Ovarian Tumors: Symptoms, Monitoring, and When to Seek Help

Ovarian tumor

Hello Doctor, during my health check-up last May, a cyst was found on my left ovary.
Three months later, during a visit to the gynecologist, it measured 4.2 cm.
I have been having blood tests done, and all tumor markers were normal.
I have continued to have vaginal ultrasounds at China Medical University for follow-up, with measurements as follows: 4.89 cm on July 21, 2020; 4.98 cm on December 15, 2020; 5.1 cm on March 30, 2021; and 5.6 cm on August 3, 2021.
The doctor said it is a benign tumor and recommended follow-ups every 3 to 6 months, so I have been consistently monitoring it every three months.
However, I have been experiencing irregular menstrual cycles, typically ranging from 33 to 38 days, sometimes extending to 40, 50 days, etc.
Currently, it has been over 40 days since my last period.
In the past two to three weeks, I have occasionally felt a sense of swelling in my lower left abdomen, which is not painful but feels uncomfortable and bloated, especially after sexual intercourse or bowel movements.
I would like to ask the doctor if the cyst is growing or if it has ruptured, causing this occasional discomfort.
My next appointment at the hospital is on December 7.
Should I first visit a general gynecologist?

Niming, 20~29 year old female. Ask Date: 2021/11/22

Dr. Wu Xianghui reply Obstetrics and Gynecology

You have been continuously monitored for multiple ovarian cysts, and there is a trend of gradual enlargement.
Surgical treatment is recommended as the appropriate course of action.

Reply Date: 2021/11/22

More Info

When it comes to ovarian tumors, particularly those that are benign and monitored over time, it’s essential to understand the symptoms, the importance of regular monitoring, and when to seek further medical attention. Based on your situation, it appears that you have been diagnosed with a benign ovarian cyst that has been consistently monitored through ultrasound and blood tests, with tumor markers remaining normal. This is a positive sign, as it suggests that the cyst is likely not malignant.

1. Understanding Symptoms: The symptoms you are experiencing, such as occasional left lower abdominal bloating or discomfort, can be attributed to the presence of the ovarian cyst. It’s not uncommon for women with ovarian cysts to experience sensations of fullness or pressure, especially during certain activities like sexual intercourse or bowel movements. These sensations can occur if the cyst is exerting pressure on surrounding structures or if it is slightly enlarging. However, if the cyst were to rupture, it could lead to more acute pain and possibly other symptoms such as nausea or changes in your menstrual cycle.

2. Monitoring and Follow-Up: Since your healthcare provider has recommended follow-up every 3-6 months, it’s crucial to adhere to this schedule. Regular monitoring through ultrasound allows for the assessment of any changes in the size or characteristics of the cyst. If the cyst remains stable and your tumor markers continue to be normal, it is likely that the cyst is benign. However, if you notice any significant changes in your symptoms, such as increased pain, changes in your menstrual cycle, or any new symptoms, it is advisable to seek medical attention sooner than your scheduled appointment.

3. When to Seek Help: You should consider seeing your gynecologist before your next scheduled appointment if you experience any of the following:
- Sudden, severe abdominal pain
- Persistent nausea or vomiting
- Fever or chills, which could indicate an infection
- Changes in your menstrual cycle that are unusual for you
- Any new or worsening symptoms that concern you
4. Next Steps: Since your next appointment is scheduled for December 7, it would be prudent to keep that appointment unless your symptoms worsen. If you feel that your symptoms are significant enough to warrant earlier evaluation, visiting a general gynecologist for a check-up could provide you with peace of mind and potentially expedite any necessary interventions.

In conclusion, while your current situation appears stable, it is essential to remain vigilant about any new symptoms and to continue with regular monitoring. Open communication with your healthcare provider about your symptoms and concerns is vital in managing your health effectively. If you have any doubts or feel uncomfortable with your symptoms, do not hesitate to reach out to your healthcare provider for advice or an earlier appointment. Your health and well-being should always be the priority.

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