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Suggest Treatment Plan For Bilateral Ovarian Cyst

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Posted on Tue, 28 Oct 2014
Question: Hi Dr. Tayal - This is actually a follow-up question from last week. You looked at my ultrasound images and gave me your impression of my ovarian cyst and some very helpful suggestions on what my doctors might do next. I just wanted to provide an update: The hormone tests my doctor ran came back completely normal, turns out I'm not in menopause after all, just not having my period. I was just wondering if this means anything (good or bad)? Apparently the CA-125 test came back in the normal range, but they did not tell me the number.

I'm still waiting to get in to see my OB/GYN (Oct. 27) but at my visit with my primary care doctor all they told me was that I had bilateral ovarian cysts. I was so glad I had the information from you, or I would have probably been very worried. I am still having a lot of pain from the cyst on the right, the one on the left is only 1.7cm and isn't giving me trouble. I didn't send you the image of that one last week.
doctor
Answered by Dr. Dr. Rakhi Tayal (1 hour later)
Brief Answer:
Normal blood tests are encouraging.

Detailed Answer:
Hello.
Nice to hear from you again.
It is good that you are not menopausal. The ovaries normally are solid structures containing plenty of follicles which mature to release ovum. Sometimes in some women due to multiple reasons, the solid ovaries are studded with cysts. It is also associated with hormonal imbalance causing a delay in the periods.
A single simple cyst like you are having is not worrisome with normal CA-125 levels. You can ask your gynecologist for hormonal treatment like oral pills which will help in a regular cyclic bleeding and will decrease the size of these cysts also.
The pain can be taken care of with the help of an over the counter anti spasmodic.
Take care.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Rakhi Tayal (7 hours later)
Thanks, Dr. Tayal, for your response and for giving me an idea of how my Gyn may procede when I am able to get in to see him. Oral contraceptives are not a good option for me. I have not taken them in about 13 years as I had a what I believe to be a TIA in 2001 that affected the left side of my body and my memory bank of numbers. I did not have any health insurance at the time, so it went untreated. All the function and memory returned after about two weeks, but considering that history, I have not used the pill since that happened.

I look forward to seeing what my Gyn proposes to do.

One of your online colleagues, Dr. XXXXXXX has also helped me out with advice on these issues and he asked me to upload images of my uterus from my recent pelvic and transvaginal ultrasounds. Those are now in my profile if you would like to see them, if that might help give some clues to this mystery.

Thanks, XXXXXXX
doctor
Answered by Dr. Dr. Rakhi Tayal (28 minutes later)
Brief Answer:
Nothing worrisome.

Detailed Answer:
Hello.
I have seen the attached images. The uterus looks normal with a normal looking endometrium. The cyst is a simple one with no septations or debris or any hyperechoic shadows. Such cysts usually disappear once the regular periods are resumed.
Given your history the birth control pills are best if avoided. You can take progesterones for a few days to have a withdrawal bleeding instead.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Rakhi Tayal

OBGYN

Practicing since :2001

Answered : 14043 Questions

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Suggest Treatment Plan For Bilateral Ovarian Cyst

Brief Answer: Normal blood tests are encouraging. Detailed Answer: Hello. Nice to hear from you again. It is good that you are not menopausal. The ovaries normally are solid structures containing plenty of follicles which mature to release ovum. Sometimes in some women due to multiple reasons, the solid ovaries are studded with cysts. It is also associated with hormonal imbalance causing a delay in the periods. A single simple cyst like you are having is not worrisome with normal CA-125 levels. You can ask your gynecologist for hormonal treatment like oral pills which will help in a regular cyclic bleeding and will decrease the size of these cysts also. The pain can be taken care of with the help of an over the counter anti spasmodic. Take care. Regards.