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What causes irregular menstruation, burning in pelvic region and lower back pain?

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Posted on Thu, 5 May 2016
Question: I am 31 years old, not on birth control, not pregnant, and had a sudden change in my period the past 3 months. It went from 5 heavy days to 3 VERY light days. Around the same time I would develop a slight burning sensation in my pelvic region which has since disappeared but now my right ovary hurts almost constantly along with lower back pain. If I move a certain way it feels like it is about to pop... strange I know. I had a transvaginal ultrasound last month which showed a 2.3 cm Mildly complex cyst with septations and low internal echos. My PCP sent me to my gynecologist and after she reviewed the ultrasound she said she was certain it was a Corpus Luteum Cyst and would go away on its own in a few weeks. My question is.... I have had symptoms for 3 months with no resolve and the ovary and back pain is increasing instead of getting better. If what she says is true, shouldn't my symptoms be resolved after 3 months? Is this a tumor instead of a functional cyst? Thanks!
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Answered by Dr. Sameer Kumar (2 hours later)
Brief Answer:
possibly endometriotic cyst or an ovarian tumour...to be ruled out

Detailed Answer:
Hello,
Thanks for the query to hcm,
The fact that you have been experiencing pain especially in the right ovarian region persistently since last 3 months and that have been extending to lower back during your menses indicate towards a possibility of development of endometriotic features.
However a 2.3 cm ovarian cyst on the right side with complexity and internal separations and low internal echoes does need to be differentiated between an endometriotic cyst or an ovarian tumour.
Hence, it is advised that you should opt for tumour markers namely CA125, CEA, AFP, BETA HCG and CA19.9 ( specific for ovarian tumour). If the values are high then there is all likelihood that we are dealing with a ovarian tumour and the next step would be CT SCAN to confirm the findings and differentiate clearly from a endometriotic cyst or corpus luteum cyst.
If the tumour markers are normal , then a diagnostic laparoscopy can be performed and this ovarian cyst can be removed and per op if endometriosis detected then fulguration can be done in the same sitting.
So i suggest the next step would be to get tumour markers done and a repeat scan after 3 weeks to look for any increase in size of the complex cyst.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sameer Kumar

OB and GYN Specialist

Practicing since :2002

Answered : 1723 Questions

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What causes irregular menstruation, burning in pelvic region and lower back pain?

Brief Answer: possibly endometriotic cyst or an ovarian tumour...to be ruled out Detailed Answer: Hello, Thanks for the query to hcm, The fact that you have been experiencing pain especially in the right ovarian region persistently since last 3 months and that have been extending to lower back during your menses indicate towards a possibility of development of endometriotic features. However a 2.3 cm ovarian cyst on the right side with complexity and internal separations and low internal echoes does need to be differentiated between an endometriotic cyst or an ovarian tumour. Hence, it is advised that you should opt for tumour markers namely CA125, CEA, AFP, BETA HCG and CA19.9 ( specific for ovarian tumour). If the values are high then there is all likelihood that we are dealing with a ovarian tumour and the next step would be CT SCAN to confirm the findings and differentiate clearly from a endometriotic cyst or corpus luteum cyst. If the tumour markers are normal , then a diagnostic laparoscopy can be performed and this ovarian cyst can be removed and per op if endometriosis detected then fulguration can be done in the same sitting. So i suggest the next step would be to get tumour markers done and a repeat scan after 3 weeks to look for any increase in size of the complex cyst. Regards