see this and I quote, "all the time"). I therefore decided to go off the pill and the problem was solved. My periods became normal and light again. My doctors never gave me the choice of going off the pill and they simply wanted to change it to a "stronger" one. Thank goodness I am now over forty and can think for myself. Doctors think that if I go off the pill I am not smart enough to use another form of birth control and I will become pregnant (I wish they would give me a little more credit) so I assume that this is why going off the pill was not given as an option.
By the way, at the age of 35 I had asked my doctor if he thought that remaining on the pill at that age was safe. He said yes but if I was concerned I should go on an ultralow dose pill so I went on Alesse. This pill completely screwed me up and in addition to irregular bleeding I began to have pelvic pain, bloating and all sorts of horrible symptoms. After three cycles I switched back to my Triphasil and everything calmed down again. I now wonder if my cyst did not begin back then. It has been there now for at least a year, almost the same size and perhaps a tad bigger (my radiologist and gynecologist tell me that it is the SAME size despite these small increases). Since I was obviously progesterone dominant due to the irregular bleeding at that time and the cyst was seen then, it may either have come about due to overstimulation of the ovaries when coming off the pill (my doctor says he sees this a lot when women go off the pill after many years) or the excess progesterone was the cause and it grew while I was still taking the pill. I have noticed that many women in early pregnancy are diagnosed with cysts and in early pregnancy the body is producing more progesterone.
Of course this is all theory and no one really knows why women develop these cysts (I sure as hell wish someone would find out though !). I personally have decided to allow my body to regulate itself as it is really the best judge of how much of a certain hormone my body needs (and not some ONE SIZE FITS ALL birth control pill !). I have to be careful during sex so that I don't get pregnant but I am a very cautious person so although it's a bit more work it is not devastating. I think I have screwed up my body enough over the past twenty years so if my husband wants an easier time of it he can have a vasectomy. If I had the choice of having a simple sterilizing procedure done which could be done in a doctor's office like a vasectomy, I would have done this back in my thirties as I have always been sure that I didn't want children (much to the chagrin of my mother in law).
So that is my story. I am now going for ultrasounds every six months. My last ultrasound showed a small calcification of a few millimeters but I was told by both the radiologist and the gynecologist that this is nothing to worry about and the cyst is still a simple, fluid filled, thin walled cyst which has remained stable. I have no choice but to trust (although when first diagnosed with this cyst, I went for several other opinions and an internal ultrasound with doppler flow analysis to make sure that everyone agreed that the cyst was not dangerous .. everyone did, including a gynecologist oncologist).
You may wish to consider seeing a gynecologist who includes natural medicine in his or her practice. I am currently reading a wonderful book by Dr. Christiane Northrup entitled Women's Bodies, Women's Wisdom. Although it sometime wanders off in the wrong direction and tends to assign rather simplistic psycological reasons for certain gynecological problems, it is nevertheless extremely informative and worth reading. It helps to answer many questions that women have about their bodies and it criticizes our "macho" medical system and its biggest weaknesses when it comes to diagnosing women's problems. This is important for women as many women blindly follow their doctor's instructions without asking questions and informing themselves. It's important to find a physician who can communicate with you properly and who has "a good head on his or her shoulders" (ie. common sense). I think that we spend an awful lot of time making sure that we have the best plumber, electrician or contractor who has good references but when it comes to our doctor this is not the case.
Oops, sorry for the rant.
Hope everything goes well with your second opinions. All the best.