Hello-I am a 47 year-old woman who has had problems with cysts in the past. I had my right ovary removed in my late 30's. Fast forward to 1/14/09:
Going through perimenopause. Had my last period on January 14th and got it on May 1st. I had a sono on 12/12/09. It was ok. I had another sono on 04/29/10 (four and a half months later). This is what the report said:
Two left anechoic ovarian cysts, the larger measuring 2.4 X 1.4 X 2.0 cm. the other measuring .8 X .5 X 1.1 cm. These not visualized on the prior sono of 12/12/09. Surgical absence of the right ovary compatible with the patient's known prior oophorectomy. No fluid is identified in the cul-de-sac region.
I just received a call yesterday (05/13/10) from my gyno, who wants me to get a CA-125. I have had these in the past as I did have the R ovary removed.
Right now, I am having lower abdominal pain, feeling of fullness, constant urination and GERD. I was diagnosed years ago with fibromyalgia, IBS, Interstitial Cystitis, and GERD. These symptoms come and go.
Right now, it is exactly two weeks since I got my period. I have a feeling I am ovulating or middleschmerzing. I was in the hospital seven years ago because a cyst burst and I've been on a plane when another one burst, so I've had issues with cysts bursting.
Could these symptoms I have now be due to ovulating? I am getting worried because these anechoic cysts presented themselves in four and a half months, which is the exact time frame I did not have a period. Also, what are anechoic cysts?
When I did not have my period for those months, I was getting night sweats, hot flashes, and couldn't sleep.
I have to get that CA-125 done next week, but I am really thinking of telling my gyn. I want this other ovary removed because I am going through the change anyways.
Please tell me if any of you have gone through this and should I be really worried.
An ovarian cyst can be anything from anechoic to echogenic. Anechoic means that it absorbs sound and there are no echoes. Fluid filled simple cysts are of this type and appear dark on the ultrasound. Echogenic cysts usually have some solid components and this makes sound waves bounce off them.
If you have two anechoic ovarian cysts that are as small as you describe then these are most likely completely normal graaphian follicles that occur with ovulation. You are not menopausal as of yet because you are still getting your period and quite obviously from this ultrasound you are also still ovulating. Any ovarian cyst that is 5 cm or less is most likely a functional cyst (either a graaphian follicle or a corpus luteum .. this last one is the shell of the cyst after it has released the egg).
All this to say that you are completely normal and have not yet reached menopause. The night sweats etc.. when you did not have your period, means that you most likely did not ovulate during this time due to your ovary starting to shrink and produce less estrogen. The symptoms you describe such as the sweats go along with estrogen deficiency. I guess that your ovary wants a few last hurrahs before bidding farewell. The other symptoms you describe certainly sound like they are from the cystitis, ibs etc.. which you have already been diagnosed with.
Do the CA-125 (your doctor likely requested this due to your age and not because of what she saw on the ultrasound) and request a followup ultrasound in about three menstrual cycles. Go when you are around your period as this is when you are the least likely to see these normal cysts. Most likely the cysts will be gone and if for some reason they are not, the fact that they are simple, fluid filled cysts, means that there is a 99% chance that they are NOT cancerous. Also, at the bottom of the ultrasound report it should give the radiologist's or gynecologist's impressions of what they are seeing (ie. most likely a normal functional cyst etc..).
I would not recommend that you have the last ovary removed. Surgical menopause is brutal and final. It may also mean that you have to go on hormones for a while in order to regulate the symptoms. Your remaining ovary will give you a smoother transition into menopause and will still continue to produce small amounts of estrogen which you need in order to maintain healthy bones (mainly). It has now been documented that women who keep their ovaries until age 65 actually live longer lives.
I myself am 43 years old (soon to be 44) and have had my left ovary removed due to a large (9cm) ovarian cyst. My cyst was also anechoic but unfortunately it kept growing so rather than waiting and then having to have a more difficult surgery, I opted to have it removed by a less invasive laparoscopy (10 cms was the cutoff mark). If it had not kept growing, I would have let it remain and kept doing regular ultrasounds to keep an eye on it. Now I have one remaining ovary and unless something really horrid happens, I will make sure I keep it.
I also experience middle pain .. almost every single month as a matter of fact. Sometimes it is extremely painful and really this is an ovarian cyst rupture because this is what happens at ovulation. If I cannot afford to take time out, I take an ibuprofen around the time I am ovulating and avoid the pain altogether. Otherwise, I use a heating pad to seriously diminish the pain (ideally I would prefer to limit medication).
I hope this helps to put your mind at ease. Speak to doctor about all of this and get her to explain all of this to you. Sometimes doctors just treat us like mindless patients instead of explaining what is there and addressing our concerns (this is supposed to be part of their job).
For the bloating and cystitis, try drinking mint tea and see if this helps. After my surgery to remove my ovary, I began to have urethritis / cystitis problems and my doctor put me on potassium citrate to alkalize my urine. It has now been over a year that I have had the symptoms and they are almost gone, returning only around ovulation. I don't drink coffee, regular tea (herb tea is OK), severely limit the alcohol (especially red wine which has a lot of tannins) and I drink mint tea and camomile teas. I have read that doing these things help to minimize symptoms.
Thanks for the reply. I hope that this bloating and peeing all the time is from the IBS and interstitial cystitis and nothing else. I will take your advice and have some mint tea. I don't drink much alcohol at all, so that won't be a problem.
When I am ovulating, I do tend to have more problems like the bloating, pain, etc. and it lasts for a few days. And because I didn't have a period for almost four months, it probably made it worse.
Thanks again! I'll let you know how the CA-125 turns out. I'm hoping the number will be very low.
One more thing...the only item that was mentioned under the impression was: two left anechoic ovarian cysts with the sizes stated, followed by the comment that they were not visualized on the prior sonogram of 12/12/09. Nothing else was said. The radiologist didn't add anything about a normal functional cyst, etc. Should I be worried he didn't add any other comments? I'm happy that he used the word "cyst".
No you shouldn't worry. Some radiologists don't want to take a risk in saying a cyst is something and then have it be something else and get sued (it is very difficult to know if a simple, fluid filled cyst is either a normal follicular cyst or an abnormal but nevertheless simple cyst .. in my case, the radiologist kept scratching his head because even after a year the guy thought that it should be going away on its own .. at 18 months he finally had to concede that this was not a regular functional cyst). Fear of a lawsuit is often why some of them opt to say the least possible and not interpret anything.
Simple cysts are the least harmful type of cyst and the least likely to be dangerous. Simple cysts that are less than 5 cms are even less likely to be dangerous and these have been studied a lot by the medical profession (because they are so common). Usually a simple cyst that goes over 5 cms begins to be a bit of concern (not for cancer necessarily but just because of its size, risk of rupture and the room it takes up). Over here in Québec (Canada) a simple cyst would have to be 10 cms or over to warrant surgery (complex ones are removed even if they are smaller, just in case .. the large majority of these are also benign). In the US they usually recommend removal when it gets in the 5 to 10 cm range.
Any simple cysts that are less than 5 cms are most likely follicular and quite normal so they will go away by themselves. You should still follow up with your doctor though to make sure because sometimes these little buggers keep getting bigger instead of dissolving on their own. They are more likely to go away though so I am sure that yours will too.
Thanks so much for putting my mind at ease. I will be calling my gyno tomorrow for the script for the CA-125. You are so informative on this subject and I really appreciate you helping out so many people on this forum.
My bloating feeling is pretty much going away. It doesn't feel as bad as it did the past few days. I wonder if it was all due to me ovulating, which I'm sure it was. Maybe this feeling was that cyst bursting.
Thanks again for your help.
PS - I don't know why it states I'm a male because I am a female!!