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Dr. Andrew Rynne

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Have cyst and having one day period. Feeling fatigue, hair loss and dry vagina. Cause and treatment?

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Dr. Timothy Raichle

OBGYN

Practicing since :1999

Answered : 1680 Questions

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Posted on Mon, 17 Dec 2012 in Menstruation and Miscarriage
Question: My wife has been having 1 day menses for almost 2 years now. That is after her second delivery of our daughter. She recently saw a doctor and they advised her to have a scan and blood test.
She also has a cyst. . Her other symptoms are fatigue, hair loss, vaginal dry etc etc
Scan reports shows a cysts of dimension 1.78cm on my left ovary.
And blood test report attached.
What could be the cause and what are the treatments available. How severe this could be. Are there any dangers associated with this. I was trying to attach a report. Couldnt so pasted as below

/01/2038 02:57 +679-0000     ASL     _......... ;

PAGE 01/02


Auztec Medical Laboratories Ltd
17 Extension Strtut, Sliva, Fiji     Shop 6, Nede Street, Laiitoka^ Ffji. GF»O Box 591 Suva, Fiji
Phone: (679)331 Bfi22     ^Phape/Rnt; (67?)0000 .

Patient data: XXXXXXX
Namaka Ph:0000/0000
DOB     : 08/05/1983
ClinicalnofQS."Irregular menses

Report to:

Dr, Tupou
Namaka Medical Centra
Namaka
Nadi



Tests requested: TFT LH FSH Prog E2

Received:27/11/2012 Printed: 29/11/2012 i4:5i Lab ID ; 09S882 File No:

Endocrinology
Thyroid Function Test: TSH     (ECi)     3.65     mlU/L (0.45-4.58)
Free T4     (ECi)     13.20     pmol/L(10.00-28.20)
Free T3     (ECi)     4.61     pmol/L (4.26-8-10)
Comment: Euthyroid levels.
Bats Collacted i 27/11/2012 Time Collected ; W/S Episode i 09B882
TSH (ECi) = 3.55 Free Td (ECi) : 13,20 free T3 (ECi) : 4.61

Luteiniaing Hormone 2.3 nj/L Mid-follicular phase
Mid-cycle peak Mid-luteal phase Po 8 tmenopausal Oral contraceptive therapy * Males
Date Collacted t 27/11/2012 Time Collacted i N/s Episode i 0000

2.1 - 10,9
19.2     - 103-0
1-2 - 12,9
10.2     - 58.6
1.0 - 12.0
< 8.6



Luteinialng Bo FSH

2.3

11.2 IU/L Mid-follicular phase     3.9     -     5.8
Mid-cycle peak     4.E     -     22.5
Mid-luteal phase     1.6     -     5.1
Poatmenopausal     16.7     -     113.6
* Males     <     19.3

Date Collected t 27/11/2012 Tim* Collected i N/S Episode i 09S882

FSH

11.2



Thank you for referring this patient

Continued Over.

Fila     D
Bring out Chart     □
Telephone patient     Q
Recall patient     □



rage 1 of 2

a i«At report chall no

1/2068 02;57 +679-0000     ,■,■■.:..■■■.,

ASL

PAGE 02/02


Auztec Medical Laboratories Ltd
17 ExtaiiBiOii Stowt, Suva, Plji PhHe: (S79) 33?:tf22.
GCO Box 531 Suva Ffil
Sfiqp, fi, Neds Stnwt,Laut&ks, Firi. "honff/Fax: (679) BW0601
REPORT ;■:

Patient data: Nanctan Ranlta
Namaka Ph:0000/0000
DOB     ; 08/05/1983
Clinicalnot&$ .'Irregular menses
Tests requested: TFT LH FSH Prog E2

Report to: Dr.Tupou
Namaka Medical Centre
Namaka
Nadi
Received: 0000/2012 Printed; 29/11/2012 i4;5i i£/0 ; 0000 File No:



« 3,5
14.9 - ISO.2
61.3 - 143,1
131.0 - 800.0
      < 2.6
Progesterone

2.£ nmol/L Non-pregnanti
Pregnancy:
* Males:


-     Mid-follicular phase 0.9 - 4,7
-     Mid-lufceal phase' 16.4 - 58.9
-     PoBtmenopausal
-     First trimester
-     Second trimester
-     Third trimester

Date Collected : 27/11/2012 Time Collected s W/S Episode : 0000
Progesterone : 2,6

Estradiol

57 pmol/L Non-pregnant - Periovulatory 228     - 196S
-     Mid-follicular phase 88     - 420
-     Mid-luteal phase 294     - 1D05
Postmenopausal     < 331
* Males          < 276

Date Collected t 27/11/2012 Time Collected » N/S Episode ; Q0000

Estradiol

: 57



Pag» 2 of 3

+ *** FINAL REPORT. Please
Thank you for referring this patient
The tost report $holl not be reproduced «KC4pt In Full, iwthnut awmuvl o

»LJV
Brtng out chart     □
Telephone pstisnt     D




doctor
Answered by Dr. Timothy Raichle 3 hours later
Hello, I would be happy to help you with your question.

Can you tell me any more about what they saw on the ultrasound? Was there any comment about the uterus or the uterine lining? Were any other measurements taken besides the ovarian cyst?

By the way, the scanned document DID work. Let me know and I will try to help you!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Timothy Raichle 13 minutes later
The only thing they mentioned was cyst. They did say no mass or anything was visible
doctor
Answered by Dr. Timothy Raichle 3 hours later
Final question before I attempt an answer.

Are you saying that she has had only ONE period, or that she has a regular period with only ONE DAY of bleeding with each period?

In other words, does she have any regular bleeding at all?
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Timothy Raichle 9 hours later
Regular period with generally one day of bleeding.
doctor
Answered by Dr. Timothy Raichle 2 hours later
My impression from the information you have given is: 1-2 years of extremely light cycles, fatigue, vaginal dryness and labs that are overall normal but with borderline low estrogen levels.

She is a bit young to have a decrease in the function of her ovaries, but this is certainly possible. The ovaries produce estrogen which prepares a lining for pregnancy. When the ovaries start to "run out" of eggs, then the bleeding with the cycle becomes much lighter and the cycles often become more irregular. What is slightly unusual about her story is that she is REGULAR but LIGHTER with regard to her bleeding.

FHS is a good indicator of of "ovarian reserve". I would do the following:
1. Ask for a DAY#3 FSH and estradiol level
2. Consider a short course of regular birth control pills and see if the bleeding is more normal

This would be where I would start. Also, a consult with an REI specialist would be worth considering (Reproductive Endocrinologist).

I hope this helps!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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