Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

132 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

On alesse birth control. Pelvic pain, bladder discomfort. Scan showed adenomyosis and ovarian cyst. Concerned

Answered by
Dr.
Dr. Timothy Raichle

OBGYN

Practicing since :1999

Answered : 1681 Questions

default
Posted on Fri, 8 Feb 2013 in Women's Health
Question: Hello Dr. Raichle,

I am a 30 year old female, and I have been on Alesse birth control for approx. 10 years. That is the only medication that I take, and I have no significant medical history. I am approx. 5 foot 6, and weigh 150 lbs. I am very physically active. There is no history of ovarian or breast cancer in my family, that I am aware of (however, my paternal grandmother passed away at age 30 from a heart condition, and I am unaware of her genetics with respect to those diseases).

In mid-November 2012, I developed a nagging pain in my right pelvic area, and increased pressure on my bladder. I brushed it off as muscle strain, as I sit all day for my job, and an osteopath suggested that it might be a shortened ileopsoas muscle. The pain went away, but returned in mid-December and has not disappeared again (I suppose if anything, it ebbs and flows, getting worse after my period and when I probe the area). I went for a physical exam on January 8, and my GP immediately referred me for a pelvic and intravaginal ultrasound the next day. Today I got the results, which say:

"The uterus is anteverted and has a non-homogenous XXXXXXX echo pattern with asymmetric walls. It measures 4.5 (w) x 3.5 (a.p.) cm.

The double layer of the endometrial lining measures 0.4 cm in thickness.

Both ovaries are seen.

The right ovary measures 2.7 x 1.7 x 3.0 cm and shows a 1.2 x 0.7 x 1.7 cm cyst with XXXXXXX echoes.

The left ovary measures 2.9 x 2.3 x 2.5 cm.

The urinary bladder is distended; it contains 375 mL urine pre-void and 20 mL post-void. No fluid collection is demonstrated.

OPINION: Adenomyosis (2) Right ovaria cyst XXXXXXX

My GP didn't seem terribly concerned, but from everything I've read online, it is concerning that the cyst hasn't resolved itself after a few mentrual cycles (if the pain from November is in fact related). Also, I am a bit alarmed by the term 'internal echoes', as doesn't this indicate a complex cyst? My GP has referred me to an OBGYN, but it will be a month or so before I can be seen, and I would like a bit more explanation of what my results could mean, and what might happen moving forward (for some reason I am more concerned about the cyst, although I have never heard of adenomyosis!).

Thanks!
XXXXXXX
doctor
Answered by Dr. Timothy Raichle 3 hours later
Hello, and thank you for the question. I am sorry about the delay, but I will try and give you the best answer possible.

First of all, I can't stand when someone has a test done and noone is able to sit down and really explain the results right away. I will help you today, as the results are really not that concerning. But to summarize, here is what I am hearing:

You are a 30 year old female on birth control pills, who I will assume had no problems before November, who developed intermittent right lower quadrant pain / bladder discomfort. The pain went away, but then returned and has been present ever since. There is some association, maybe, with your cycle. There is an association with the location of your bladder.

It was appropriate to get an ultrasound. I would have also obtained a urine sample as well, because kidney stones might also present in this manner. As far as the ultrasound findings, here is how I would interpret what you are saying:
1. The dimensions of the uterus are normal
2. The lining (the part that grows and sheds) is normal at 4mm
3. The ovaries are normal

The comment about the right ovarian cyst obviously concerns you. The size of the ovary itself is normal, and the cyst of concern is actually quite small. In all likelihood, it represents a small amount of bleeding within the cyst. It is quite possible that if you had an ultrasound in November when this pain started, this cyst might have appeared larger, and what you are seeing in December / January represents decreasing size of the same area. The best plan, in this case, and based on your persistent pain, is to repeat the ultrasound about 6-8 weeks after it was performed. If the cyst is still there and your pain is still present, you can discuss with your OB/GYN whether the cyst should be removed.

Finally, the comment about adenomyosis is a bit annoying. This is virtually impossible to diagnosis on ultrasound and the pain you are describing does not fit with this condition. Adenomyosis is a benign condition where there is some invasion of the muscle wall of the uterus by the lining or glandular layer. It is a condition associated with heavy cycles and significant cycle related cramping. Your pain does not follow such an obvious pattern.

So you are left with a diagnosis of a probable "hemorrhagic ovarian cyst" that is small and likely will resolve over time. If your pain resolves with the resolution of the cyst, then the cyst was the cause of the pain. If the cyst resolves and your pain persists, then your pain is something else!

I hope that this helps. Please let me know if there is anything that I am missing!!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Timothy Raichle 11 hours later
Dear Dr. Raichle,

Thank you very much for the clear answer, and interpretation of my results! I should have mentioned that my GP did in fact do a urine test. There were some leukocytes in the sample, but no sign of bacteria. In any case, knowing that the cyst is likely nothing to worry about, and that adenomyosis is benign definitely eases my mind until I can follow up with my real-life OBGYN appointment next month. Thanks again!

Regards,
XXXXXXX
doctor
Answered by Dr. Timothy Raichle 6 hours later
Thank you for the followup. I think that you are on the right track. If anything comes up or there are further questions, you are welcome to direct a question to me as you did. Good luck!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,   ,   ,   ,   ,  
Drug/Medication
Lab Tests
Medical Topics

Recent questions on  Renal stones

doctor1 MD

I am a man of 46-weight 74kg

. Since 4/7/2011 night I was having headache with uneasiness-GIDDINESS (gabraahat)..I took headache pill but go no effect. I went to Doctor who took my b.p. & it was 92 120 - he prescribe me 5 days medicine for blood pressure normalcy but it got no affect. It tinckle mmy mind & I went to Govt. Hospital & start with medicine doctors who first ask for my ecg & eye test..which resultly came normal. He referred me to neurology deptt & doctor overthere asked me to do the EEG which came abnormal -reports states as -ABNORMAL EEG RECORD suggestive of localization related Epilepsy arising from Lt. Fronto Tempero Region ...for which doctors said that there are fitts in my brain.. I never had such problem nor ever I felt any symptoms of these..even I enquired from my elders reg.this but nothing was ever I got the symptom..even not in genetic..I am surprised to hear that.. Doctor then advise me to do the MRI of brain. MRI report was clear - norml except .. Incidental note is made of muscosal thickening in left frontal sinus and left anterior ethmoid sinus. - NO DEFINITE LESION SEEN. PLEASE CORRELATE CLINICALLY. Doctor prescribe me following medicines



Valparin Chrono 300 mg - 1 + 2 for two months



I want to know the reason of this sudden fitts in my brain. May be (1) reason that I took a pc (half) of medicine called Vigora at 3rd July night while I had a drink (one) already about 1 hour ago ( I forgot )..Is this may be reason...



2) May be I was having medicines already for my liver fatty & kidney stone & lately for my intestines... these

were - Evion 400mg, Cyra D , Nucoxia 90 mg, Tiniba 500, Novamox 500, 250, claribid, etc etc..



3} How much time I have to take these medicine ?



4) Is there are any side effect of these medicines ?



5) If I can take a homeopathy medicine for my stomach problems & for side effects..



Your reply & guidance will be much appreciated..



Thank you a lot.



Manmohan

doctor1 MD

have had pancreatitis off and on for over two years now...had gallbladder removed 3 years ago...sphinter of oddi disfunction, biliary diskenesia, i cannot eat without throwing up everytime, i have chronic diahrea, i was just admitted to the hospital with severe pain in my abdomen which was constant right side of my belly button and radiated to my right side and was burning. No fever. No white blood cell elevation..ct scan showed no bowel obstruction or inflammation and blood work showed no pancreatic elevation. They said nothing was wrong with me and sent me home...SOMETHING is wrong. I asked for a CT of my appendix and they did CT without contrast looking for kidney stones. No stones. Never redid CT for appendix. What should i do and what might this be?

doctor1 MD

I am 48 year old male. My wight is 60 kgs. I have no sugar or BP problem. recntly about a month back, I experienced pain in lower abdomine and pain in testicles after I passed urin. I could not pass urine that day for almost 6 hours and when I passed it was under pressure. The pain started after I passed urine. Though I suffered the pain for about an hour or so later it did not relapse. However I had some discomfor in my lower back and hip. I consulted a doc who suspected kidney stone. I took the medicine (homeo) prescribedby him. I also followed hios suggestion of drinking good amunt of water. Though the pain has completely dissapeared i some time do have a dull pain in the back and just above the testicles on the sides. It does not in any way affect my regualr work, but definitely a bit discomfortable. My question to you is 1. Does retaining urine under pressure in bladder cause renal stones. 2. What care shopuld I take ?

doctor1 MD

Hi, I am Dennis. I am under a GP care. I have well controlled high BP and my colest. levels are great. I do have several Gall stones but they mostly do not bother me. I have had several kidney stones in the past. I am currently 61 years old. I have an arthritis doctor as well for treatment of drymouth and I have osteo arth. in most of my joints for which I take no meds. I have a ruptured disk and premature spinal stenosis which was diagnosed by a back doctor by MRI. The stenosis makes my legs very weak when walking any distance and I cling to a grocery kart with much desire. But I have one other pain which scares me as it is intense and severe though short lived when it occures. I have had it for years. It occures usually when I bend over or twist around (as when in a car seat). It happens at night sometimes when I sit up or roll. It is almost predictable but I am obsessively cautious when I move. It feels like an ice pick stabbing me or even a tearing sensation usually right at the diaphram level or at the very bottom of my rib cage. More often on the left side, sometimes on the right. More lately I have bee hit with these pains a little high between the ribs. Am I having muscles ripping apart? The pain sometimes feels like a charlie horse which I have experienced very rarely in my legs. The pain may last only 2 or 3 seconds or it may last 10 or 12, but either way it forces me to hold my breath and not move except to stretch my body upward. My doctor says only that it is likely something muscular-skeletal, but that is as far as I get with this. I am confused about this and wonder if my muscles are falling apart. Do I have multiple hernias?

doctor1 MD

I have a recurring pain in my stmach right side a few inches above my hip, What can it be??

doctor1 MD

I've had a pain in my mid back, more towards the left. It feels like a muscle and sometimes is a burning pain that radiates to my stomach. What could this be?

doctor1 MD

My kidney stones do not bother me why would my doctor want me to get the shockwave procedure done .