Ovarian Cyst and Endometriosis

[BecBec69]

I am 40yrs old, I had a Partial Hysterectomy in Dec 09.  At that time the doctor advises she burned off the endo on my ovaries and the endo was also in my uterus. She left my ovaries and part of my cervics.  On May 30 I went to the ER for serve abdominal pain that started May 29th.  They did labs, xrays, ct scans, and a pelvic exam.  I was told the labs were good, xrays nothing, ct scans showed cyst on my left ovary. Also my blood pressure was low 87/53, and I take medicine for high blood pressure.  I was sent home with orders to have a Pelvic ultrasound and HIDA scan.  US showed the small cyst on my left ovary and HIDA scan normal.  (I have a family history of colon cancer and female cancer.) I then went to my doctor on June 2nd.  He review all the test and advise if symtoms return to come back in.  On June 29th the pain started again in my lower abd,  I went to the doctor, he admitted me for more testing.  US done showing small cyst on my left and now right ovary. My GYN doctor request GI doctor to exam.  He did a EGD and Colonoscopy, both were clear. So then I was discharged on July 2nd, still unclear as to what was causing the pain.  During the inpatient stay my blood pressure stayed low (93/62 was one of them taken). My GYN recommend that I have a Zoladex shot to shut off my ovaries.   So on July 6th I was given the shot.  I have a follow up appointment with my GP doctor on July 16th and a US scheduled for July 29th and pelvic exam.  I guess what I am asking is what do I need to know, and what questions should I be asking these doctors when I go to my appointments.  Thank you

[BecBec69]

I want to thank you so much for your help.  I did still experience pain after the colon prep.  During the procedure I was awake and could feel the doctor pushing on something that was very painful.  If the pain comes back I will mention to the doctor about the color doppler US.  
But I am hoping that the Zoladex works.  How long can I stay on the treatment and what are the side effects?
I did get the results of the CA 125 today it was 27, which I understand is good.

Thank you so much Dr. B

[Elaine Brown, MD]

Hi!
It sounds like your doctors are doing a good job.  It certainly is a mystery!
Left lower quadrant pain is usually caused by one of two things--colon or ovaries.
Constipation is a big player--often people are give pain killers and those make the constipation worse which makes the pain worse, and a vicious cycle ensues.
One way to know if this is what is happening in your case is if your symptoms were relieved by the prep for the colonoscopy.  The prep would have cleaned you out, and the symptoms should have cleared too.
The OTHER thing that causes pain in that area is the ovaries.  Cysts can form and rupture, Or the ovaries can twist.  The best way to diagnose this problem would be to do a color doppler ultrasound of the ovaries DURING an episode of pain.  The doppler should show a reduced blood flow to the ovary if it is twisted.

If your pain is due to endometriosis or cysts, shutting down your ovaries with the Zoladex should stop the symptoms.

I hope this is helpful to you!
Dr B