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Young with a complex ovarian cyst - is "wait and see" the only option?
So I am new here, and could really use some quality advice.
Basically, I have always had irregular cycles. After being on the pill for 2 years, I went off to get a Paragard IUD. This brought my sex drive back and actually fixed my seasonal allergies (which were great before I went on the pill and seemed to get triggered by the hormone change). However, once I had the Paragard, my cycles got irregular again (read: I spotted for 8 months). In February I was finally diagnosed with PCOS (the Paragard is in place and fine), although I am HWP and active. I am borderline insulin resistant and have high testosterone/free testosterone.
Anyway, fast forward to the first week in March, when I began having symptoms of intense pain over my left ovary. I went to the nurse practitioner and she sent me to the ER, telling them I was worried about an ovarian cyst. They were concerned that I might have ovarian torsion because my ovaries are already enlarged from the PCOS. A transvaginal ultrasound found a 4.8cm cyst on my left ovary. They weren't able to tell if it was hemorrhagic or an endometrioma, so they gave me Percocet and sent me to my reproductive endocrinologist.
The RE looked at it and said she thought it was hemorrhagic, but couldn't be sure, and that it was definitely "complex and multiocular, but does not appear to have solid contents" She gave me Tylenol 3 and sent me home, telling me the cyst would reabsorb on it's own. She didn't even schedule a follow up with me, although at one point she said we would do another ultrasound in a few weeks.
The problem? I am not impressed AT ALL with this RE. She has lost my lab results, told me then from memory, and was incorrect. She has said that she would call me about medication the next business day, and then not called me for a week. When I was in 7/10 pain in her office from the cyst and couldn't take Percocet because I am too drowsy to drive safely when I'm on it, she gave me another pain prescription I couldn't fill at the hospital (I had to go to a local pharmacy) - even in the ER they gave me one Percocet to take until I could get the prescription filled!
And this cyst is not going away. If anything, it's getting worse. Even taking Tylenol 3, I can't walk more than 5 min at a slow pace before I start feeling intense pain in my groin and burning/numbness down my back, butt, and back of my thigh on the left. Having a bowel movement hurts (over the cyst), and I have to take pain medication to get to sleep at night since there isn't a position in which I feel comfortable. I've read enough articles online to know that since I'm premenopausal and the cyst did not have any solid contents, the standard approach is a "wait and see" for 8 weeks or two menstrual cycles. I would be willing to do that
A. If I could control this pain well, and
B. If I had menstrual cycles.
The problem is, because of my PCOS, I am not cycling right now. If it is a cyst that might bleed/collapse down with my menstrual bleed, I will be waiting a LONG time for that to happen. Additionally, I am in a medical program and I need to lift/move patients in a hospital this summer, as well as walk all day long. I can't do that in the state I'm in, even with pain medication, and I need to complete this rotation to graduate on time. And lastly (this is a minor thing, but really) I am in a long term, monogamous relationship and my partner is being VERY understanding, but sex isn't even on the table right now. Even orgasms without penetration leave me feeling MUCH worse than before (I assume because I tend to contract all my muscles when I orgasm, which probably pushes on the cyst). I am young and have a good sex drive - waiting 8 weeks to have sex sounds horrible.
:-( So, is it worth a second opinion, or will all doctors tell me I have to "wait and see?" I do have a strong history of ovarian cancer in my family, but I understand a cyst without solid contents is very unlikely to be ovarian cancer. If I do seek a second opinion, where do I go? Another reproductive endocrinologist? Another OBGYN? If I end up having surgery (which I would welcome right now) will it have to be at the hospital where the doctor practices? (if so, then I need to choose both the doctor and the hospital they work with wisely)
Ugh. Thank you SO much for your help!
Basically, I have always had irregular cycles. After being on the pill for 2 years, I went off to get a Paragard IUD. This brought my sex drive back and actually fixed my seasonal allergies (which were great before I went on the pill and seemed to get triggered by the hormone change). However, once I had the Paragard, my cycles got irregular again (read: I spotted for 8 months). In February I was finally diagnosed with PCOS (the Paragard is in place and fine), although I am HWP and active. I am borderline insulin resistant and have high testosterone/free testosterone.
Anyway, fast forward to the first week in March, when I began having symptoms of intense pain over my left ovary. I went to the nurse practitioner and she sent me to the ER, telling them I was worried about an ovarian cyst. They were concerned that I might have ovarian torsion because my ovaries are already enlarged from the PCOS. A transvaginal ultrasound found a 4.8cm cyst on my left ovary. They weren't able to tell if it was hemorrhagic or an endometrioma, so they gave me Percocet and sent me to my reproductive endocrinologist.
The RE looked at it and said she thought it was hemorrhagic, but couldn't be sure, and that it was definitely "complex and multiocular, but does not appear to have solid contents" She gave me Tylenol 3 and sent me home, telling me the cyst would reabsorb on it's own. She didn't even schedule a follow up with me, although at one point she said we would do another ultrasound in a few weeks.
The problem? I am not impressed AT ALL with this RE. She has lost my lab results, told me then from memory, and was incorrect. She has said that she would call me about medication the next business day, and then not called me for a week. When I was in 7/10 pain in her office from the cyst and couldn't take Percocet because I am too drowsy to drive safely when I'm on it, she gave me another pain prescription I couldn't fill at the hospital (I had to go to a local pharmacy) - even in the ER they gave me one Percocet to take until I could get the prescription filled!
And this cyst is not going away. If anything, it's getting worse. Even taking Tylenol 3, I can't walk more than 5 min at a slow pace before I start feeling intense pain in my groin and burning/numbness down my back, butt, and back of my thigh on the left. Having a bowel movement hurts (over the cyst), and I have to take pain medication to get to sleep at night since there isn't a position in which I feel comfortable. I've read enough articles online to know that since I'm premenopausal and the cyst did not have any solid contents, the standard approach is a "wait and see" for 8 weeks or two menstrual cycles. I would be willing to do that
A. If I could control this pain well, and
B. If I had menstrual cycles.
The problem is, because of my PCOS, I am not cycling right now. If it is a cyst that might bleed/collapse down with my menstrual bleed, I will be waiting a LONG time for that to happen. Additionally, I am in a medical program and I need to lift/move patients in a hospital this summer, as well as walk all day long. I can't do that in the state I'm in, even with pain medication, and I need to complete this rotation to graduate on time. And lastly (this is a minor thing, but really) I am in a long term, monogamous relationship and my partner is being VERY understanding, but sex isn't even on the table right now. Even orgasms without penetration leave me feeling MUCH worse than before (I assume because I tend to contract all my muscles when I orgasm, which probably pushes on the cyst). I am young and have a good sex drive - waiting 8 weeks to have sex sounds horrible.
:-( So, is it worth a second opinion, or will all doctors tell me I have to "wait and see?" I do have a strong history of ovarian cancer in my family, but I understand a cyst without solid contents is very unlikely to be ovarian cancer. If I do seek a second opinion, where do I go? Another reproductive endocrinologist? Another OBGYN? If I end up having surgery (which I would welcome right now) will it have to be at the hospital where the doctor practices? (if so, then I need to choose both the doctor and the hospital they work with wisely)
Ugh. Thank you SO much for your help!
Thanks for the input. I am still in a lot of pain and am now, of course, bloated as well. *rolls eyes* The joys of being a woman! I would jump the fence for surgery in a second right now, but have definitely learned a lot about complications from reading this board. So I will proceed with caution. Right now the challenge is trying to find a good OBGYN. It seems like they are all focused on baby-making and not angry ovaries. ;-)
I had an Ovarian Cyst when I was 15, basically they told me to wait and see because they usually clear up with no complications(other than the pain). Mine wasnt the cancerous form so it cleared up normally. I would get a second opinion, what one doctor says may be different from another as far as treatment options. I think you would be able to have the surgery at the hospital of your choosing. I hope this was atleast somewhat helpful, I'm not a doctor or anything, I've just had experiences with Ovarian Cysts.
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