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Endrometrioma
I am 43 years old, and have an endrometrioma on my right ovary. It has been there for at least two years. I receive an internal and external ultrasound every year because my mother died of ovarian cancer at the age of 57 (in 1988), one year after her diagnosis. I had an MRI on the cyst last year to make sure that it was an endometrioma. The cyst has grown since last year. My ovary measures 7.8 cm at this point in time. My CA 125 is 36. My OB/GYN is suggesting removal of the right ovary (I have two children, and am well past wanting to have any more!) He also told me that depending on what he sees, he might take the left ovary, and possibly do a "clean sweep" of the uterus if necessary. What are your thoughts on removal of one/two or everything at my age? I have said for years that I wanted to get rid of my ovaries, but now that the time might be here, I am concerned about being thrown into menopause. Thanks for your time!
I had to comment because our situations are very similar. I'm 48 and have had an endometrioma on my left ovary for at least 5 years. Fortunately, it doesn't cause pain and hasn't grown. It's about 3 cm. I think there is also a smaller one on my right ovary. My mother also died of ovarian cancer, at age 50, within a year of her diagnosis.
Because of my mom, I've been vigilant about going for my pelvic ultrasounds, getting pap smears and all that. Along with the cysts, I have a uterine fibroid that isn't causing me much trouble and I'm older, so hysterectomy is a subject that has come up with my gynecologist. And it's interesting that, like you, now that it could really happen, I'm very hesitant...before I'd say take it all out and now I want to keep it all in!
I've seen women go through sudden menopause after surgery and it was rough on them. One coworker had terrible hot flashes that you could see coming. It seems like everyone I've known that had one ovary removed eventually had to go back to remove it all. It's different for everyone, but that's what I've seen.
My doctor and I agreed to continue with our watchful waiting. I don't have any advice about what to do, but if it's growing rapidly, it may make the decision for you. :-) I just wanted to let you know that others are also going through the same kind of situation and share your concerns.
Because of my mom, I've been vigilant about going for my pelvic ultrasounds, getting pap smears and all that. Along with the cysts, I have a uterine fibroid that isn't causing me much trouble and I'm older, so hysterectomy is a subject that has come up with my gynecologist. And it's interesting that, like you, now that it could really happen, I'm very hesitant...before I'd say take it all out and now I want to keep it all in!
I've seen women go through sudden menopause after surgery and it was rough on them. One coworker had terrible hot flashes that you could see coming. It seems like everyone I've known that had one ovary removed eventually had to go back to remove it all. It's different for everyone, but that's what I've seen.
My doctor and I agreed to continue with our watchful waiting. I don't have any advice about what to do, but if it's growing rapidly, it may make the decision for you. :-) I just wanted to let you know that others are also going through the same kind of situation and share your concerns.
The loss of one ovary will make no noticeable difference and you will still have some type of menstrual cycle afterwards. The loss of both ovaries means either instant menopause, or you can try HRT for a few years until you are closer to a typical menopause age (but no need for HRT after menopause age...it's the later HRT that is the source of so much controversy now).
I completed natural menopause at age 46 (my last period was at age 45 a year prior), so you are not that far from an age that is normal for menopause. Granted, the mid-40's is on the earlier end of the menopause timeline, but it's not impossible either.
With your ovarian cancer family history, I can understand your alarm and the need for some piece of mind. The only way to eliminate the risk entirely is to remove ovaries before any stage of cancer can develop. Of course, just because your mother had this (I am sorry for your loss!) that does not instantly mean you are destined to have the same thing happen to you.
Your CA-125 is one point above the normal range, but even a benign cyst can cause this elevation. The doctor won't know what is really happening until surgery and pathology.
Many ob/gyns prefer to remove parts that have immediate problems only and leave the other normal healthy ones intact. Others will say there is sufficient risk with some or all of the remaining parts that they should be removed now (or expect another surgery at a later date). That is where it comes down to making an informed decision.
My fear of doctors, hospitals and cancer was great enough that I opted to remove the immediate problem (left ovary/tube) and the high risk problem (right ovary/tube) in one operation and hopefully never worry about this problem ever again. I didn't have a history of uterus problems, so I didn't need a hysterectomy. If you have an endrometrioma, then you are a candidate for either a clean up or a removal of the uterus. How much or how little to remove is a decision you and the doctor need to make together. Or it can be a conditional decision depending on what the doctor sees in surgery.
Best wishes to you and I hope this helped a little bit.
I completed natural menopause at age 46 (my last period was at age 45 a year prior), so you are not that far from an age that is normal for menopause. Granted, the mid-40's is on the earlier end of the menopause timeline, but it's not impossible either.
With your ovarian cancer family history, I can understand your alarm and the need for some piece of mind. The only way to eliminate the risk entirely is to remove ovaries before any stage of cancer can develop. Of course, just because your mother had this (I am sorry for your loss!) that does not instantly mean you are destined to have the same thing happen to you.
Your CA-125 is one point above the normal range, but even a benign cyst can cause this elevation. The doctor won't know what is really happening until surgery and pathology.
Many ob/gyns prefer to remove parts that have immediate problems only and leave the other normal healthy ones intact. Others will say there is sufficient risk with some or all of the remaining parts that they should be removed now (or expect another surgery at a later date). That is where it comes down to making an informed decision.
My fear of doctors, hospitals and cancer was great enough that I opted to remove the immediate problem (left ovary/tube) and the high risk problem (right ovary/tube) in one operation and hopefully never worry about this problem ever again. I didn't have a history of uterus problems, so I didn't need a hysterectomy. If you have an endrometrioma, then you are a candidate for either a clean up or a removal of the uterus. How much or how little to remove is a decision you and the doctor need to make together. Or it can be a conditional decision depending on what the doctor sees in surgery.
Best wishes to you and I hope this helped a little bit.
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