Is there a connection?

HI
I have just been told that I have an ovarian mass of 11cm on my left ovary.  I have had the CA 125 blood test and still waiting the result.  I am being fasttracked for an operation within the next 2 weeks because the mass is pressing on my bladder and causing problems with urinating, and of course the risk of cancer. In my early 20s I started getting facial hair which has got worse as I have got older.  I am now 54 and had my last period in June 2007 after becoming very unregular for a year or so.  Occassionally before a period I would get terrible pain in my lower abdomen area and on reflection I think this could have been around the time of ovulation.  In the last year or so of my periods I recall getting pain when I ovulated and some sticky reddish discharge.  When I was 25 I had 2 miscarriages very close together.  I got pregnant when I was 40.  I had been on the pill for quite a while on and off.  I would keep forgetting to take it or not bothering because I was leaving it up to fate if I got pregnant or not.  I have an Auntie who has suffered with facial hair for years and she struggled to get pregnant.  Also another Auntie who miscarried 6 times.  I am wondering if there is any correlation between my present condition and the symptoms that I have described above?
Many thanks

[Elaine Brown, MD]

Hi!
Your question will be much easier to answer once you know what the pathology report on the cyst is.  I certainly hope that it has been there for years and is what was causing your discomfort because if it has been there for a long time it is not cancer!
I could tie all your symptoms together under one diagnosis of PCOS or polycystic ovary syndrome.  Another possibility would be congenital adrenal hyperplasia.
A very large cyst such as the one you have often turns out to be a mucinous cystadenoma ( a benign cyst filled with mucous).  These have to be removed because they don't go away on their own, and can cause problems such as twisting.
If you were my patient, I would also ask whether you wanted to have a hysterectomy at the time of surgery.  (If it is cancer, this won't be optional though).  Recently the trend has been toward more and more conservative surgery--many studies are showing a benefit of keeping the ovaries even after menopause.  On the other hand, you really reduce your cancer risk if you remove everything "while you're in there".
Everyone has her own right answer to the question, its just something to consider.

One other possibility that could explain infertility and a cyst is endometriosis, but I think that is less likely.
I hope all goes well for you!
Good luck!
Dr B

[shaddycat]

Thank you very much for the comprehensive reply.  I'm not so sure about the infertility side of things as I never really tried to get pregnant.  I guess that is one of those unknowns.  We all want to know the answers straight away and I am no different.  But I shouldn't have too much longer to wait.  One thing that makes me think it is not PCOS is that most of my life my periods were regular.