I was recently dx with a small (3cm) simple cyst on my left ovary. On the ultrasound report I also noticed, "small amount of Free Fluid" was found.
Is this normal, something to worry about? I spoke to my GYN, and she explained that this is actually a good sign, it means the cyst is slowly starting to go away. She scheduled me for another ultrasound in 8 weeks, and wants me to start taking BC pills until then to help shrink the cyst.
I am still concerned. Would this be a sign of Ovarian Cancer?
Hi, I'll see what I can do to answer your question. Keep in mind I don't know a lot about ovaries or cysts.
I'm not totally sure, but I think the "free fluid" means that you had a cyst pop (what is the proper word for that? resolve?). Women who are still ovulating form cysts, then they resolve. It is when those cysts grow large, or problematic (complex, etc) that they become a problem.
It sounds like your cyst(s) is fluid filled. That is good. It is also standard to follow up with another ultrasound in a few months to see if the cyst is growing, staying the same, shrinking, or resolved.
Your doctor seems to be on top of this. That's good!
Hopefully, one of the ladies who knows ovaries and cysts better than I will be in here shortly to give you more info.
It has nothing to do with ovarian cancer, and your doctor is right. All cysts are made up of fluid, if there is fluid showing up, the cyst is disolving. its a good sign.
When, or if it ruptures, they usually do, it will feel like cramps and then when the fluid is absorbed back into the body, which is what always happens, youll feel GREAT! Normally this happens around the time of your period. Most of us have small cysts which we dont even know we have.
PLease dont think twice about this- your fine.
Just so you know, cancer is in CELLS - not fluid, and would show up in a PAP test....
Your cyst is within the normal range so it is most likely a normal follicular cyst. The kind that all women develop when they are ovulating.
I am rather surprised that your gynecologist has recommended the pill. It is now known that birth control pills do nothing to hasten the disappearance of cysts. There have been scientific studies to prove this and most doctors no longer follow this practice. You may wish to do some of your own research on this. All that is needed is watchful waiting, meaning doing another ultrasound in six weeks to see if the cyst has disappeared.
If possible, try to go for your ultrasound around the time of your period as this is when you are the least likely to see cysts. Otherwise, you may see another one and the whole worrying process will start all over again.
As for the fluid, all women have a certain amount of fluid in their abdomen and a small amount of fluid is quite normal. Usually the fluid is not visible on the ultrasound but perhaps it was on yours. Pickle eyes is correct when she says that sometimes fluid is caused by cysts rupturing and it is quite possible that when you last ovulated, some of the fluid in the follicular cyst that released its egg, went into the abdomen. This fluid will be absorbed by your body in a short time. Your cyst could be a corpus luteal cyst (as opposed to a follicular cyst) which is the shell of a follicular cyst after it has released its egg. Sometimes these things close off and fill up with liquid. Both follicular and corpus luteal cysts come and go with a woman's normal cycle.
I hope I have managed to help a little. It is extremely likely that the cyst will be gone by the next ultrasound so try not to worry.
The pap test is not for ovarian cancer but for cervical cancer, two completely different things. There is currently no screening test for ovarian cancer and the medical field is working on this. There is a blood test called the CA-125 which tests for a specific cancer antigen that is normally present in large numbers when ovarian or peritoneal cancer is present, but this is a very unreliable test, especially in pre menopausal women. The "look" of an ovarian growth on an ultrasound can also be a telling sign for cancer. Complex ovarian cysts can sometimes be cancer (cysts that have both solid and liquid components) although most complex cysts are still benign. Solid ovarian tumours can also be cancer (or not). Radiologists are now quite good at recognizing an adnexal mass' morphology (the "look") and being able to tell what kind of cyst a woman has on her ovary, including ovarian cancer. This is not a 100% sure thing however and only a biopsy of the growth can tell for sure.
Unfortunately, women grow follicular cysts on their ovaries every month and this is a part of the normal process of fertility. It is therefore very difficult to differentiate between a normal follicular or corpus luteal cyst and an abnormal one. For example, when I was diagnosed with a simple ovarian cyst on my ovary, they thought that it was completely normal. However, it continued to grow until it was about 9 cms. At this point it was removed and biopsied and it was a serous cyst, an abnormal growth but nevertheless completely benign. My CA-125 test during the 18 months that I watched this cyst remained at around 6 or 7 (anything under 35 is considered normal). During this time, I would have given anything to have a definitive test for ovarian cancer but there wasn't one. They are very close to having one so perhaps in the future we will be able to have the pap smear for cervical cancer and this other test for ovarian cancer. Who knows.
The Following User Says Thank You to estria For This Useful Post: Hrslauta1978 (10-05-2011)
Oh and by the way, a lot of fluid in the abdomen DOES have something to do with cancer. It is called ascites and this is probably why Parker is concerned. However, Parker, I would absolutely not worry one bit about this as a small amount of fluid is completely normal. A friend of mine was diagnosed with peritoneal cancer last year and she had approximately 5 litres of fluid in her abdomen (this is a huge amount). This was a completely different situation than yours, of course, but I remember that the fluid caused her a tremendous amount of discomfort.
I have no doubt that your small cyst will be gone by your next ultrasound try not to worry.
Estria, thanks for calling me on that. I wrote, differnt from what my brain was thinking. I have Multiple Scerlosis, and sometimes do that. What I had been thinking is that a Biopsy of Cells, or a pap test type scraping of cells would be the way to determine Cancer, not fluid, BECAUSE Parker seemed to think JUST BECAUSE there was fluid, that it meant cancer. But your right, I screwedd up my answer. Thank you for clarifying.
Ive been dealing with both cysts and now a fibroid in my uterus for many months now. Ive had several cysts rupture, causing extreme pain, and because I have so many other issues with bleeding, I had an Ablation (Novasure) done. BIggest mistake of my life. One thing they dont tell you is that if you have ablation done, youll never have a normal uterine biopsy again. They cant get tissue, there is too much scarring. Im facing a hysterectomy now and am terrified. I know not to jump into that surgery, but quite honestly, there isnt much chance of them knowing FOR SURE what they are dealing with on me, without going on and removing it....the placement and size of this are too large to remove, so looks like I am headed towards the surgery.
Thank you again for your wisdom and explanation.
My goodness, this sounds awful. I had no idea that an endometrial ablation meant that future biopsies would not be possible. It does make sense now that you mention it but this is definitely something they should tell you BEFORE you have the procedure.
Why are they thinking of doing a hysterectomy ? Did the ablation not take care of the problem ? Is it only due to the fibroids and if so, are they causing problems ? If not, just don't worry about them, they will shrink with menopause. I too have a fibroid in my uterus that they see on the ultrasound everytime (while I was watching my cyst). It is not very large and has remained the same. It also does not cause any problems (I did have irregular bleeding problems at one time but this was due to endometrial atrophy from long term pill which was the biggest mistake of MY life .. stopping the pill solved the problem). Sometimes these damned things do cause a lot of problems though and my cousin recently had to have a hysterectomy and oopherectomy due to her one remaining ovary being so enlarged and to her having so many large fibroids that they were causing problems. She is extremely happy that she had this procedure as her life had gotten very difficult and now she is problem free (although I assume she has to go on HRT as she is in her thirties). Her sister had her fibroids removed surgically so you may want to consider this option as well. In this case, find someone who is extremely experienced with doing the procedure.
As for the cysts rupturing, I am not sure they can do much for this except to perhaps shut down your ovaries altogether. I have horrible ovulation pain myself but I try to manage it with heating pads, Advil and hot baths. The ovulation which followed my surgery was particularly painful as my abdomen was still in the process of healing so the fluid or blood from the follicular cyst was not particularly welcome at that time. Sometimes even the muscles around my bladder are sore for a few days. My doctor has suggested that I take ibuprofen before ovulation actually occurs as this will reduce the prostaglandins in the blood that cause the inflammation and pain. Ibuprofen evidently works better if taken at the first sign of pain or even prior if one knows they are going to be sore. I try to do this but sometimes it is difficult to know exactly what day I will ovulate and the little bugger takes me by surprise.
I hope they find a solution to your problem. If for any reason you do end up opting for a hysterectomy, see if you can find a physician who is comfortable doing a LAVH (laparoscopically assisted vaginal hysterectomy) as this will mean less pain and a much faster recovery time. Depending upon your anatomy, this may or may not be possible. I sincerely hope that they manage to solve the problem without surgery though. By the way, for fibroids there is also the option of embolization. This is where they cut off the blood supply to the fibroids so that they shrink. It is a day procedure that does not require general anaesthesia so this may be a less invasive option for you.
I am rather surprised that your gynecologist has recommended the pill. It is now known that birth control pills do nothing to hasten the disappearance of cysts.
I guess this news hasn't reached our backwaters yet LOL, because my gynecologist had me on a double dosage of birth control pills until the end of my 28 day cycle for an egg-sized cyst which was causing pain during intercourse. She said it could have been caused by my irregular BCP taking (I'd skip a day here and there and forgot to take two the next day). Whatever did the trick, my cyst disappeared with my period. Afterwards I stopped taking the pill altogether and haven't had cysts since.
Last edited by jana83; 06-17-2009 at 10:52 AM.
Reason: shortened the quote
Estria, hi and thanks . Its nice to talk to someone who knows what she is talking about. Ive gotten allot of feedback in discussing this with so many people, my head is spinning. First, I dont know if you read in the other post, I have MS. Because of it, I cannot do any heat at all. NO hot baths, or heating pads, ever. Ill wind up in bed for a week. I can barely stand the summer months to begin with, and Im a sales rep! Im in and out of the car and air conditioning all season long! But thats another story.
Im 42, have never had kids- I have 3 stepchildren who live with me- and that, was birth control for me. Because of this, no surgeon Ive spoken to is interested in doing laproscopic on me. Trust Me- Ive investigated the DaVinci, and wanted it done..they all say, that Im too tiny, my vaginal walls are too strong (from not giving birth) and they arent comfortable with it. So, that leaves me scared, too.
The Fibroid which I have, cannot be removed surgically. They currently have me on Progesterone, to see if it helps to shrink it...however, I wont know until Ive been on it awhile longer if it is doing anything. I do know that something wacky is going on. Ive been spotting non stop, with a mucus-y type blood for the past two weeks. Im thinking its thinning my endometrial lining? I have an appointment with my GYN next week. Had to postpone the last one- I was bleeding too badly.
And, thats where all this both starts and begins. I had the ablation to stop the insane bleeding..it didnt work. Not even alittle bit. I have bled for ten months, almost non stop. I was on b/c pills, which took care of it, prior to the ablation, but Im so high risk for stroke, I decided to have the ablation and a tubal, and go off the pills. So now Im pill free, not supposed to be able to get pregnant and still bleeding! Then, they decide to try progeserone, supposedly much safer in the stroke risk factor arena, and will stop the bleeding. Not So Much, as they say. Im still bleeding, although its no longer clotting, its more spotting.
They feel the bleeding is probably due to the fibroid, and I have had my TSH and hormones checked....im not close to peri-menopausal. I cant take this for another five years until it happens...(just guessing on the time frame) Im seriously willing to have the surgery, if it will put an end to this misery. But, I do know the risks, and Im not 100% certain that I should do it. Having MS makes my life hard enough...two or three times a year, I have a complete relapse and wind up on IV Steroids, or complete bed rest. Im not a stupid woman, I have a high powered job, as a Director, and I also am working on my Doctorate...having MS hasnt stopped me, but bleeding 24-7 is starting to!
So, thats my story. Wish it would have a good ending...and any suggestions are welcome!
Oh my goodness, it sounds like you are going through hell. Yes depending upon the amount and type of progesterone, it could actually be causing the bleeding. In my case, the strength of the progesterone in the triphasic kind of pill caused my lining to atrophy and form varicose like veins which began to cause bleeding with the clots that you speak of. This scared the living daylights out of me and when I went to my doctor he actually wanted to put me on another type of pill (!). I consulted a gynecologist and she wanted to do the same thing. My G.P. said that perhaps the pill was not strong enough for me and I needed a stronger one and the gyne wanted to increase the progesterone. Each of them wanted to change my pill, after I had been on it for over 20 years and finally I asked them if simply going off the pill altogether would fix the problem (this option was NEVER offered to me and I had to come up with it myself). They said yes so I said, good !, decision made .. don't ever try to offer me hormones ever again. Sure enough, my cycle went back to normal and almost immediately. There is NOTHING in the oral contraceptive pamphlet about this type of thing happening and according to my doctors they see it ALL THE TIME. My bleeding began one mid-cycle with small black clots and brown spotting, the following month, nothing and then all hell broke loose with mid-cycle heavy clots. It always occurred on day 11-14 of the pill pack, when the progesterone dosage was being increased.
I wonder if the bleeding and spotting that you are experiencing is not due to the ablation. Of course I imagine that the fibroid could also be the cause. Have you ever been off the hormones altogether ? I also have read that if DVT is of concern that the progesterone only pill is a better option so this makes sense about the progesterone. But it would be nice if you could simply be problem free without the hormones. Have you tried to consult someone else, perhaps in a more specialized centre or someplace that specializes in treating MS patients ? Sometimes one doctor will refuse to perform a procedure and the real reason is that he or she is simply not comfortable with performing it because they don't have enough experience.
Hopefully the progesterone will shrink this thing. On the bright side, uterine cancer is not high risk for young, tiny women. Obese women are at very high risk of uterine cancer, especially as they get older. Also, if you were on the pill for most of your life, this is a huge uterine cancer risk reducer because the pill keeps your lining thin. Another way they can look at your uterine lining is with an ultrasound but I imagine this has already been tried. I would be very surprised if your lining was thickened, what with the pill, the progesterone and the ablation. So even if they cannot do an endometrial biopsy, it is unlikely to be uterine cancer. However, I fully realize that you would rather be 100% sure and this I completely understand.
Perhaps someone else will come on who has a good suggestion or who has gone through the same thing.
Parker, I am sorry we have monopolized your thread. If you are still there, please tell us how things are going.
Most likely your cyst would have disappeared anyway, even without the BCP's. They have done a number of studies that compared watchful waiting with no BCP's to taking oral contraceptives to help the cyst disappear. There was absolutely no difference between the two. This is probably because normal follicular cysts come and go anyway so the pill would not make a difference. There have also been scientific studies to prove that abnormal cysts do not disappear with the pill which makes sense, since they are not cyclical in nature and therefore would not be affected by hormones.
On the BCP pamphlet it says that oral contraceptives can actually prevent cysts from occurring. Well DUH, they must think we are idiots. The pill is an anti-ovulant and is supposed to keep you from ovulating so of course it should minimize or even block the development of graphian follicles (or ovarian cysts that are normal).
HOWEVER, I am absolutely not convinced that the pill does not cause abnormal cysts in women who have been on them continuously for many years. I do not think that any study has been done on women who have chosen to remain on the pill for decades without any break (such as to have children, for example). I firmly believe that my abnormal cyst came about either while I was on the pill or when I stopped taking it and my ovary was not able to function normally for some reason (I stopped taking it due to irregular bleeding after twenty years of continuous use .. I had developed endometrial atrophy and I suspect that my left ovary was also atrophic and malfunctioning thus the cyst). The doctors tell us that it is safe to take the pill continuously without going off of it but I have not seen any study that tests this. There are not many women who have chosen not to have children so I imagine that it would be difficult to find such a test group in large enough numbers.
Estria, I completely agree with what you're saying (I just had no idea at the time and I was very scared). I find it irresponsible for doctors to be pushing BCPs at women just because they're convenient and effective in preventing a pregnancy. There are other safe and more healthy methods out there. I have become very skeptical about the pill. I stopped taking it partly because I felt my body telling me to - if that makes sense. It seemed to be saying "enough". I have also talked to my homeopath about it (she is a retired anesthesiologist and quite disillusioned with the medical profession) and she claimed the pill can cause many reproductive health problems, as well as infertility. Though I haven't heard of this being a verified fact - but who would tell the public anyway?
Parker, if I were you I would try going without the pill. If the cyst has begun shrinking on its own, it should continue to do so without the pill. Maybe cut down on caffeine - it has been proven that caffeine can promote cyst growth. Of course, eating healthy, getting some exercise and reducing stress can't hurt either.