Recurrent Cysts

[Ctck]

I'll try to be as breif as possible. I am a 46 yo and have been on tamoxifen for 1 and 1/2 years for high risk of bc. Since 2/06 I have been followed recurrent ovarian cysts. Cysts are always 2cm and smaller and switch from left to right and sometimes on both ovaries. They are described as appearing simple. I had a D&C in 4/06 due to endo thickening. All benign. Since then I have not had a normal period. Starting 6/06 I have severe pain every 26 days with no to very little bleeding. The pain lasts 24 to 36 hours and I am bed ridden. I can descibe the pain as like having labor contractions. I also have constipation, bloating and intense pressure during these 24 hours and also urinary freq during this time. I've ruled out GI with colonoscopy and CT scan. Recent CT scan stated small bilateral adenxal cysts, enlarged uterus with free fluid in cul-de-sac. I scheduled for ovary removal as I'm tired of the continuous follow-up (also reduce BC risk). Dr. feels I may have cervical stenosis from prior D&C, will do another D&C at same time. Ca 125 normal. Tamoxifen stopped 9/06 with no change. I would appreciate an opinion on proper course. Thank you.

[Annekathryn Goodman, M.D.]

Hi There,
I agree with your decisions. One other thing to think about is whether it makes sense to consider the removal of your uterus. If you have cervical stenosis and you have pain, sometimes, the uterus can be part of the pain syndrome. The ovarian cysts are probably tamoxifen effect.

You should ask your surgeon about these options and then think about whether it makes sense to just remove the ovaries or consider a full hysterectomy.

best wishes

[Ctck]

I would like to add the fluid in cul-de-sac was only on recent ct scan. All serial TV ultrasounds show no fluid and uterus as upper limits of normal. Also about 5 days after these pain episodes I return to feeling normal. Thanks again.