painful ovarian cysts

Had a ct scan with contrast to diagnose an episode of extreme lower left abdominal pain.  Cysts were found on both ovaries the left being 4.8cm. I was not told what type they were. I saw the surgeon and due to my age 50, and due to the fact that last year a previous ct scan showed the cysts while looking for a hernia, had that surgery last June. Thought the pain was due to the hernia repair. It was quite large. I have suffered with my periods. lots of cramps, bloating etc. Also I have suffered what I call "spells". Severe episodes of gastric upset. They seem to occur around the cycle time, either just before or after.  No way to predict when they will happen but since menopause is knocking at my door I have noticed a relationship to the spell to the cycle. Had a cycle in Dec after 2months. then not again until july, aug, and 2 days in sept. The Sept one is the worst spell of all. I have had much gastro workups which has left no diagnosis. The surgeon suggests removing the ovaries with the laproscopic deal. I would like to think..no ovaries no more spells. Is it dangerous to leave the ovaries in at my age. Could these gastric upsets be related to the menstral cycle, I have read so much my brain hurts.  The surgeon is a top notch guy and I can't believe he could or would recommend removal if it weren't in my best interest. Do I really have a choice? Any advice would be helpful to me. At my age what hormone effects should I expect? Thank you so much for any time.

[Machelle Seibel, MD]

Pain is always difficult to understand, both for patients and for doctors. What would seem to very painful is often not for some patients and what would seem to be not painful can often be excruciating. That said, since you have had a thorough evaluation of your intestinal tract and now have cysts on your ovaries, there is a good chance (not certainty) that the ovaries are part of the pain, especially since the pain coincides with your menstrual bleeding.

Many women do have their ovaries at age 50, but since menopause is near and your ovaries have cysts implying there might be a problem, it is a time when the decision to remove them often occurs. Recovery from taking out the ovaries by laparoscopy can be anywhere from a few days to a few weeks. Since you are still having periods, your loss of your ovaries will likely lead to some symptoms of menopause and you and your doctor should discuss that ahead of time and decide what kind of treatment you would want to try. You always have a choice about surgery. If you are confident in your doctor and he has explained to you why he wants to remove the ovaries and you have had evaluation for other things, it seems like a reasonable decision to make based on the information you have provided.

Machelle M. Seibel, MD

[GLou]

Thank you so much