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Tashalynn2001 posted:
Here is a bit of background before I ask my question. My first day of my LMP was 12/3/12. I take Apri for 21 days and start a new pack during the time I should take the inactive pills. 4 months on, next month withdrawal bleeding. Ive never missed a pill and havent taken antibiotics for quite some time. Last Sunday(1/27/13), I started having sharp pains by my right ovary. The pain can be felt in my my right low back as well. I had a pap that Wednesday and my dr thought I might have an ovarian cyst and scheduled an ultrasound. I went today(2/5) for the ultrasound. The tech looked at the right ovary, uterus and left ovary. He spent most of the scan looking at my left ovary. He asked me 3 different times when my last period was and looked confused every time I told him. He also asked for complete details on the severity of my periods. Just wondering if anyone had any thoughts as to what he saw or was so perplexed by? He said my dr would have results in a couple of days. I'm sorta scared. Thanks for the help.
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Jane Harrison Hohner, RN, RNP responded:
Dear Tashalynn: Thanks for your patience in awaiting a reply. So you are on continuous birth control pills (BCPs) with a quarterly withdrawal bleed. With that regimen one should have some suppressive effects against the development of simple ovarian cysts. Still it is reasonable, if a woman has right lower quadrant pain upon exam, to rule out a cyst by ultrasound.

It's hard to know what the tech "saw" that caused him to keep refocusing on the left ovary. It sounds like he did not visualize any cyst on the right ovary. A couple of POSSIBLE explanations MIGHT include:

1. A left sided cyst despite the use of the BCP.

2. A left sided cyst which had the appearance of an endometrioma (cyst caused by endometriosis). Such cysts can have a complex appearance (ie solid plus cystic features) which can look more worrisome. Women with endometriosis tend to have very severe menstrual cramps and/or chronic pelvic pain.

3. A left sided cyst (eg a dermoid cyst) which is not hormonally driven. They can be present, and undetected, for many years.

4. A left sided mass within the bowel (doubt this since there were so many menstrual questions)

His confusion about your menstrual history may just be an unfamiliarity with continuous dose BCP regimens.

Hopefully your GYN called you once they received the ultrasound results as read by the radiologist. It is within your rights as a patient to request a copy for your files at home so you can re-read the results. It can then be available if you change care providers. Feel free to write us back if you have further questions (put my name in the subject line so I can find you).

Yours,
Jane


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