How should I respond to a 3.2 cm ovarian cyst, with pain in that area too?

[GablesAnne]

In August, we found a 3.2 cm cyst on an ovary. In mid-October we'll look again to see if it's there, has grown, or has shrunk.

Meanwhile, I've spent my entire deductible in 2018 on trying to find out why I have this lower abdominal pain (which I share with you just to give the size and scope of my efforts and the consistency of the pain).

My appendix was removed 25 years ago otherwise I'd suspect the appendix as the cause. The only other thing in that area is the right ovary. Right?

Today, I asked my doc if we could run this test called CA125 and she declined, doesn't want to do it.  

I'm 34 years old with low right abdominal pain persistent for months, my periods have changed recently, and I've lost 30 pounds this year without trying. I'm surprised she doesn't want to run the test.

I’d like your opinion on what is the best path forward. Do I need that test or is there no reason to do it?  

2018 test history:

colonoscopy January  

then:

URINALYSIS(UA), US transvaginal, APTT(PTT), PROTIME-INR(PT), CBC WITH AUTO DIFF (CBCD), CT ABDOMEN AND PELVIS W CONT

[old_before_my_time]

The CA125 test is not useful in diagnosing ovarian cancer especially in women in their reproductive years. There are too many false positives / elevated results when there is no cancer. It's usefulness is in assessing the efficacy of treatment / chemo for women who have ovarian cancer and are undergoing treatment.

Most ovarian cysts are benign and resolve on their own within a few months, no intervention / surgery needed. 3.2cm is still on the small side so the standard of care would be to do another ultrasound after a certain period of time (2 months seems reasonable). What does the imaging report say about the characteristics of the cyst?

The pain could be from the cyst even though it's on the small side. I had a 9.5cm cyst and had only one day of pain and then the pain resolved even though the cyst was still there. It's possible too that scar tissue from the appendectomy could be causing the pain. One wouldn't think it would be that after 25 years but my mom ended up with a bowel obstruction many years (probably more than 25) after an appendectomy. She had no pain all those years until one night she awoke in excruciating pain and a scan showed a bowel obstruction which ended up requiring surgery. Her surgeon told her that it must have been from the appendectomy scar tissue since she'd had no other surgeries. Of course, yours isn't likely a bowel obstruction but you could still have scar tissue causing pain. I have read that it's difficult to determine the presence and extent of scar tissue.

Hope you get answers and relief soon. Keep us posted.

[GablesAnne]

Thank you for your time and information. I supposed scar tissue could be the cause as well though my primary doc (internist) says it's too consistent to usually be scar tissue. Though I did have some skin-surface-level nerve pangs on the scar in my 20s.

We know it's not GI and it's not neuro. I wonder how we can possibly find out what it is. If there is still a cyst in a few more weeks on my right ovary, then we might keep exploring that option.