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Old 03-07-2010, 10:51 PM   #1
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Ovarian Cyst - Do I have to do anything?

Thanks in advance for any advice...

I visited my doctor in December because I was having menstrual irregularities. This has not been uncommon for me over the past couple of years, because I've lost and regained a lot of weight. In the process of investigating my heavy menstrual bleeding (which we determined was due to my weight fluctuations) the doctor found a small, fluid-filled ovarian cyst on the ultrasound. He said it was no big deal, and we'd check it again in 2 months. When I came back, they said it was still there and still the same size, so I had a CA-125 test (to check for ovarian cancer), and it came back normal. The doctor said it was a small corpus luteum cyst, and said he wanted me to take estrogen for one month and come back to repeat the ultrasound.

I am very uncomfortable taking estrogen. I am 30 years old, and I am currently on the minipill because I am nervous about estrogen. I am very overweight, and I have varicose veins that cause my legs to swell. Obviously, I think the risks of blood clots, etc. on estrogen is just too high for me when I just have this little cyst that is not even causing any pain or discomfort.

The doctor said if my next u/s still showed the cyst, he'd send me to a gyno to see if it needs to be removed. Needless to say, I'm not excited about the prospect of having a small, fluid-filled cyst that is not causing any problems removed surgically.

I guess my question is, do I HAVE to do anything about this? Can I just forget about it? I haven't read about any major problems that can be caused by ovarian cysts, other than pain, torsion, etc. (which I obviously would go to the doctor for.)

Thanks again for any advice.

 
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Old 03-08-2010, 10:14 AM   #2
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Re: Ovarian Cyst - Do I have to do anything?

SRC,

Why does the doctor want to put you on estrogen to get rid of the cyst ? This will do NOTHING except perhaps to increase your risk of bloodclots and uterine cancer. Any doctor worth his salt should know that unopposed estrogen is NEVER prescribed if a women still has her uterus. In addition, up to date doctors know now that simple cysts such as the one you have, will either go away on its own or it will not, irregardless of added hormones.

If this is a corpus luteal cyst, it will go away BY ITSELF and nothing needs to be done. If it does not go away by itself after a few months (3-5 menstrual cycles) then it is not a corpus luteum but an abnormal cyst and no amount of hormone is going to make an abnormal cyst go away. If the cyst is remaining the same size and it is not associated with any symptoms, you can simply go for yearly ultrasounds to keep an eye on it and that's it. Nothing else needs to be done. If my abnormal simple cyst had not kept growing, this is definitely what I would have done. Who needs unnecessary surgery ? Oh and my doctors all thought my cyst was a functional cyst too, until they were proven wrong .. the cyst was still there 18 months later (no functional cyst hangs around for that long).

How large is this cyst ? You said it was small so it is most likely just a normal functional cyst (either follicular or corpus luteal) which will go away by itself in time. If it is not a functional cyst and it stays the same then you don't need to do anything and can simply keep an eye on it with ultrasounds.

Your instincts are bang on so follow what they are telling you. Either get a second opinion from a gynecologist or simply ask to be referred to the gynecologist right away and refuse the estrogen. A good doctor should not be afraid to have his opinion checked by someone else. I am quite sure that no gynecologist will put you on unopposed estrogen. Oh and by the way, your menstrual problems are most likely due to the pill ! I am surprised that your doctor has not mentioned this.

After 20 years on the pill, I also began to have irregular bleeding (irregular bleeding can either mean that you are skipping periods or that you have additional bleeding etc.. anything out of the ordinary really). I suddenly started to have irregular episodes of extremely heavy bleeding. My primary care wanted to put me on a "stronger" pill with more estrogen and I consulted a gyne. She wanted to put me on progesterone. With one saying one thing and the other saying something else, I told them that if the pill is the problem then I am going off of it. I did and my cycles went back to normal IMMEDIATELY. My problem was solved. I later read that sometimes the endometrial lining atrophies after long term pill use and women can either bleed a lot or (more commonly) stop getting their periods altogether. Both doctors told me that this happens ALL THE TIME with women on long term pill use. Huh ! There is NOTHING in the insert about this. Anyway, after being scared TO DEATH after that experience and then having an asymptomatic ovarian cyst found on an ultrasound that had to eventually be removed (it was growing) etc.. etc.. I have decided to use another form of birth control until menopause.

Get a second opinion. What your doctor is telling you is not standard procedure and may put you at risk for other problems, especially if you are carrying some extra weight. You are smart to question what you are being told.

Take care of yourself.

Estria

 
Old 03-08-2010, 02:12 PM   #3
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Re: Ovarian Cyst - Do I have to do anything?

Thank you so much for the thorough response. I should clarify a couple of things. I guess it wouldn't be unopposed estrogen, because I am on the progestin-only minipill. However, it's still .625 mg of estrogen, which according to my calculations, is about 10 times the amount that was in the low dose birth control pills that I used to take, and I got off of those because of my fear of the side effects of estrogen. I'm not about to start such a high dose of estrogen with my risk factors - thank you for making me feel better about that decision.

I had been off of all birth control for a year when my period went crazy, but like I said, I lost and regained about 70 pounds, so I'm assuming that had a lot to do with it. At any rate, the doctor did say it was a small, fluid filled cyst, and when I questioned him he did say "corpus luteum cyst," so yes, I'm assuming it is a functional cyst. That's why I was a little baffled that he wanted to treat it.

Thanks so much for the reassurance!

 
Old 03-08-2010, 03:08 PM   #4
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Re: Ovarian Cyst - Do I have to do anything?

SRC,

You have to understand something. There is absolutely NO WAY that your doctor can know for sure that what you have is a corpus luteal cyst. NO WAY whatsoever. He is making an assumption. Because it is a fluid filled, small cyst, he is assuming that it is a functional cyst, be it follicular or corpus luteal. The odds are that it IS a functional cyst because most of them are. You have to realize, however, that there is no way someone can say for sure what kind of an ovarian cyst they are looking at through an ultrasound. I still remember the radiologists scratching their heads and wondering why my "functional" cyst was not going away. Well DUH ! it's because it was not a functional cyst but an abnormal one. These are also pretty common but not nearly as common as functional cysts (which are rampant .. these are just bigger versions of our graaphian follicles that contain our eggs and can grow as large as 5 cms).

If your irregular bleeding episodes occurred while you were NOT on the pill then you really should see a gynecologist and follow through on this. You cannot simply ASSUME that the irregular bleeding is due to your weight change. Did your doctor look at the thickness of your uterus to see if it is too thick ? or if perhaps you have uterine fibroids. A thickened uterus or fibroids can cause irregular bleeding. As can something like a thyroid imbalance. An endometrial biopsy can sometimes find the problem if it is in the uterus and usually a gyne will do this when a woman is experiencing irregular bleeding. The biopsy takes about five minutes and can be done in a doctor's office. Just be sure to take a couple of ibuprofen about an hour before the procedure to negate cramping (this is what I did and I was fine). If you are having irregular bleeding, DO NOT assume that it is due to your weight loss and gain as it may be due to something else. Once other things have been ruled out, then you can go ahead and say it is DUB (dysfunctional uterine bleeding). DUB is a diagnosis of exclusion and too many doctors arrive at this diagnosis first rather than last.

As for the hormones, this dosage of estrogen is indeed high, even if you are on the mini pill. If your doctor has recommended that you add estrogen to you mini pill, does he know if your birth control will still be as effective as before ? Or is he screwing around with the hormone balance ? If he wants to add estrogen, you would be better off simply going off the mini pill and using a low dose combination birth control pill. At least you would not be on a high dose of estrogen which comes with serious risks (these risks are magnified if you are overweight or have circulation problems, which you say you do).

I totally understand what it is like to loose and regain a lot of weight. I myself lost 70 lbs over the past years after having regained it again. My doctor also thought that my irregular bleeding was due to my weight and this is why he wanted to give me a stronger birth control pill. He, however, also did an endometrial biopsy to make sure that nothing else was going on in there. Fortunately, I did not listen to him, went off the pill and my period regulated itself (since in my case, the pill was the problem .. although not because it was not strong enough as the doctor suspected).

I would strongly urge you to see a gynecologist ... mainly for the irregular bleeding problem and also to follow up on the ovarian cyst. Your family doctor seems to be making a lot of assumptions and you need to verify that his assumptions are indeed fact. The cyst is not such a serious issue but the irregular bleeding should be looked into.

Hang in there and I hope you find a solution very soon.

Regards,

Estria

 
Old 04-28-2010, 12:29 PM   #5
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Question Re: Ovarian Cyst - Do I have to do anything?

Quote:
Originally Posted by estria View Post
SRC,

Hi, im 26 and have a cyst in my right ovary and have had a bad pain on my right upper side of my waist. Is this normal?

Im very scared

You have to understand something. There is absolutely NO WAY that your doctor can know for sure that what you have is a corpus luteal cyst. NO WAY whatsoever. He is making an assumption. Because it is a fluid filled, small cyst, he is assuming that it is a functional cyst, be it follicular or corpus luteal. The odds are that it IS a functional cyst because most of them are. You have to realize, however, that there is no way someone can say for sure what kind of an ovarian cyst they are looking at through an ultrasound. I still remember the radiologists scratching their heads and wondering why my "functional" cyst was not going away. Well DUH ! it's because it was not a functional cyst but an abnormal one. These are also pretty common but not nearly as common as functional cysts (which are rampant .. these are just bigger versions of our graaphian follicles that contain our eggs and can grow as large as 5 cms).

If your irregular bleeding episodes occurred while you were NOT on the pill then you really should see a gynecologist and follow through on this. You cannot simply ASSUME that the irregular bleeding is due to your weight change. Did your doctor look at the thickness of your uterus to see if it is too thick ? or if perhaps you have uterine fibroids. A thickened uterus or fibroids can cause irregular bleeding. As can something like a thyroid imbalance. An endometrial biopsy can sometimes find the problem if it is in the uterus and usually a gyne will do this when a woman is experiencing irregular bleeding. The biopsy takes about five minutes and can be done in a doctor's office. Just be sure to take a couple of ibuprofen about an hour before the procedure to negate cramping (this is what I did and I was fine). If you are having irregular bleeding, DO NOT assume that it is due to your weight loss and gain as it may be due to something else. Once other things have been ruled out, then you can go ahead and say it is DUB (dysfunctional uterine bleeding). DUB is a diagnosis of exclusion and too many doctors arrive at this diagnosis first rather than last.

As for the hormones, this dosage of estrogen is indeed high, even if you are on the mini pill. If your doctor has recommended that you add estrogen to you mini pill, does he know if your birth control will still be as effective as before ? Or is he screwing around with the hormone balance ? If he wants to add estrogen, you would be better off simply going off the mini pill and using a low dose combination birth control pill. At least you would not be on a high dose of estrogen which comes with serious risks (these risks are magnified if you are overweight or have circulation problems, which you say you do).

I totally understand what it is like to loose and regain a lot of weight. I myself lost 70 lbs over the past years after having regained it again. My doctor also thought that my irregular bleeding was due to my weight and this is why he wanted to give me a stronger birth control pill. He, however, also did an endometrial biopsy to make sure that nothing else was going on in there. Fortunately, I did not listen to him, went off the pill and my period regulated itself (since in my case, the pill was the problem .. although not because it was not strong enough as the doctor suspected).

I would strongly urge you to see a gynecologist ... mainly for the irregular bleeding problem and also to follow up on the ovarian cyst. Your family doctor seems to be making a lot of assumptions and you need to verify that his assumptions are indeed fact. The cyst is not such a serious issue but the irregular bleeding should be looked into.

Hang in there and I hope you find a solution very soon.

Regards,

Estria

 
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