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Swelling In Lower Abdomen, Ultrasound Showed Cyst. Can I Have It Shrunk By Taking Holistic Method?

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Posted on Fri, 28 Sep 2012
Question: While I am traveling outside US, I has found that my lower adominal had a swollen ball shape pop up. I went to one of the hospital there 3 days ago and the doctor made a diagnosis by altrasound. She said it's a 6 cm chocolate cyst. She also recomended me to get a get a laparoscopy done in 2- 3 months, the latest. I'm thinking of getting it done after I come back to US next month but I would like to know if I can have it shrinkened by taking holistic method. As I heard that the cyst will come back even I have the surgery done. Also, can I travel for the size of the cyst? Will it easily get rupture? Thank you.
doctor
Answered by Dr. Sree Gouri SR (1 hour later)
hi,
Thanks for the query.

Sometimes when endometriosis affects ovary that can form endometrioma or chocolate cyst,
Normally small cysts can be managed with medicines like analgesics, hormonal therapy like contraceptive pills, progesterone only pills, danazol, GnRH analogues etc,
But for a cyst with size of 6cm surgical removal is best option, as hormonal treatment in this case is only partially effective and can cause side effects also,
You can go for laparoscopic surgical approach, as laser surgery and cauterization are less effective and recurrence chance is there as you said, better to go for laparoscopic excision of ovarian adhesions and endometrioma.
You can travel but have to be careful and take precautions like, avoid lifting, pushing, pulling weights etc, avoid acts that will increase abdominal pressure like constipation etc, be cautious if pain abdomen etc occurs consult doctor immediately.


Hope I have answered your query. I will be available to answer your follow up queries. If you are satisfied with all my answer, please rate the answer after closing the discussion.
Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sree Gouri SR (2 hours later)
Thank you for answering my questions.

Another concern I have is if there's any chance that the cyst is cancerous? The doctor here told me that the Ultrasound provides the best indication and it's most likely a noncancerous cyst. I requested her to get another test and she took a blood test for me. I can get the result next Friday. If the blood test also shows that it's a noncanerous. Does it mean I can completely worried free?
Also, does the regular birth control pill help temporay while I'm traveling? I just want to stable my cyst as I also heard that if it's too big, it may burst by itself.

Thanks,
AAAA
doctor
Answered by Dr. Sree Gouri SR (3 hours later)
hi,
endometriotic cyst usually show some characteristic features like hypo-echoic area with thick wall etc,
cancerous cysts will have features like thick septa, irregular wall, hetero-echoic areas etc.
usually blood test can detect the levels of CA 125, but it that can be supportive but not confirmatory for diagnosis.
so by ultrasound and blood test we can possibly tell the nature of the cyst but confirmation can be done by histopathological examination only.

you can use birth control pills as they will suppress menstruation to some extent decreasing the accumulation of blood inside the cyst. You can go for other hormonal tablets also if needed as I told before with your doctor's advice.

Wish you Good Health, If you are satisfied with my response please rate the answer after closing the discussion.
Take care.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sree Gouri SR (28 hours later)
My blood test result came out today. The CA 125 read 71.1H. The doctor here is an experienced doctor but I would like to get the second opinion. She said the result is normal even the normal range is 0-35 U/m1. Based on her observation and ultrasound scan, mine should be noncancerous. She also mentioned some people who have cancerous cyst may have result 300-1000 H, but some of them may have CA 125 within the normal range. I'm not sure if my result is supportive but I'm a little confused.

I'm sorry that I forgot to include the following questions:

*I'm very careful and treating myself like a pregnant woman, not lifting weight, pushing/pulling nor putting pressure on my abdominal. But for a 6cm chocolate cyst, will it have a chance to get rupture by itself?

*I will be in China for another month. If I'm not taking any treatment, will my cyst grow even bigger in a month? how fast it can grow?

Thank you very much for answering my questions.


AAAA
doctor
Answered by Dr. Sree Gouri SR (14 hours later)
hi,

CA 125 levels will be elevated in many conditions other than carcinoma and endometriosis is one of them,
by taking into consideration your ultrasound features and elevated CA 125 levels it can be possibly taken that your cyst is endometrioma.

usually chocolate cyst will rupture because of some strenuous activity or by external pressure on the abdomen etc, by limiting these things we can prevent spontaneous rupture to some extent.

as the cyst contains endometrial tissue it can secrete blood periodically, which can cause enlargement of the cyst, so better to take medical treatment as you said previously you can go for small dose oral contraceptive pills cyclically or preferably continuously which will cause which can cause endometrial tissue atrophy leading to limiting the growth of the cyst.
if not with your doctor advice you can go for medicines like danazol or GnRH analogues etc.

Wish you Good Health, If you are satisfied with my response please rate the answer after closing the discussion.
Take care.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sree Gouri SR (6 days later)
Dear Dr. Sree Gouri SR,

Thank you so much for your detailed explainations that make me understand more what is happening in my body. With all the frustration and panicing, especially while traveling outside the states, I can't imagine what I'd gonna be without your help.

My period came 5-6 days earlier than normal last week. It happened before when I was under-stress or worried too much. I think this's the case. It was heavy bleeding with cramp in the first two days. After that, it got lighter and ended on the fifth day. Few days before my period, I touched on the pop up area and felt the cyst turned bigger. But after forth days of my period, I felt it's shrinked back to the original size. Is it because of my uterus turning bigger before and during the period? I'm feeling stress relieved by talking with other freinds with the same problems. I canceled some of my travel plans because of my cyst. If I go travel again, is it the best time right after my period? Of course I will be careful and take precaution.

Besides, while I research on chocolate cyst, I found some info about homepathic remedies which can help people with chocolate cyst. I know it's not the regular western way to cure. But just wonder if you have heard any successful case by using those remedies. I also heard about food like chocolate, saturated fat, and alcohol ....etc can stimulate the estrogen which can lead to increasing chance of having ovarian cyst. Is it true?

Thank you very much.

God Bless you.

Sincerely,
AAAA
doctor
Answered by Dr. Sree Gouri SR (11 hours later)
hi,

thank you and welcome again,

-stress and strain can alter the menstrual cycles that may be reason for your early onset of periods,
and also as your ovaries are involved in endometriosis by forming chocolate cyst that can also lead to increased frequency of cycles called polymenorrhoea that may also be one cause for early onset of periods.

-menorrhagia(excessive bleeding during periods) and dysmenorrhoea(pain during periods) are symptoms of endometriosis,

-size of the chocolate cyst of ovary can increase during periods due to accumulation of cyclical blood and after periods there may be some amount of shrinkage due to absorption of serum,
only the endometrial shedding occurs during periods that will not alter size of uterus much.

-yes, it is better to travel after periods when pain etc symptoms subsides, with proper care.

-some articles telling effect of homeopathic medicine but based on proper studies better to go for allopathic medical treatment for relief of symptoms.
-though it is said that some type of foods can affect estrogen levels, theoretically in the pathogenesis of endometriosis these are not stressed.


don't worry, there will be some solution for every problem .
Wish you Good Health, If you are satisfied with my response please rate the answer after closing the discussion.
Take care.





Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sree Gouri SR (13 days later)
I just had a wonderful trip after my period. I didn't really feel a thing in my abdominal for a little more than a week. But two weeks after my period, I feel little cramp and score on my hip bones every other days. Is it related to ovulation? Also, I start having breast tenderness like I am about to have another period. I was told that I should have the cyst quite some times. But I've just started having this kind of feeling since July, something feel like when I was pergnant. Are all these related to my hormonal changes due to my cyst? I have heavy bleeding during my period for almost a year that I regretfully ignored though.

Thank you very much for answering my questions again.

Sincerely,
AAAA
doctor
Answered by Dr. Sree Gouri SR (3 hours later)
hi,

most probably your pain could be ovulatory pain which is also called mittelschmerz, this will be more intense in case of endometriosis,
breast tenderness can also be experienced in some women during ovulation,
for more details you can see my article
http://srsree.blogspot.in/2012/08/mittelschmerz.html
endometriosis also causes increased bleeding during periods, once you start taking treatment all these symptoms will possibly decrease.


Wish you Good Health, If you are satisfied with my response please rate the answer after closing the discussion.
Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sree Gouri SR (18 days later)
Hi,

I'm back to the states and went to my OBG and took another Ultrasound for the color flow for my cyst. But he cannot tell it's an Emdo-Chocolate cyst or Hemorrhagic cyst. I was told that the 6-cm cyst is squished with my left ovary and tube. The color flow inside the cyst is not clear either. He also found some spot of Emdo on the linning of my uterus. Now I have two choices:

1. wait and see if the cyst will shrink by itself and he will give me some hormone/birth control these 6-8 weeks. If it's Hemorrhagic cyst, it will shrink, if not it's more likely Emdo. Then, he would suguest to do the laparoscopy.

2. go for laparoscopy now. He will take out my ovary together with the cyst to prevent the recurrance( I don't plan to have more kids in the future) and treat the spots of emdo on the linning of my uterus. He said the cyst is too squished to seperate from the ovary and the heavy period is due to the emdo on the linning of my uterus not the hemorrhagic csyt if there is a case.

My concern is if there is another way to tell exactly what kind of cyst it is, beside ultrasound? If it's really a Hemorrhagic cyst, I don't really have to go laparoscopy to take out my ovary and later find out it's not necessary. It will get shrinked by itself, right? If I have only one ovary, what will it affect my life, eg. early menopause, lower level of estrogen and affect my mood, etc? My doctor very encourage me to have it taken out. Also, if I take birth control, will it stop working by shrinking my cyst when I stop using it? Any side effect if I take it until my menopause. I'm almost 44 and I have 7-8 years to reach menopause from my family history. As I know from above discussion, by limiting excecise or pressure on adominal I can prevent spontaneous rupture of chocolate cyst to some extent. For Hemorrhagic cyst, how can I prevent it twist? I want to get rid of my cyst asap but don't want to take the operation if it's not necessary.

Thank you so much for your answers. You are so excellent. If I close the discussion and rate the answer, can I continue the question? do I have to start again?

Sincerely,
AAA
doctor
Answered by Dr. Sree Gouri SR (1 hour later)
hi,

one thing I want to tell first is endometriosis is growth of endometrium (which is inner layer of uterine cavity) outside the uterus, when it grows in the ovary and forms cyst it is called endometrioma or chocolate cyst,
so what you mentioned as 'the spots of emdo on the linning of my uterus' cannot be endometriosis, possibly that could be adenomyosis which means growth of endometrial tissue into myometrium(the second layer of uterus), that cannot be usually treated by laparoscopy or hysteroscopy usually, medical treatment can help to some extent,

now for your questions:
-another way is FNAC(fine needle aspiration cytology) but rarely during the procedure the cyst may rupture,
-if that was hemorrhagic cyst that usually might have decreased in size to some extent as it is already 40 days over from first scan,
but you can go for medical treatment as,
by taking the contraceptive pills continuously without break endometrioma size can also decrease and symptoms will relieve,
adenomyosis(if present) symptoms also decrease to some extent,
-one ovary can manage the body needs,
-birth control pills to be used only for 3 to 6 months with regualr followup, by that time the response of your cyst can be estimated, if it shrinks good, if not better to go for surgical management,
-limiting the activity etc also applies to prevent the twist of hemorrhagic cyst,

finally suggestion is, if you are not having any pain etc at present and as your doctor is having doubt about hemorrhagic cyst, you can go for pills for one month after the completion of pack you go for ultrasound if cyst size is decreased you can continue the pills without break for two more months, if cyst size remained same or increased or if you develop pain abdomen etc features at any point of time go for laparoscopy.
so you discuss this with your doctor and proceed according to his advice.

usually question will be rated after closing, after closing you may not continue, after closing the question if you want to ask new question directly to me you can go for the link: WWW.WWWW.WW and click on 'ask me a question' button.

Wish you Good Health, If you are satisfied with my response please rate the answer after closing the discussion.
Take care.


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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Sree Gouri SR

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Swelling In Lower Abdomen, Ultrasound Showed Cyst. Can I Have It Shrunk By Taking Holistic Method?

hi,
Thanks for the query.

Sometimes when endometriosis affects ovary that can form endometrioma or chocolate cyst,
Normally small cysts can be managed with medicines like analgesics, hormonal therapy like contraceptive pills, progesterone only pills, danazol, GnRH analogues etc,
But for a cyst with size of 6cm surgical removal is best option, as hormonal treatment in this case is only partially effective and can cause side effects also,
You can go for laparoscopic surgical approach, as laser surgery and cauterization are less effective and recurrence chance is there as you said, better to go for laparoscopic excision of ovarian adhesions and endometrioma.
You can travel but have to be careful and take precautions like, avoid lifting, pushing, pulling weights etc, avoid acts that will increase abdominal pressure like constipation etc, be cautious if pain abdomen etc occurs consult doctor immediately.


Hope I have answered your query. I will be available to answer your follow up queries. If you are satisfied with all my answer, please rate the answer after closing the discussion.
Take care.