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Painful Ovarian Cyst
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Painful Ovarian Cyst

I had diverticulitis in 2004 and so when late last year I started having frequent pain in my lower left abdomen along with bleeding/spotting for 30 days. My Gastro doctor did a CT scan w/ contrast, found no evidence of diverticulitis but did find a there was fluid in my pelvic cavity and indications of a cyst. He told me to see my gynecologist.  I went to my gynecologist and she did several tests, including a transvaginal ultrasound and noticed I had "one small cyst" - after dealing with the pain and bleeding for 2 more weeks, she did a D&C to stop bleeding. She had tried hormones and after D&C tried bc pills. One week later, I was still in a great deal of pain and it was getting worse (the pain was intermittent rather than constant) so she did another transvaginal and found cyst had grown double the size and there was a second one, plus uterus was enlarged. Did surgery to remove cyst. I felt great for 3-4 weeks and then pain started up again (low left, occasional pulling pain on right, intense lower back pain, nausea, lightheadedness). Had additional transvaginal scan in January and was told there was a "very tiny cyst" so Dr. put me on low dose bc pills again but is hesitant to do anything further and wants me to wait for scheduled transvaginal the end of next week. In the meantime, I have started pain diary and have found pain is consistently happening 3-4 times an hour, getting worse and I haven't had a period since early December. I am 49 years old and up until recently have never had a problem with either cysts or with my period (regular every 28 days). I had a second CT scan w/ contrast done a week ago (again to confirm no diverticulitis), everything is normal but there "is again noted to be a 4 cm cystic structure to left of uterus and posterior to dome of bladder which likely represents an ovarian cyst". "Stability of cystic structure seen in left adnexa likely to represent an ovarian cyst - no appreciable change from prior exam in October". Not sure if this means the cyst grew back or was missed the first time.  I did tell my gynecologist about the second CT scan and faxed her a copy of it but the nurse said she didn't need to see me any earlier - I suppose since the appt. is next Thursday.

Do you have any suggestions/thoughts?
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A.  I am sorry to hear you are having such a hard time. It is difficult to offer suggestions for more unusual situations in the absence of an exam and a more detailed history, but I would offer the following suggestions.  One would be to get a pregnancy test. It is the commonest cause of pain, enlarged uterus, lack of menses and ovarian cyst. If it is positive, then it is important to look for the source which can rarely be due to other sources of the hormone hCG than just the pregnancy.  You could also have adenomyosis, a condition that occurs when the lining of the uterus grows into the muscle of the uterus.  That enlarges the uterus and can cause bleeding that is hard to stop with either a D&C or birth control pills.  It is like endometriosis of the uterus.  Sometimes a higher dose progesterone medication like megace can stop that type of bleeding and problems.  Other less usual causes could be due to a neurological condition called Temporal Lobe Epilepsy.  This is more common in people with a history of being knocked out at some time in the past and who have blue or hazel eyes, are left handed and prematurely grey hair. It can show up around menopause. It can be diagnosed with a thorough history and an EEG which is like an EKG for your heart but the leads go around your head rather than your chest.  Also, sometimes the hormone FSH rises very high as women approach menopause and that causes cysts.  FSH normally rises around mid to late 40s but rarely gets very high and instead of a normal egg developing that month, a cyst develops.

Machelle Seibel, MD
6 Comments
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Avatar_n_tn
I can sympathize, it sounds like you have exactly what I have.  I have been diagnosed with a left ovarian cyst, 3 cm x 1.8.  It was found on a CT with barium contrast.  I'm scheduled for an ultrasound Wednesday.  The CT also showed a mildly enlarged uterus.  I am 46 years old.  I have left side pain occasionally (when twisting or certain movements), some occasional middle and right side stabbing pains, a pretty constant backache, a very bloated abdomen and no appetite.  The only difference with me though, is I have no breakthrough bleeding.  I only bleeding during my period, and it has been heavier with clots and lots of pain for about 6 months now.  My dr. worries me because she said "this CT is not good" .. I got a copy of the report.  It only says a simple ovarian cyst, recommended for followup in a few cycles, and a mildly enlarged uterus.  Do the two not normally go hand-in-hand?  Could she be thinking they are related, i.e. cancer from one that has spread to the other?  I read that if that were the case, there would be a lot of different symptoms that are worse by now, and the CT would have shown some metastasis or nodes or something.  For now, I'm putting up with the discomfort and hoping the ultrasound shows something non-cancerous and treatable.
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Avatar_n_tn
I am 24 and when I was 21 I was having severe bleeding and abdominal pain. When I had my youngest daughter I almost bled to death. My hematocrit was 4 when I left the hospital. I went to my obgyn and he done tests and decided I needed a hysterectomy. I still have my overies and now I am having severe pain and pain during intercourse. I was diagnosed with a overian cyst on my right overy. I have had a laproscopy and other tests. Now I am afraid I am going to have to have that overy removed and I am only 24. He might just remove the cyst but I hate going through surgery. Dose anyone have any tips or something to help relieve fear. I am a nurse but scared to death.
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Avatar_n_tn
Yes, I am having problems too.  It seems every 1 1/2years I have prolonged heavy periods lasting several weeks.  I do have fibroids and I am 51 yrs old, otherwise healthy.  4 years ago they found a 5cm complex cyst on my right ovary.  I just had a sonogram yesterday and they said they cannot find the left one and the right has a small simple cyst. They have never been able to locate the left one. My period was once 5 weeks.Aways seem to resolve on their own and revert back to normal at least for awhile this time it had been 2 years and I had gone 3 months without a period when I finally had one its prolonged and heavy.  This is getting tiring.  What do you think about this.
Thank you.
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Avatar_n_tn
i have a cyst on my right overy and i been on 2 diff types of birth control pills it hurts i tryed pain medcaine for the pain it dosent help and its bothering my stomach to wear i cant eat i feel sick at my stomach my doctor keeps switching my birth control pills i had an untrl sound done 2 times that was it i had the cyst for all most a year it will be a year in july
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Avatar_n_tn
Hi, I'm 25 and have been dealing with a large simple left ovarian cyst since Sept/Oct 2005. The cyst at it's maximum measured 7cm and is located between my vagina and rectum per CT scan results. I have been going to my gyn office every 6 weeks since the cyst was found for transvaginal u/s. All of my hormonal labs have come back normal along with CA-125 and other tumor markers. I have been on triphasic birth control pills since Dec 2005 to keep the cyst from enlarging and to dissolve the cyst. I am now scheduled for a laparoscopic surgery to remove the cyst on May 23rd. I'm nervous, scared and excited for the surgery. I just want the cyst removed so I don't have to deal with this anymore (hopefully). My husband and I definitely want children so that's the main goal for us. The cyst has displaced my uterus anteriorly, which makes sense for the reason I haven't gotten pregnant (I hope).Once the cyst is removed and my uterus going into it's normal position I hope to become pregnant. I really don't have that much pain with this cyst which amazes my doctor. The only things I feel are a sensation of pulling, especially when going to the restroom, occassional low back and leg pain. The worst thing for me is the bloating! I can't stand to wear jeans. Luckily, I'm a RN so I practically live in scrubs which are comfortable for me. If anyone has any comments, advice or experience with lap surgery I would appreciate it. Thanks.
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