Help! VERY "septated" lesion on ovary!

[Finallyy]

I had my ultrasound back in July 08 when I began having chronic menstrual cramps, which have since not gone away. The ultrasound was performed because in early Jan 2007 I was put on an anti-breast cancer drug called Megace, to increase my appetite as I was very thin. The dr didn't tell me Megace was a hormone.

Well when I took it I began having 2 to 3 periods a month for 6 months, doctors tried to stop the frequent bleeding with hormones and steroids, which induced Panic Attacks, horrific migraines, acne and then I stopped treatment and my periods just stopped altogether in August 07 clear up until January  08 where I had 2 normal periods. I thought my periods were getting back to normal until I did not menstruate again until this past July 08 where I had 2 more normal periods but then my menses disappeared again and have chronic cramps.


Anyway the ultrasound was very disturbing compared to past ultrasounds before 2007 which always appeared normal; (thin endometrial stripe, small ovaries, tiny follices, no cysts, lumps, lesions or anything._


This ultrasound is as follows:

Endometrial stripe: Heterogeneous and thickened to 1.3 cm
Fluid: small amount of fluid is present within the uterine canal; free pelvic fluid

Right ovary: Measures  4 x 3.6 x 3 cmand contains multiple cysts; the largest is 1.9 x 1.5 x 1.3 cm.

LEFT OVARY:  Measures 2.9 x 2.7 x 2.6 cm and also contains multiple cysts; the largest is a SEPTATED LESION MEASURING 1.8 x 1.8 x 1.8 cm.

IMPRESSION FROM THE RADIOLOGIST:
Multiple bilateral ovarian cysts including a septated right-sided lesion; the pevlic cul-de-sac fluid may relate to a possible cyst rupture; Thickened hetereogeneous fluid containing endometrium.



My doctor told me that my cysts did not appear to him as the PCOS, he also told me that all of my hormonal labwork was normal, and that I do not fit the clinical representation of PCOS (No skin tags or discoloration, not overweight, I'm not insulin resistant, my lh:fsh ratio is normal, prolactin, tsh, and testosterone is also normal, my cortisol levels were only mildly elevated). His conclusion was that I screwed up my hormonal balance with all of the drugs in early 2007 and it left me with a hormonal imbalance and things of that nature.

He did NOT comment on any of these other things and I was not tested for cancer but I have been in pevlic pain ever since July.. please help!

[JosieHock]

Hey there -

I've found things on ultrasound reports that weren't mentioned as well.  It's easy to scare ourselves silly, isn't it?  

I don't know anything about PCOS cysts and what qualifies them as such, but I know more than I'd like to about complex cysts!

Bottom line is this.  If you are not comfortable with your Doctor's reco's, or his or her attention to your complaints, or the findings on your u/s, then you need to speak up, or find another doc.  We need to be our own best advocates.  

[Finallyy]

Thank you so much for responding, I appreciate any words at all.

My doctor didn't recommend a second ultrasound but I think one should be done simply because I've had menstrual cramps ever since July when my periods started back up again. They seem to have disappeared again, though, too.

Unfortunately I had to find out about the lesion on my own. I retrieved the u/s results from the hospital. The only thing my doctor commented on was a ruptured cyst.

I know that cysts associated with PCOS are considered very small, and I do not know if my cysts (usually around 1.9 cm range) would be considered a PCOS-like cyst or not---my doctor said no.

[JosieHock]

Hi there - I can't speak to all of your post, but I can tell you that that cyst is very, very small and that's probably why your Dr. is not concerned.  Cysts that size, even septated, are usually not pursued aggressively.  Are you having a follow up ultrasound in a couple of months to see if the cyst is gone, or persistant?  

[Finallyy]

I forgot to mention that I was 20 years old when this began, I never had breast cancer, no prior history of menstrual irregularities, and am now almost 22 years old.