Menopause Fibroid and multiple ovarian cysts question

I don't know what to do.

I am 56 and I am 3 years into menopause. In Dec 2010 right at the start of menopause they found a left ovarian cyst and a mid center uterine fibroid by pelvic ultrasound because I bled after one year cessation of periods. Gyn checked my blood for cancer cells and it was fine, so she decided to go on a wait and see approach.

Almost 4 years later just recently I started having some unexplained pelvic pain with bladder symptoms (no bleeding) and it prompted me to see my gyn again. She ordered another pelvic ultrasound and now I have multiple ovarian cysts on both ovaries and the uterine fibroid has grown just a little. It went from 2.7cm to 3 cm in size. A small increase. I also have a retroverted uterus. Because my pain and bladder issues improved she said to have another ultrasound in 6 months.

I just saw my pdoc last week and explained that I am very moody and irritable as I also have MDD and GAD and he attributed it to my depression. I didn't think that it might be my hormone levels.

When I bear down to urinate at night I have bladder pain again. I just made another appt with my gyn and I see her on Monday to get my hormone levels checked.

I am torn because I am wondering if I need a hysterectomy. These new cysts have occurred after menopause and the fibroid has not shrunk but grown a little. If I am going to need surgery eventually, I want to get it done now while I am still rather young. This wait and see approach and get another ultrasound in 6 months worries me. Ovarian cancer can have very vague symptoms and it can spread. Chances are it is not cancer but also I have no use for these organs anymore and repeating tests is not something I want to keep doing.

Do I have the right to ask for a hysterectomy? Is this a viable option?

I realize that you cannot advise me of what to do, but any comments, suggestions or hearing your own experience would greatly be appreciated.

If anything, six months sounds, too long to wait in between. Because you are post menopause, your concerns are, indeed, most valid.
http://www.womenshealth.gov/publicat...ian-cysts.html
I believe, on a personal level, you are well within your rights, to discuss such an option.

Yes, I agree. Thank you healing4me. I am uncomfortable with waiting 6 months as these cysts were not present on previous ultrasound at the beginning of menopause. They are now on both ovaries and multiple and I am having very bad issues with hormonal imbalance. Very extreme mood swings. I went to my pdoc and thought I had a mood disorder but he said no you don't have a mood disorder....just depression. Thanks again. Going to gyn in the morning but I don't know what she will think or say.

Take care

Hopefully she hears you out, on your concerns.

Meant to ask, did she give you the CA-125 blood test? I hear, too well, your fear of ovarian cancer, etc. Though as my dr stated, that isn't a complete fool proof test, it will indicate inflammation. The not fool proof, is that if inflammation, what level is it caught?
Why not have preventative measures? I know I was ready to do it, when I had my c scare.
Why even go down that path, if you don't have to? Noone wants that prognosis. After a certain age ovarian cancer risk subsides, but with all these new cysts, etc, it's time some clearer answers are given. Wait and see, isn't acceptable.
Gosh, with my risk level, I think it's one to two weeks, unusual bloating, call...

The only test she has done so far other than a pap and mammo, was a urine test to rule out a UTI. Nothing else! No CA 125. I agree that it is not reliable in early staging. So.... I do think she is being too conservative. This is the 2nd wait and see as far as my symptoms. I just need to explain my concerns. She may not be open to surgery so I may have to get a second opinion.

You can certainly tell your doctor you want to talk about the possibility of having a hysterectomy. You can also seek a second opinion if you don't like the response you get. There are pros and cons and it deserves a thorough discussion.

Well...it was a rather strange meeting with my gyn. She said that I am not hormonal. She didn't opt to do any testing. She was finally convinced after I kept saying that I wasn't comfortable waiting 6 more months. The small increase in the fibroid was her only concern. She finally agreed to check with my insurance company about pre-certification to do a total laparoscopic hysterectomy but only because I insisted. Of course she needs a good reason to do the surgery. She said I wasn't bleeding and the ovarian cysts are small. If felt like a tennis match but she finally agreed.

Maybe I am being too cautious but I just want to have surgery now while I am still in my fifties and leaving these multiple cysts and a fibroid in me for years just increases the chances for cancer. Years ago there would have been no question to do surgery. Now they put it off because they find that in most cases there is no cancer. Ovarian cancer if missed is a deadly one. Why do I want to wait and take the risk at my age? I just don't.

So we will see if she can make the case for my insurance to agree.

I hope this works out well for you. If your insurance turns you down, please don't feel shy about appealing, using medical research and family history if that is relevant. Follow the instructions in your insurance company handbook. I've done that and it worked for some very expensive treatments that they first turned down.

Good luck to you.

Still waiting on pre-certification for total hysterectomy...... Hopefully I will know something soon.

OK....total hysterectomy is scheduled for first week of November. My gyn doc finally agreed to do the surgery. Actually my insurance was not in the way. I just hope that I am doing the right thing.



We will see! Thanks guys for your support!

My doc wants me to have a uterine biopsy....but I just plain refused. I only talked to an office person and my doc got the message and did not call me so I hope she is just accepting my decision. Pathology can be done when they do the surgery. I just don't need the trauma from that if we are going to do the surgery anyway. Hope she understands...

Total hysterectomy is scheduled for November 4th



BUT.......

I don't have to have a biopsy......

Yeayyyyyyy!

I was sooooo against that!

Please wish me luck and especially blessings....