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Old 10-07-2009, 01:46 PM   #1
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What About Ovarian Cysts?

I'm post op 2 pituitary surgeries and also had a bi-lateral adrenalectomy for cushings disease. So my pituitary gland doesn't work and I'm left with addison's diesase. To say that I'm hormonally challenged would be an understatement!! LOL

My gyno did female hormone bloodwork a while back and said that my progesterone was low but because I take growth hormone via injection everyday, taking the progesterone by pill was not an option. They interact. <shrug>

So fast forward . . . . my period is sparatic. For about 3 months it was right on que and for the last 3 months it was MIA. Last week finally had a light period (with lots of brownish stuff) and pain that required me to hold the bottom of my stomach every time I stood up from my recliner.

In the meantime my GI doc ordered a CT to check for a gastro problem I'm having and they found a "rather large cyst on one of my ovaries". So I called my gyno and spoke to the nurse. She acts like shes put out that I even called and goes into the spill about how CT's always find cysts on ovaries and it's probably nothing to worry about. So I tell her that I've been having other problems and should have already called but just have been putting it off until they told me what was seen on the CT. That didn't impress her at all, needless to say.

So now the GI doc has scheduled an upper endoscopy on the same day the nurse scheduled me to come in and see the gyno. Go figure . . . . I called and left her another message and she has yet to call me back.

Anywho . . . . what should I think about the cyst along with my symptoms? Anytime I do any amout of walking I get a lot of pain in the lower abdominal area and just have to sit down for it to ease off. Could a cyst cause that?

I've tried to read up on cyst and find that there are many different types, too much for me to understand.

Thanks for any replies . . . .
Amy

 
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Old 10-07-2009, 05:03 PM   #2
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estria HB Userestria HB Userestria HB Userestria HB User
Re: What About Ovarian Cysts?

Hello Amy,

The reason the nurse seemed unconcerned about the cyst is because all women grow cysts on their ovaries every month so at any point in time, a scan will most likely show an ovarian cyst. These functional cysts are completely normal and contain our eggs. They rupture every month and release the egg into the fallopian tube and then the shell of the cyst begins to release progesterone in order to prepare the uterus for conception. If the egg is not fertilized, then the body cleans out the uterus with your period and everything begins again. This means that cysts will be very visible just before ovulation (about 10-14 days after the start of your period when the follicles are larger) and just after (when the shell or corpus luteal cyst remains and the cysts that did not rupture are reabsorbed into the ovaries). Cysts can also be visible at other times since we are not really like machines and our cycles can have blips and vary.

Most of the time the cysts they see on scans are these types of functional cysts (follicular and corpus luteal). Sometimes though we have abnormal types of cysts such as serous cysts, mucinous cysts, dermoid cysts and hemmorrhagic or "chocolate" cysts. Some of these cysts do have "sinister equivalents" but most often even these are completely benign. However, these abnormal cysts are less likely to go away on their own and if they persist or grow larger, the doctor will recommend removal. I myself had a large serous cyst and watched it for about 18 months before it was decided that surgical removal was the best option. My cyst was growing very slowly and it was believed that eventually it may cause problems by pressing on the other organs or if it ruptured. My cyst began at about 7 cms and I had it removed when it got to around 9 cms. It was a simple, unilocular cyst, meaning that it was filled with fluid, was only on one ovary and had thin walls. A complex cyst is one that has both fluid and solid components and these have to be watched more closely as rarely these can be cancerous (however most often they are benign and they cause more worry than anything else). Simple cysts are the least likely to be cancerous.

Do you know how large your cyst is and if it is a simple or complex cyst ? Normally, an ultrasound is required to see this. They can usually identify a cyst by it's appearance on the ultrasound and at the very least they can tell if it is a simple or complex cyst. Simple cysts that are under 5 cms are most likely normal functional cysts that will go away within 1-3 menstrual cycles. If they are between 5 and 10 cms (like mine was) they can be watched to see if they go away but may have to be removed if they persist. Complex cysts can also be reabsorbed into the ovary, depending upon their size. Anything over 10 cms should really be removed as this can cause problems on the pelvic organs and may also torse the ovary due to its size (this is when the ovary twists on itself and cuts off its own blood supply .. extremely painful and an emergency in order to save the ovarian tissue .. otherwise it necrotizes or dies off). Torsion is a rare occurence but it does happen as does rupture. For cyst rupture most often no action is required except for pain control. The fluid that is released into the abdomen is painful but will be eventually absorbed by the body. If a hemorraghic cyst bursts it will release blood into the abdomen and this is an emergency as blood is not the same as serous fluid. Naturally, if there is fever and the shakes, this is an emergency that needs to be addressed as pelvic infection may be present. Most often, though, a cystic rupture is self limited and will improve within a few days.

I hope I have helped to clarify the confusing world of cysts. I would recommend that you ask your gynecologist to perform an ultrasound to see what kind of cyst you have and if it should be watched. You should also tell her your symptoms as these are sometimes related to the cyst, depending upon its size and if it is close to any nerves. Our anatomy is unique and where a large cyst may cause no symptoms in one woman, a smaller cyst can cause excruciating pain in another. My 9 cm cyst gave me no symptoms whatsoever. I had pain with ovulation but I still do even after my left ovary was removed with the cyst.

I hope you find the right balance for your pituitary and adrenal gland problem. This may take some time but you should be persistent until you are feeling like your old self again. All the best.

Estria

 
Old 10-07-2009, 06:08 PM   #3
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kalimae7371 HB User
Re: What About Ovarian Cysts?

YES, that helped a lot!! Thank you so much for the reply. I was having a hard time finding a message board that talked about ovarian cysts until I ran across this one.

The GI doc said it was "a rather large cyst". I am waiting on a copy to be mailed to me so that I can take it to the gyno with me for my appt. So I will be able to read it myself. That should clear some things up for me as to what the CT report states.

So now I understand why she was so casual and non-concerned about it. I have been having other problems though and did go on to explain that to her after her spill about CT not being the best apparatus for detecting cysts.

Soooo, guess we'll just go from here. The next step to put my mind at ease will be actually seeing the CT report and what it states.

Again, thank you so much for going into such great detail to explain this to me. Now it makes so much more sense!!!

Amy

 
Old 10-08-2009, 06:04 PM   #4
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Re: What About Ovarian Cysts?

I just got a copy of the CT scan and it shows a 4 CM ovarian cyst. It doesn't say what type. Guess at CT can't distinguish fluid filled, simple, complex, etc. (sorry, I'm confused - LOL)

Anyway, is 4 CM "rather large" as the GI doctor stated? I'm just curious what constitutes large, small, inbetween, etc.

 
Old 10-09-2009, 06:46 AM   #5
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estria HB Userestria HB Userestria HB Userestria HB User
Re: What About Ovarian Cysts?

Hi Amy,

A 4 cm cyst is not that large and if it is a simple cyst then it is most likely a normal follicular cyst that will be gone in 1-3 menstrual cycles. Follicular and corpus luteal cysts can grow as large as 5 cms. Anything larger is suspicious for something other than a functional cyst but even these can sometimes go away on their own (although I have never heard of cysts between 6 and 10 cms or over going away on their own). This means that you are still well within the normal range of a normal cyst.

The nurse is right, a CT is not the best tool for looking at ovarian cysts and most likely your gyno will do an ultrasound. This is the gold standard for ovarian cysts and with this tool it will be possible to see if the cyst is simple or complex and what kind of morphology it has. A simple, thin walled, fluid filled cyst on one ovary that is 4 cms will most likely go away on its own. Of course it is virtually impossible to tell a functional simple cyst from a non functional one (abnormal cysts can grow on practically any part of the body .. kidneys, uterus .. on the outside of the body etc.. they are fluid filled sacs basically). When it was first seen, my 7 cm cyst looked just like a functional cyst. However, I KNEW that by its size this could not be so and the gyne also knew. My G.P. and even the radiologist thought it was a functional cyst and for all I know perhaps it started that way and persisted for some reason, who knows really.

If you need any help interpreting the CT report, come back and let us know. But keep in mind that this machine is not the gold standard for cysts and that only the ultrasound will give you the most meaningful information. The CT is good for other things.

Take care and best regards,

Estria

 
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