I am 48 yrs old and have had normal periods up to Dec. '08 when I had 2 periods. I skipped my regular period in February and I have been spotting for 3 weeks. During this time and following my breasts have been swollen and sensitive. Then I began to have swelling/bloating of stomach, pressure on rectum, bladder, pelvis causing me to urinate and or move bowels following eating or drinking. I have occassional lower back pressure and cramping. The side of my abdomen is pulling/stretching similar to that during pregnancy. I am very uncomfortable. I had a pelvic ultra sound with result of 2 fibroids and an ovarian cyst. My PCP tells me there is no treatment. Do these other symptoms require the fibroids and cyst to be treated in any way ?
All depends on their size. Uterine fibroids may cause spotting, heavy menstrual bleeding and cramping, most definitely. They are extremely common in all women though and completely benign. If they are large and causing problems there are a number of ways to take care of the problem including embolization (cutting off the blood flow to the fibroids so that they shrink) and removal with surgery. If you can wait it out until menopause, the fibroids are supposed to shrink at this time so this would probably be best. Has your PCP done an endometrial biopsy for the spotting ? At our age this is usually done just to rule out other issues with the uterus. Also, I assume that you are up to date on your yearly pap smears and / or HPV test ? These are also important when spotting and irregular bleeding is an issue.
As for the cyst, if it is a fluid filled cyst that is less than 5 cm then this is most likely a normal follicular cyst that all women get every month and it will go away over the next few cycles. I have a large cyst that is not the functional kind and I am having it removed with surgery as these types don't go away on their own. Mine is almost 9 cms though.
Find out more information about the cyst and just be sure that it is the right kind of cyst and not something that needs to be followed. Otherwise, a followup ultrasound would be in order.
Thanks so much for your advice. I appreciate the suggestions and will pursue the endometrial biopsy with my GYN, who I see tomorrow. I am up to date as of Dec 10, 2008 with my PAP/HPV, both normal at that time. I think my biggest concern right now is the swelling of my stomach and the discomfort that it is creating along with the other symptoms. I am hoping I will get some answers or a plan of how to handle the symptoms going forward if they do not improve. You seem very well versed on the subject. Is it from personal experience or are you in the medical field?
Thanks again, if you think of anything else, I would appreciate your input.
When I turned 42 I began to have irregular bleeding and pain and this is when they found my very large ovarian cyst. At this time they also did an endometrial biopsy to rule out endometrial hyperplasia (although this was unlikely to be the case as I had been on the birth control pil for over 20 years and this usually thins the lining rather than thickening it).
The irregular bleeding was caused by oral contraceptives which I had been on for over 20 years. Some of the pain was also caused by this (endometrial atrophy). The proof of this was that once I went off the pill, my irregular bleeding problem and most of my pain resolved within a couple of months. Endometrial atrophy can sometimes cause varicose like veins to form in the uterine lining which begin to bleed. It also makes the uterus fragile. My doctors all wanted to change my pill to another brand and no one ever gave me the option of stopping the pill altogether. I figured that if the pill was causing the problem then stopping it should fix it and it did. I vowed never to go on the pill again, no matter what the medical field says.
The ovarian cyst, however, remained and I watched it for about a year and a half as it grew slowly but surely (ultrasounds every six months). My gynecologist now thinks that it would be best to remove it and I am so tired of the anxiety with this thing that I agree. My surgery will be scheduled for sometime in mid April. Over the past year and a half I have read as much material as I could get my hands on on the topic of ovarian cysts, especially since they can never really know with 100% certainty if an abnormal cyst is benign (most of them are and simple cysts like mine are almost always benign .. I still don't like that "almost" bit). I have read numerous studies and medical papers that I found on the topic as I needed to have up to date information in order to make a sound decision regarding this issue. Again my doctors said that it was a completely normal follicular cyst and that it would go away in a few months. I KNEW that a cyst of this size was most likely an abnormal cyst and I insisted on getting 6 month ultrasounds to keep a close eye on it. It is always good to read and then go with your gut feeling.
Dr. Christiane Northrup has written at least two very interesting books that I highly recommend: "Women's Bodies, Women's Wisdom" and "The Wisdom of Menopause". These books discuss many women's issues and help us to understand what the heck is going with our bodies at different times of our lives. When I read certain sections of her books I actually broke down because she was so "on the money". Her books have really helped me to inform and empower myself. Before I had my little "midlife health crisis" at the age of 42, I completely ignored my body and I was borderline obese. I have made a 180 degree turnaround since that time. I lost 60 lbs, began to exercise and eat right and only drink a little bit of wine on weekends. I also made it a point to inform myself about my body and will continue to do so. At the moment I am trying to do regular exercise and loose a few more lbs before my surgery (although my weight is pretty close to healthy). I want to be in the best of shape so that I can recover quickly. My husband keeps telling me that the laparoscopy is a small day surgery but I don't believe that any procedure is routine and I want to be as healthy as possible when I go in. I prefer to take an active role in my health rather than a passive one and I think that we can do a lot to maintain some control over our health (obviously total control is impossible .. in anything for that matter).
I think that even when we are not well, empowering ourselves with knowledge and a plan of action enables us to get the healing process started. The mind is a powerful part of our body and we are the only ones who have control of this. The medical field is not yet clear on how the mind and body are connected but they know that it is (the placebo effect can sometimes have as high an effect in recovery as 20%! .. this is why they have to be sure to eliminate it in pharmaceutical studies .. because it is so important). When I did not know what was causing my medical problems I fell apart for a time and then I decided to take control and try to do something about it .. I designed a more structured lifestyle which included daily walks and exercise and better eating habits. Concentrating on this rather than on my medical condition as I awaited the results helped me to get through. I now feel a lot better, even though I will need to have surgery to correct the problem.
I hope my own experience has helped to spur you on to persist in finding the cause of your problem. I assume that they did not find any free fluid in your pelvic cavity when they did the ultrasound ? Perhaps an MRI or a CT scan may be in order, especially since you seem to be very uncomfortable. I wish you all the best and hope you get to the root of the problem very soon so that you can begin to get better.
Try at age 39! even younger! I started getting perimenopuase symptoms in my 30's. My 'mother' had total hysterectomy at age 40! Cysts that were spreading and she also had endometriosis I believe.
Were you totally exhausted? I have total physical fatigue and this is the first time in my entire lifetime that I have bled twice in one month, though the second 'bleed' is spotting of 5 days.. learned from yrs of going to dr's that often we are correct and dr's are wrong. As grandma wisely said (she wanted to be a dr. and studied medicine) ' you know your body better than anyone else'.
I would seriously recommend that you pick up a copy of Dr. Northrup's books, Women's Bodies / Women's Wisdom and the Wisdom of Menopause. These give all sorts of suggestions on how to reclaim yourself and start to feel the best you have ever felt. They helped me a lot to take charge of my health. I am currently four weeks past my operation to remove my left ovary and tube and I am feeling very well. I do believe that the steps I took prior to surgery made a big difference in my speedy recovery.