Ovarian Cysts, Uterine Fibroids, and Gastrointestinal Issues

Colorectal polyps, polycystic ovary syndrome, uterine fibroids, and unknown conditions?

Hello, doctor.
I have undergone ultrasound examinations at two obstetrics and gynecology clinics, which revealed polycystic ovaries and uterine fibroids.
The first clinic detected polycystic ovaries through an abdominal ultrasound, while the second clinic, using an invasive method, confirmed the presence of uterine fibroids and noted a suspected polycystic ovary that requires blood tests for confirmation.

1) Is it necessary to conduct blood tests to confirm polycystic ovary syndrome (PCOS)?
2) Recently, I have been experiencing bloating and pain in my uterus and ovaries, and I am concerned about the possibility of cancer.
However, I am unsure how to find a hospital and a doctor to address this.
A week ago, I experienced an inability to have a bowel movement (I haven't had a bowel movement in nearly a month), and my stool was stuck at the anus.
I consulted a colorectal specialist who assisted in manually removing some stool and used a liquid enema to clear part of the blockage.
During the procedure, I felt pain in the diagonal area regardless of whether I was lying on my side.
The doctor mentioned it could be related to the ovaries, but I am unsure if the other side is the uterus.
The next day, I experienced lower back and spinal pain, a feeling of pressure in my head, burning during urination, frequent urination, and intermittent bloating and pain on both sides and near my private area.

1) Is there a risk of infection in the uterus and ovaries during the manual removal of stool? Which department should I consult for further examination? Yesterday, after standing for about 15 minutes, I broke out in a sweat, had difficulty breathing, my blood pressure was 63, I experienced tinnitus and dizziness, my limbs felt cold, and I had a feeling of pressure in my head and bloating in my stomach.
A nurse suggested I might be in shock and advised resting for a while.
My blood pressure stabilized, but I still felt dizzy and bloated.
When I jogged lightly, I felt discomfort under my left and right chest, and applying light pressure to the lower middle of my chest made me feel nauseous.
I suspect these symptoms started after the stool removal procedure a week ago.
Therefore, I visited another hospital's colorectal department, but the doctor was reluctant to conduct further examinations and simply told me to follow up with the previous hospital and doctor.

I am unsure what is wrong with my body, but I clearly feel that something is not right.
I want to find a hospital and a doctor to investigate my current and potential health issues, but I do not know how to start looking for the right hospital and physician.
I have tried researching and looking at doctors' specialties, but it has become more complicated.
What outpatient departments should I consult for examinations? Thank you for your patience in reading this, and thank you.

Jiang, 30~39 year old female. Ask Date: 2016/10/14

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, I apologize for not being able to diagnose based on the described symptoms.
Polycystic ovary syndrome (PCOS) requires blood tests and ultrasound for a comprehensive evaluation.
As for the other symptoms, they are not significantly related to gynecology.
If you continue to experience discomfort, I recommend visiting a hospital for a thorough examination.
Wishing you good health.

Reply Date: 2016/10/14

More Info

It sounds like you are experiencing a complex set of symptoms related to your reproductive and gastrointestinal health. Let's break down your concerns and address them systematically.

Understanding Ovarian Cysts and Uterine Fibroids
1. Polycystic Ovary Syndrome (PCOS): To confirm a diagnosis of PCOS, blood tests are indeed necessary. These tests typically measure hormone levels, including androgens (male hormones), and may also include tests for insulin resistance. The ultrasound findings of multiple cysts on the ovaries can support the diagnosis, but the hormonal profile is crucial for a definitive diagnosis.

2. Uterine Fibroids: These are benign tumors of the uterus that can cause symptoms such as pelvic pain, heavy menstrual bleeding, and pressure symptoms. The presence of fibroids can be confirmed through ultrasound, and while they are generally not cancerous, they can sometimes cause discomfort or complications depending on their size and location.

Addressing Your Symptoms
You mentioned experiencing abdominal pain, discomfort, and gastrointestinal issues, including constipation. Here are some points to consider:
- Pelvic Pain: The pain you are experiencing could be related to the ovarian cysts or fibroids. Both conditions can cause pelvic discomfort, especially if they are large or if they are pressing on surrounding structures.
- Gastrointestinal Symptoms: The constipation and difficulty with bowel movements can lead to abdominal pain and discomfort. It's essential to address constipation through dietary changes (increased fiber intake), hydration, and possibly the use of laxatives if necessary.
- Infection Concerns: You asked whether the procedures performed during your visit to the colorectal specialist could lead to infections in the uterus or ovaries. While the risk is generally low, any invasive procedure carries some risk of infection. If you experience fever, increased pain, or unusual discharge, you should seek medical attention promptly.

Finding the Right Medical Help
Given your complex symptoms, it would be advisable to consult with multiple specialists:
1. Gynecologist: Since you have concerns about ovarian cysts and fibroids, a gynecologist should be your first point of contact. They can perform further evaluations, including blood tests for hormone levels and possibly a follow-up ultrasound.

2. Gastroenterologist: Given your gastrointestinal symptoms, particularly the constipation and abdominal pain, a gastroenterologist can help assess your digestive health. They may recommend further imaging studies or endoscopic procedures if necessary.

3. Primary Care Physician: Your primary care doctor can coordinate your care and refer you to specialists as needed. They can also help manage any systemic symptoms you are experiencing, such as dizziness, fatigue, or changes in blood pressure.

Next Steps
- Schedule Appointments: Start by scheduling an appointment with a gynecologist to address your reproductive health concerns. Bring all your previous medical records, including ultrasound results and any blood tests.

- Gastrointestinal Evaluation: After consulting with the gynecologist, if your gastrointestinal symptoms persist, make an appointment with a gastroenterologist. They can provide a comprehensive evaluation of your digestive health.

- Monitor Symptoms: Keep a detailed record of your symptoms, including when they occur, their severity, and any associated factors (like diet or activity level). This information will be valuable for your healthcare providers.

- Emergency Care: If you experience severe symptoms such as intense abdominal pain, fever, or signs of shock (like fainting or severe dizziness), seek emergency medical care immediately.

Conclusion
Navigating health concerns can be overwhelming, especially when multiple systems are involved. By systematically addressing your symptoms and seeking the appropriate specialists, you can work towards a clearer understanding of your health and the necessary treatments. Remember to advocate for yourself and communicate openly with your healthcare providers about all your symptoms and concerns.

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