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Having Post Menopause Spotting, Pain In Vagina And Discomfort In Ovary. Should I Be Worried?

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Posted on Sun, 18 Nov 2012
Question: I am having post menopause spotting & pain in vigina & discomfort in in lower right side (ovary area) had transvaginal ultrasound found calification on right ovary and right paraovarian cyst. When I had the ultrasound done I had my yearly mammogram. They just called and found a small nodule in right breast. Going back Tuesday for another mammogram. I'm a bit freaked out right now. Never thought I would have multiple women's issues simultaneously. I to have another test next Tuesday (for the one issue) I have to wait until XXXXXXX to have the test for the second issue. & waiting for some 'gel' to clear up the third issue. If not, then some camera test will have to be performed. This all just started about 2 weeks ago. I just hope that the 3 are not connected and will all be benign - just a big unrelated coincidence. Should my doctor wait until XXXXXXX 2013 to do another Transvaginal ultra sound? Shoud I have a CA-125 ? Breast lump found by mammorgram, Calcification within the right ovary (sometime associated with neoplasm) and right paraovarian cyst. and spotting & pain- What tests should be done now? or should I just keep waiting to see if it gets worse & I die? should I get another doctor? Should I be worried or what???? Starting to freak out
doctor
Answered by Dr. Sree Gouri SR (3 hours later)
Hi,
Thanks for the query.

As your ultrasound didn't show any changes in uterine endometrium the cause of your postmenopausal spotting could be thinning and drying of the lower genital mucosa due to decreased estrogen content. Your pain in vagina can also be due to this.
If paraovarian cyst is larger in size (more than 10cms), complex, solid, dense, irregularly shaped then there is more possibility for malignancy.
If smaller, simple and regularly shaped cyst is there, then more possibly it could be benign cyst, and can subside by its own. Regular followup is necessary.
Calcification of ovary itself will not always associated with neoplasia.
With combination of physical examination, ultrasound and CA-125 levels we can come to one conclusion.
So you can once undergo CA-125 levels with your doctor advice.
As your breast lump is small in size without any skin changes or nipple changes the chance of malignancy is less, anyhow better to go for repeat mammogram in view of your age.
Some ovarian malignancies and breast carcinomas are estrogen dependent.
But don't worry this possibility is less.
Don't get panic as nowadays there is treatment for every problem.


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 (19 hours later)
At this point in time, should my doctor order me to have a CA-125? He says he really hates them because of the false pos & neg results. I knda agree, but all the posts of women who seem to have one of the symptoms/results I am having ALL got the CA-125.

I go Tuesday for another Mammogram & ultra sound of my right breast. Never in a million years did I think (that would come back off) I was there because of the spotting & the ovary. Just had my yearly mammogram done while I was there.

I am trying to stay calm (xanax) helps LOL

Yes, the two peripheral calcifications are on the right ovary and at the largest measures 3mm. There is a 1.4x0.9x1.0 cm cystic structure noted adjacent to the right ovary. The report says that there is normal vascular flow in both ovaries.

The uterus is anteverted, measuring 6.3x2.7x4.1 cm. The endometrial echo complex measures 4mm in thickness. There is a trace amount of fluid noted in the endometrial cavity. Right posterior body fibroid measuring 0.8x0.6x1.7 cm compared to 1.0x0.8x0.9 cm and a submucosal fibroid measuring 0.9x0.6x0.8 cm compared to 1.3x0.9x1.3 cm

My right ovary measures 2.3x0.8x1.8 cm.

Does this sound like I should be looking for another doctor? Or just playing the waiting game. Having another transvaginal ultrasound done in late XXXXXXX 2013 as he stated?

I do have pain/discomfort feeling on my lower right side. Feels like when I use to ovulate, but a little more intense. Should a small paraovarian cyst cause pain or discomfort?

Please get back to me

Thanks, XXXXXXX
doctor
Answered by Dr. Sree Gouri SR (2 hours later)
Hi,

It is true that CA-125 levels can give false positive and false negative results, but when used along with clinical and radiological findings it can help in coming to correct diagnosis.
So there is nothing wrong in undergoing CA-125 levels.
As your para-ovarian cyst is smaller in size and with normal ovarian blood supply, usually follow up only is needed, may be because of that your doctor advised repeat ultrasound in January.
And also usually fibroids will shrink in size after reaching menopause, so in followup scan the size of the fibroids can also be compared.
Usually smaller para-ovarian cyst will not cause pain but in some conditions like when the cyst gets infected or depending on the position when it exerts pressure on bowel or bladder it can cause pain.
So better to wait and watch and follow your doctor's instructions.
Hopefully repeat mammogram and ultrasound will exclude serious problems.

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 (2 hours later)
Thanks, hope the ultra sound on breat goes fine too- Hopefully, the up coming storm, doesn't end up canceling my test on Tuesday - Wish me luck!
doctor
Answered by Dr. Sree Gouri SR (16 hours later)
Hi,

Don't worry, hopefully you will not have any major problem. All the best.

Wish you Good Health, If you are satisfied with my response please rate the answer after closing the discussion.
Take care.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

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

OBGYN

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Having Post Menopause Spotting, Pain In Vagina And Discomfort In Ovary. Should I Be Worried?

Hi,
Thanks for the query.

As your ultrasound didn't show any changes in uterine endometrium the cause of your postmenopausal spotting could be thinning and drying of the lower genital mucosa due to decreased estrogen content. Your pain in vagina can also be due to this.
If paraovarian cyst is larger in size (more than 10cms), complex, solid, dense, irregularly shaped then there is more possibility for malignancy.
If smaller, simple and regularly shaped cyst is there, then more possibly it could be benign cyst, and can subside by its own. Regular followup is necessary.
Calcification of ovary itself will not always associated with neoplasia.
With combination of physical examination, ultrasound and CA-125 levels we can come to one conclusion.
So you can once undergo CA-125 levels with your doctor advice.
As your breast lump is small in size without any skin changes or nipple changes the chance of malignancy is less, anyhow better to go for repeat mammogram in view of your age.
Some ovarian malignancies and breast carcinomas are estrogen dependent.
But don't worry this possibility is less.
Don't get panic as nowadays there is treatment for every problem.


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.