Dear Dr. Linda,
I have posted this question to Dr. Judy as well, and I would really appreciate your opinion about this.
I am 54 and had a hysterectomy in 1998 for fibroids. Ovaries were left. I never had any hot flashes or problem until a few years ago, when I was hit with panic and anxiety, palpitations, hot flashes, shortness of breath. I have not taken HRT except for a one month trial in October 2007 of Estrace tablets, and a progesterone cream from a naturpathic doctor. Neither helped with waking up in the night several times, panic, hot flashes, so I quit them. In December 2007 I had abdominal cramping after intercourse and was found to have significant vaginal atrophy, which had never bothered me before. It just appeared. My Gyn put me on VagiFem in January 2008. He did an ultrasound in January which showed some ovarian cysts on the left ovary. He didn't expect them to get larger. He just repeated the ultrasound last week, and he was surprised that the cyst has grown (this was a transvaginal ultrasound, the first one was not). I think the VagiFem is doing this as I never had ovary problems before I started messing with hormone replacement. Since I have had a hysterectomy I don't know what stage of menopause I'm in. My FSH is pretty high according to the Gyn I am in 'ovarian failure' so does that mean I am postmenopausal? I know ovarian cancer is higher in my age group. I have no history of ovarian cancer or reproductive cancer in my family and the CA 125 was negative - BUT does this mean anything? The CA 125 isn't very accurate, but my doc seems to be not worried because the numbers on that test are low. However, the CA 125 was done in January 2008 when the cysts were small, so shouldn't he repeat the test since it has grown? Also, I don't have any discomfort in the ovary area or any symptoms of ovarian cancer. But I guess that doesn't mean anything either?
He wants to perform a laparscopic aspiration of the cyst on Feb 28. I've been reading a little about aspirating cysts and it doesn't sound like a good idea, esp. if the thing is cancerous and it ruptures and spreads in my abdomen. I then asked him if he could just remove both ovaries and he readily agreed, without telling me that it can cause a lot of problems - like higher cardiovascular disease, bone loss, etc. He also told me if he was worried, he'd bump another patient and put me in ASAP. The reason he's doing it now is because he's going on vacation and so was I
until April....I told him I wouldn't have much of a vacation worrying about all of this, so he moved the date up. I should say that I had a tiny cerebral aneurysm that (luckily) did not rupture and that I had the horrible decision to make in 2005-2006 of getting it clipped or monitoring it. I had it clipped (29 stitches on my temple to my ear) March 2006 and I am trying to not stress out because I don't want my BP going up (it's normal without pills). I recovered from that traumatic surgery ok, but still dealing with residual stress. The doctor knows this and was kind enough to feel some compassion for my dilemma. I'm maxed out from worrying for the past several years. Can't take much more of this.
What is my best method to approach this dilemma? Can I have a laparoscopy to remove the ovary with the cyst intact? I would much prefer that to an invasive abdominal incision. He can visualize the right ovary at that time as well, right?
As for the vaginal atrophy, I don't like taking VagiFem as it is HRT. It causes some discharge and I can't stay on it forever. What do you recommend to keep the tissues in good condition? Is there anything? I'm all for a holistic approach to anything if it can be done that way.
I see I've hit you with lots of stuff here, but I honestly don't know where to turn. The only medication I'm taking is Xanax .25 mg 2-3 times a day (was less before this fresh hell developed), I am not overweight and am pretty healthy.
How would you handle these two issues: ovarian cyst in post?meno woman and vaginal atrophy?
Thank you from the bottom of my heart,
"Earth is the insane asylum of the universe".