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Post menopausal ov cyst & fibroid = Hysterectomy?? Post menopausal ov cyst & fibroid = Hysterectomy??

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Unread 04-24-2010, 08:05 AM
Post menopausal ov cyst & fibroid = Hysterectomy??

My first post here. Found this site while researching pros and cons of hysterectomy, along with other options. I am 54, menopausal, and had bleeding Oct and Nov of 2009. My gyn did vaginal ultrasoung Dec 1, and found a small ovarian cyst L side, a thickened endo lining, 7 mm, and fibroids. Did endo biopsy, no problem found.
Followup ultrasound, Feb 1, ovarian cyst not found, but left ovary still a little enlarged. Endo lining is now 1.4 cm. Submucosal and transmural fiboid still there, not much change in size. So mid March I had a hysterocopy, along with D&C, and ablation. The lining was actually atrophied, and the D&C found no evidence of malignancy. 2 weeks after D&C, bleeding again for 4 days. Another ultrasound, and left ovary is enlarged, with larger cyst seen. Endometrial echoes are now at 2.3 cm - most probably because of the underlying fibroid. As a result of these tests, and my pelvic discomfor, I was referred to a Dr in Orlando for evaluation of lap assisted vaginal hysterectomy. Appt next week.
Apparently the concern is that I am post menopausal, and fibroids should be shrinking, not growing. Also ovarian cysts unusual in menopause.
The endometrial thickness is of concern, went from 7mm to 2.3 cm. in 4 months.

So my gyn considers this a benign hysterectomy situation. After researching this, I am concerned about what will happen it we approach it as benign surgery, and malignancy is found after doing this type surgery.

Any suggestions on where I can post to see if anyone has an opinion on this? Thanks so much. Sorry for lengthy post!!!:
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Unread 04-24-2010, 07:31 PM
Re: Post menopausal ov cyst & fibroid = Hysterectomy??

Thanks, Xen , for your response. It is obvious you have done a lot of research on this subject. I had not read that women can go in and out of menopause, although I have read about the different things that influence production of estrogen. I haven't had a period in a year and a half. But yes, you are correct. Rapid weight gain of 12 lbs. prior to the start of all of this.
I will check out the thread you reference on fibroids...Thanks for the very reasonable explanation of what could be causing these issues! Do you also have fibroids? Thanks again for your help.
Unread 04-25-2010, 08:35 AM
Re: Post menopausal ov cyst & fibroid = Hysterectomy??

Hello Denise.. I understand your need to get all the information you can before making your decision. My story has some similarities...At my annual exam my doctor found my fibroid was getting larger and my ovary had a suspicious mass. Like your doc, mine was concerned because everything is supposed to be shrinking when we are post menopausal (I am 59) I began researching, like you, and also found this site, read about the da Vinci then selected a doctor in my area who did the surgery. He concurred with my primary about the need for a hysterectomy.The CA125 blood test showed no elevation so he decided not to have a GYN oncologist on call when he perfomed the surgery. But, had he found a malignancy, I would have been closed and rescheduled for another date with the GYN oncologist. Since ovanian cancer is more prevalent in women who have not had children (I have not) , I was still worried (the blood test is not absolute). I had virtually no symptoms prior to all this happening, and it came as quite a shock. I was so very thankful for this website to get me through the emotional turmoil of having this procedure. If you are feeling uncomfortable with the need for surgery, absolutely get a second opinion and even a third. When I questioned my primary doctor on the actual need for surgery, he said "are you willing to take the chance?" Since we've known each other for 20 years, I truly valued his input. So, good luck to you and be sure to let us know how you are doing...
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Unread 04-25-2010, 06:53 PM
Re: Post menopausal ov cyst & fibroid = Hysterectomy??


I am so glad you have found us and I hope you are finding the site informative and supportive!

It can be tricky sometimes to know if you are in menopause, though once you are there, you are there! But getting to that point can be a wild ride as your body changes and your hormones fluctuate! Has your doctor checked your FSH level? How about your estrogen levels? Besides having no period for around 12 months, those levels can help indicate you are in menopause. If you are in menopause, your FSH level is going to be in the double digits and your estrone level should be much higher than your estradiol level--which would be low.

When menopause is evident and fibroids are growing and the endometrial lining is thickened, it can be a cause for concern. But don't panic! You never want to waste a good painic! (Oh yes, I know, much easier said than done! )

If you are concerned about malignancy issues, I would recommend that you find out if you can be referred to a gynecological oncologist. Those doctors are the ones who are the most knowledgeable regarding your risks. And never hesitate to seek additional opinions to help you know what is best for you!

You don't want to to head into this surgery if it is not the best choice for you. There may be alternatives you can consider if you are dealing with a benign situation. While an aromatase inhibitors are only FDA approved for postmenopausal women with breast cancer, there are studies and trials being done to see if they will be beneficial for treating other issues. So it won't hurt to ask about this treatment, but don't be surprised if you aren't able to find much response at this time for your specific issues.

I know the decision to have a hysterectomy is a big one and not always an easy one to make! Even weighing all the pros and cons, it is not always a black and white decision! My goes out to you as you work with your medical teams to determine what is right for you at this time!

Unread 04-26-2010, 07:17 AM
Re: Post menopausal ov cyst & fibroid = Hysterectomy??

Thanks both of you for your response. This is a great site with a lot of information. Kimmie, the presentation does sound similar. My Gyn referred me to a surgeon who specializes in LAVH for evaluation. She (my Gyn) said she considers this a benign situation. I asked her about the da Vinci surgery, but she said if the surgeon agreed that it seemed to be benign, the LAVH would be much less invasive for me. I see the new doc Wednesday. And I think your suggestion about talking to my PCP is a great one! I really like my GYN, she is all about total wellness, nutrition, etc. She always takes the most natural approach to every situation. So for her to recommend the surgery has some meaning to me. I have used my PCP for 15 years, and he asked to see my results after the D&C (which were good ). So after talking with the surgical gyn, I think I will see my primary with all my records and let him weigh in! Great suggestion, sometimes we get all bogged down and don't think of these options!
To Weiser, yes I have been on the wild ride for a number of years. My old gyn was old school, did not check my hormone levels, basically told me to live with it. No help for hot flashes, insomia, heavy erratic periods,etc, etc. I went to him for what I now know if estogen dominance, (VERY swollen tender breasts for 4 months straight) and he gave me a scrip for Danacrine. I didn't fill it, looked it up, and when I found out what it was and the side effects, decided it was time for a new doctor.
My new (current) gyn immediately did a battery of tests for hormones, thyroid, etc. Two tests, 6 months apart. Both showed the FSH in the postmenopausal range. Estradiol was also in the postmenopausal range.
Because of that, it concerns me a little about the changes which have occurred. However, after reading so many posts on here, I realize that although it's not normal, sometimes it just happens with no malignancy. I think sometimes I go straight to the bad stuff - However, my brother died at the age of 41 with colon cancer, and my mother is now fighting lung cancer. So I have witnessed first hand what can go wrong. However, I still think that this situation will be fine.
I just want to make the right decision on what to do - I know there's no going back!
I will check out the aromatase inhibitors which Xen also mentioned... Thanks to all!

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