Endometrioma Cyst - Does this mean I may have Endometriosis?

[Faymaster]

Hello.  I posted a little while back, but wanted to make a complete new topic since my latest US showed something new.

Back story - October of 2016 I was diagnosed with a 2CM cyst on my right ovary.  My gyn was more concerned about a fibroid that had doubled in size in 6 months so she recommended another ultrasound after 2 menstrual cycles.

Well, I waited about 6 months and received an US in April of 2016 that showed the fibroid was stable and had not changed, but the cyst on my right ovary was still there and went from 2cm to 3.4cm and had septation with a lacy appearance which is probable hemorragic cyst. My right ovary was also enlarged measuring 5.7x3.7x3.7  My gyn again wanted to wait another 2 menstrual cycles because she always seemed to blame it on ovulation.

Jump to yesterday 7/31/17 I received my 3rd US and I just wanted to post the exact results to get some clarifcation.

PELVIC ULTRASOUND 7/31/2017 8:46 AM

CLINICAL DATA:  Female, 27 years. Unspecified ovarian cyst, right side.

COMPARISON STUDY: None available.  

COMMENTS:
Transabdominal images were obtained for overall imaging of the pelvis.
Endovaginal scans were obtained for more detailed evaluation of the
endometrium, myometrium, ovaries and adnexa.  

UTERUS: Measures 7.9 x 3.8 x 5.5 cm. Fibroid is again noted on the left
measuring up to 3.5 cm, similar the prior study..

ENDOMETRIAL STRIPE: 11 mm which is within normal limits.

RIGHT OVARY: Measures 4.2 x 3.1 x 2.6 cm. Complex cyst measuring 2.2 x 1.9 x 2
cm with diffuse low-level echoes internally. No blood flow is noted within the
internal echoes. On the prior study the complicated right ovarian cyst
measuring up to 3.4 cm.

LEFT OVARY: Measures 3.6 x 2.7 x 2.6 cm. Unremarkable.

No adnexal masses or free fluid.
The visualized portions of the urinary bladder are unremarkable.

===========
IMPRESSION:
===========

1.  Redemonstration of a complex cyst in the right ovary with diffuse
low-level echoes currently measuring up to 2.2 cm either representing a
hemorrhagic cyst or endometrioma. The previously noted complex right ovarian
cyst measured 3.4 cm. Consider follow-up in one to 2 menstrual cycles.
2.  Redemonstration of left uterine fibroid measuring up to 3.5 cm.


My questions are:

-  How will they be able to tell exactly what type of cyst it is?  It seems as though they are always guessing.

- Why am I always having to get repeat US? When will my gyno recommend something else and what options do I have?

- When looking up this type of cyst "endometriomas" the word "endometriosis" always seems to come up.  Is this something that I more than likely have since I have this type of cyst?

- I read that these cyst can "burst" but can they shrink? My cyst did get smaller so I'm hoping it just goes away on it's own, but I also would like to know if I have something else more serious going on in there.

Any info will help!  I'm usually the type of person to put my health last, but over the last several years I have suffered from severe abdominal pain (which I always blame on gas because I don't know what else), bloating, spotting, irregular menstrual cycles and very bad clotting which my gyno states is because I use tampons. I get regular colonoscopies so I know i'm good in that area.  I get pain in both sides, but mostly my right and something it feels like I'm pulling my muscles so tight when I'm walking.  Just getting to the point where I am starting to worry a tiny bit. hehe

I also should include no history of ovarian cancer, but my brother and I suffer from a genetic disorder called Juvenile Polyposis Syndrome which causes polyps in the colon, rectum and stomach and possibly elsewhere.  Is also gives us a higher risk of stomach and colon cancer.  My brother (30) was diagnosed with Colon Cancer at 25 and my father died at 32 of colon cancer.  I wasn't sure if this is something I should even mention.  I get colonoscopies every year because of this disorder and we are told our children would inherit the missing gene as well (50%) chance so kids are out of the question for me.  I do not want to put a child through that.  

Thank you!

[old_before_my_time]

Unfortunately, imaging is not exact so they can't always determine the type of cyst. Ovarian cysts are common and almost always benign. Plus many go away on their own, including hemorrhagic ones. But I don't think endometriomas do. Since your cyst has shrunk some, it may just go away within the next few months or so. But your symptoms of abdominal pain and irregular cycles could be an indication that you have endometriosis which could mean the cyst is an endometrioma. You would need to have exploratory surgery and a tissue biopsy to diagnose endometriosis.  

It seems I read that ultrasound is a good way to assess ovarian cysts. So CT or MRI may not be any more helpful and can be costly. CT exposes you to radiation.

Here is some info about ovarian cysts - http://ovaryresearch.com/ovarian_cysts.htm.

Please keep us posted. Hopefully, this cyst will resolve!