confused

[redhat1]

I am 53, last periond 1yr, 2months ago. Experienced two very short (less than a day) episodes of light spotting. Reported to gyn at annual visit in July. Sent me for a pelvic and transvaginal ultrasound. Called a few days later to tell me the uterine lining was 10.3 (told me it s/b closer to 5 after menopause) Scheduled me for a uterine biopsy (with a "straw" type instrument) Just ret'd frm apptmt-Dr was unable to obtain biopsy due to a tipped uterus. Said he saw clot on the cervix(had the second episode of spotting this week) and that he would do a hysteroscopy as a one day surgery after repeating ultrasound in mid-Sept. That all sounded logical and not tooo scarey until he mentioned that the ovaries were of concern also.
There are 2 or 3 cysts on ovary-he says that there s/b no ovarian cysts as I am menopausal. He has sent me for a Ca125 blood test and says, depending on results, may have to do laparoscopy to remove ovary/ovaries during other procedure. What are the chances that I have 2 serious issues going on at the same time? I asked a few questions, but was so surprised by this turn of events that I probably neglected some important ones. I shld mention that my regular caregiver is a "nurse/midwife" with an excellent reputation in the ob/gyn practice and that she never even mentioned the ovary issue. The dr I saw tonight is well-regarded but I do not know him. Any advice on any of this?  I'll get the CA125 tomorrow a.m. Thank you

[Machelle Seibel, MD]

Although the ovaries are supposed to be "quite" in menopause, cysts do come and go just as they do in the reproductive years. They can make some hormones and that makes the uterine lining thicker. It is good to get a CA 125 but that can be a little up due to many things besides ovarian cancer. Things like endometriosis or fibroids can make the level high or slightly elevated.  

It is not "wrong" to take out the ovaries in a person who is menopausal and who has cysts, but you can go get a second opinion. You can also wait one to three months to see if the cysts go away on their own.
Machelle M. Seibel, MD

[redhat1]

Thank you for your response. CA125 came back at 12..dr says under 35 is considered normal so I am very relieved. Am scheduled for a hysteroscopy and D&C for uterine thickening Oct1. One week before that another transvaginal ultrasound is scheduled to look at ovarian cysts again;depending on result may also be scheduled for a possible laparoscopic salpingo-oopherectomy same day as D&C. Should I insist on a second opinion re the ovaries/tubes? Is it feasible to obtain a second opinion in less than a week?? I know the D&C is necessary to biopsy lining, just am hesitant to have ovary removed (dr actually said he could remove both if I choose even tho the other has no cysts on it at all)  while at same time don't want to risk ovarian cancer. Thank you again!

[redhat1]

Just obtained a copy of original ultrasound report...shows endometrial lining thickness=10.4
"Adnexa:Right Ovary:partially visible
Right ovary size:35mmx29mmx16mm volume 7.0 ml
Simple cysts right ovary
cyst 1: mean value 10mm D1:12mm  D2:8mm
cyst 2: mean value 12mm D1: 17mm D2: 7mm
Comments: COMPLEX CYST ALSO SEEN 15x11.
Left ovary :visible, Outline: smooth, normal physiological changes
Left ovary size: 27mmx21mmx8mm Volume:2.2 ml
Bladder/kidneys normal
Cul de Sac/Pouch of Douglas: no free fluid visible"
Does this complex cyst look like a big deal or am I worrying (a LOT) abt something that is most likely not a serious problem? Is the difference in size of ovaries significant?(if I am understanding this, the "problem" ovary is much larger than the right.)

Any light you might shed on this would be much appreciated! Thank you