Depression-Ovarian Cysts Link?

[littlekartz]

Before I commit to another regimen of regular medicine to treat my depression and consider laparoscopy for my pelvic issues, I'd like to know if there is a possible link between the two problems.

Before today:
1997 – cystectomy (fluid filled approx 4.5”), diagnosed depression, resumed trilevelin to prevent further cysts
2000 – 25mg Zoloft for crying spells and mild aspergers
2003 – ceased trilevelin after migraine lasted 2 weeks
2005 – gave birth, nursed, Zoloft progressed to 100 mg
2006 – Mirena IUC

Family history:
My niece is autistic, and she had an ovarian cystectomy at age 3.
Mother had endometriosis, hysterectomy at age 30.

October 2007
Chronic back pain and right side pelvic pain revealed the IUC was wedged into the top of the uterus, after trying to re-position a couple of times, I decided to have it removed.  One side of the T was bent over. Within days a blood-filled mass about 2" formed on the right ovary.  I had a CA125 test that came back at 21.

One week later (10/15/07), the cyst burst and bled out.  I don't believe this is endometriosis.  My ob/gyn was to the point of offering lupron or laparoscopy, but suggested Implan while we wait and see.  

By sheer chaos, I have managed to take my Zoloft less and less, and now the bottle is completely lost.  I have withdrawal symptoms of dizzyness, nausea and emotional - coupled with chronic lower back pain, right ovary pain that sometimes includes the center and left pelvic areas as well, bloating - that I suspect another cyst has come up.  I understand Implanon is probably the last option left for me to keep the cysts in check.  If I have a reaction (like I've had with many other birth control pills), what do I do?

I just don't feel like the whole picture is being considered, but that there may be one thing behind all of these issues.  Any thoughts, suggestions or resources you can recommend, anything at all would be greatly appreciated!

[littlekartz]

Thanks - that's the information that will help get me started!

[John Kim, M.D.]

Sorry, I'm in California and I don't know of anyone in Tampa. Is there a University Clinic there? You could see a Reproductive Endocrinologist who specializes in female hormone disorders. They are found in OB/GYN departments or private practice.

[littlekartz]

Thank you for your response - I'm going to see what kind of specialists I can find.  I'm not up on my specialist doctor labels, but is there a type of hormonal specialist (endocrinologist?) that might be worth talking to, or getting some tests?  The psychiatrist follows the same paint by numbers diagnosis as the gynecologist, I think moreso because that's what the insurance companies dictate, so I need to find someone mind/body on that end as well.  I'm in the Tampa Bay area - what do you recommend as a way of finding these specialists... yellow pages, internet sites, ???

[John Kim, M.D.]

I think I would have to have a detailed history of your depression and other pychosocial history before I could make a good comment.
However, I can answer you generally that there can be a link between ovarian cysts and depression.  I do not think ovarian cysts cause depression; however if your hormones are out of balance causing you to have ovarian cysts--the same imbalance can be a result of brain dysfunctions that can be linked to depression or brain dysfunctions ie a dysfunctional hypothalamic pulse generator can cause ovulation dysfunction and ovarian cysts. Since the hypothalamus is part of your brain, if you have stressor in your life that can cause depression, these same stressor can cause hypothalamic dysfunction that then causes you not to ovulate regularly and possible generate ovarian cysts. There can be a number of thing linking your female reproductive functions to depression. For instance, if you have chronic pelvic pain, the increased pain can be manifested by depression symptoms. And alternatively, if you are depressed any painful stimulus like one from a hemorrhagic cyst can be experienced with more intensity than if you were not depressed. As you can see, these issues can be quite complex. I would recommend that you see a gynecologist who may specialize in pelvic pain or mind/body approaches to gynecology who can go over your history completely and suggest other options.
If your psychiatrist feels it would do no harm to stop anitdepressants, than there are alternative approaches to treating depression such as mind/body programs, cognitive therapy etc. I would see your psychiatrist to discuss this. I wish you the best.