Ovarian Cysts: Symptoms, Treatment, and Concerns

Ovarian cystadenoma

Hello, doctor! I experienced menstrual irregularities for a week, followed by persistent abdominal bloating for over a week, although the amount was minimal.
I consulted a general obstetrician and gynecologist, and during the first examination, an ovarian cyst measuring 4.2 cm was detected.
I received an injection that was supposed to help clear the menstrual flow.
The next day, the flow was still minimal, and it stopped for two days.
On the fifth day, I experienced a heavier flow resembling my period, so I returned for a follow-up.
During the second examination, the ovarian cyst had increased to 4.6 cm.
This time, the doctor prescribed medication to stop the bleeding and asked me to return in a week.
I took the medication, but after three days, the flow decreased.
By the time of my third follow-up, there was still a small amount of dark red discharge.
I occasionally felt discomfort and dull pain in my lower left abdomen, sometimes accompanied by the urge to have a bowel movement, but I was unable to pass stool.
I also experienced lower back pain and occasional dizziness.
The examination revealed that the ovarian cyst had grown to 5.4 cm.
The doctor instructed me to refrain from urination for three hours before my next check-up in three days, stating that if it continued to grow, surgery might be necessary.
This time, the doctor advised against taking hemostatic medication to allow the bleeding to complete.
It feels like there’s a constant push to let the bleeding finish, then a pause, and then back to forcing it again.
Is this good for my body? Is the growth rate of the cyst within two weeks considered fast?

ANNY, 40~49 year old female. Ask Date: 2017/01/06

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, I'm sorry that I cannot provide a diagnosis based on what you've described.
I recommend visiting a hospital to see a gynecologist.
Wishing you good health.

Reply Date: 2017/01/06

More Info

Understanding ovarian cysts can be quite complex, especially when they are associated with symptoms such as abdominal pain, irregular bleeding, and discomfort. In your case, it seems that you have been experiencing a series of complications related to an ovarian cyst, specifically a serous cystadenoma, which has been increasing in size over a short period.

Symptoms of Ovarian Cysts
Ovarian cysts can present with a variety of symptoms, some of which you are experiencing. Common symptoms include:
1. Abdominal Pain: This can range from a dull ache to sharp pain, especially if the cyst is large or if it ruptures.

2. Bloating: Many women report a feeling of fullness or pressure in the abdomen.

3. Irregular Menstrual Cycles: Cysts can cause changes in your menstrual cycle, leading to heavier or lighter periods, or even missed periods.

4. Discomfort during Bowel Movements: As you mentioned, the sensation of needing to have a bowel movement can occur if the cyst is pressing on the intestines.

5. Lower Back Pain: This can be a referred pain from the pelvic region.

Treatment Options
The management of ovarian cysts often depends on their size, type, and the symptoms they produce. Here are some common approaches:
1. Observation: If the cyst is small and asymptomatic, doctors may recommend a watch-and-wait approach, with follow-up ultrasounds to monitor its size.

2. Medication: Hormonal contraceptives can help regulate menstrual cycles and may prevent the formation of new cysts. However, they do not typically shrink existing cysts.

3. Surgery: If the cyst is large (like the 5.4 cm cyst you mentioned), persistent, or causing significant symptoms, surgical intervention may be necessary. This can involve cystectomy (removal of the cyst) or oophorectomy (removal of the ovary) depending on the situation.

Concerns About Your Current Treatment
Your current treatment plan seems to involve alternating between stopping and starting medications to manage bleeding and cyst growth. This approach can be frustrating and may not provide a clear resolution to your symptoms. Here are some considerations:
- Rapid Growth of Cysts: The increase from 4.2 cm to 5.4 cm in less than two weeks is indeed concerning. Rapid growth can sometimes indicate a more serious condition, such as a malignant cyst, although most ovarian cysts are benign.

- Hormonal Fluctuations: The back-and-forth nature of your treatment may lead to hormonal fluctuations, which can exacerbate symptoms and make it difficult for your body to stabilize.

- Follow-Up: It is crucial to have regular follow-ups with your healthcare provider, especially given the rapid growth of the cyst. If you feel that your symptoms are not being adequately addressed, consider seeking a second opinion or asking for a referral to a gynecologic oncologist, who specializes in ovarian conditions.

Conclusion
In summary, while ovarian cysts are common and often benign, your situation requires careful monitoring and possibly more aggressive treatment due to the rapid increase in size and associated symptoms. It is essential to communicate openly with your healthcare provider about your symptoms and concerns, and to advocate for a treatment plan that prioritizes your health and well-being. If you experience severe pain, fever, or any other alarming symptoms, seek immediate medical attention.

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