22nd November 2007
Hello CynwithCIN,
What you are describing sounds like the functioning of a perfectly healthy female body ! Follicles and small functional cysts that come and go like the ones you are describing are perfectly normal. You had mentioned a 4 cm cystic lesion on your right ovary that seemed to persist for some time (going to 3.5 cm .. then 3.2 cm etc..) but then resolved. I assume that none of these cysts look suspicious and are all simple cysts, correct ?
Now as to the fact that you are on the pill (ie. an "anti-ovulant") and that you have persistent pain, that's another matter and perhaps I can shed some light on this for you with my own experience. I have been taking the triphasil birthcontrol pill continuously since the age of 20 (I am now 41). I had never experienced any problems and previous to the pill, I too used to have extremely painful periods and horrible acne which resolved with the triphasil. When I was in my late 30's, I expressed concern to my doctor about being on the pill at my age and he told me that although with the more modern low dose pills it is no longer dangerous right up until the age of menopause, I may be more comfortable switching to one of the ultra low dose formulas such as Alesse. This sounded prudent to me and I began taking Alesse. As soon as I switched, I started to experience a gamut of strange sensations in my pelvic region varying from menstrual type cramps to a sort of pulling and stretching sensation to a mild pressure in my lower abdomen (under the bellybutton). Also, I would sometimes have a very light period and sometimes miss it altogether (I realize that with the pill we are only experiencing withdrawal bleeding and not actually shedding our lining .. but still). I knew that the first few months on the pill (or on a new pill) would present with some adjustment so I stuck with it but after a few months of this, I became really scared and decided to go back to my Triphasil. Everything calmed down almost immediately and I threw my ultrolow dose pills into the trashcan. This past August, while on my regular pills and right after I began to experience irregular breakthrough bleeding, I also began to experience that same mild cramping pain and pressure in the pelvic area in addition to some of those strange pulling sensations. Also, right before the bleeding episode, I had a distinct sharp pain which travelled from left to right (to me this implies that I may have been ovulating).
Recently I have been reading many medical articles that state that with the low dose and now the newest ultralow dose pills, ovulation is definitely still occuring. This is especially the case during the seven day withdrawal period where no hormones are given and during which time they can actually see follicles begin to form. Of course contraception is still completely reliable due to the fact that the endometrium is being kept at such a thin stripe (with all of the progesterone) that the egg (even if fertilized) cannot embed itself in the uterine lining and begin to grow. So as you can see, ovulation can definitely still be happening despite your being on the pill.
In my case, I suspect that all of those pains and sensations that I was experiencing when I switched to the ultralow dose pill and quite recently when my regular pill began to fail and cause breakthrough bleeding problems, had to do with ovulation and that my now rather large cyst actually formed (or at least began) while I was on the pill and not as soon as I got off of it. Of course, not having had an ultrasound prior to going off the pill, I have no way of proving this but having lived inside this body for over 40 years, I think I know what feels normal and what does not (of course aging can present new challenges). I have heard that in such cases and in cases of breakthrough bleeding, doctors sometimes give stronger anti-ovulants or supplement with more estrogen .. there are even estrogen hormone pills that can be given during the 7 day breakthrough bleeding period to reduce ovulation. I am definitely not happy with this option as we all know of the cancer causing effects too much estrogen can cause. How do they know how much estrogen is enough or too much ? Too much of even a good thing is still too much and our bodies need to maintain the right balance in order to work properly.
In regards to my current cystic situation, my general practioner left a message on my machine yesterday saying that the most recent followup ultrasound is not something to worry about because there has been no increase in size (true this is definitely a plus). I am still waiting to hear from my gynecologist and I suspect that we will most likely end up opting for further monitoring before deciding to go to surgery. Since I suspect that this cyst occurred around mid to end of August (when I had that bout of pain and discomfort), I have no problem with giving it a little more time to resolve on its own, provided we can keep an eye on it. In addition, I have only been off the pill for the past three cycles so if the pill was the cause of some sort of hormone imbalance that caused the cyst to form, then it is only fair to give my body a chance to try to correct the problem on its own first. If the problem began as soon as I got off the pill (ie. overstimulation of the ovaries) then again I need to give the body a chance first.
The sooner the medical profession decides to begin to monitor women for hormone imbalances and to study how these factors influence gynecological problems the better off we will ALL be. I hope this has helped to shed some light on your own situation. Keep us posted.
What you are describing sounds like the functioning of a perfectly healthy female body ! Follicles and small functional cysts that come and go like the ones you are describing are perfectly normal. You had mentioned a 4 cm cystic lesion on your right ovary that seemed to persist for some time (going to 3.5 cm .. then 3.2 cm etc..) but then resolved. I assume that none of these cysts look suspicious and are all simple cysts, correct ?
Now as to the fact that you are on the pill (ie. an "anti-ovulant") and that you have persistent pain, that's another matter and perhaps I can shed some light on this for you with my own experience. I have been taking the triphasil birthcontrol pill continuously since the age of 20 (I am now 41). I had never experienced any problems and previous to the pill, I too used to have extremely painful periods and horrible acne which resolved with the triphasil. When I was in my late 30's, I expressed concern to my doctor about being on the pill at my age and he told me that although with the more modern low dose pills it is no longer dangerous right up until the age of menopause, I may be more comfortable switching to one of the ultra low dose formulas such as Alesse. This sounded prudent to me and I began taking Alesse. As soon as I switched, I started to experience a gamut of strange sensations in my pelvic region varying from menstrual type cramps to a sort of pulling and stretching sensation to a mild pressure in my lower abdomen (under the bellybutton). Also, I would sometimes have a very light period and sometimes miss it altogether (I realize that with the pill we are only experiencing withdrawal bleeding and not actually shedding our lining .. but still). I knew that the first few months on the pill (or on a new pill) would present with some adjustment so I stuck with it but after a few months of this, I became really scared and decided to go back to my Triphasil. Everything calmed down almost immediately and I threw my ultrolow dose pills into the trashcan. This past August, while on my regular pills and right after I began to experience irregular breakthrough bleeding, I also began to experience that same mild cramping pain and pressure in the pelvic area in addition to some of those strange pulling sensations. Also, right before the bleeding episode, I had a distinct sharp pain which travelled from left to right (to me this implies that I may have been ovulating).
Recently I have been reading many medical articles that state that with the low dose and now the newest ultralow dose pills, ovulation is definitely still occuring. This is especially the case during the seven day withdrawal period where no hormones are given and during which time they can actually see follicles begin to form. Of course contraception is still completely reliable due to the fact that the endometrium is being kept at such a thin stripe (with all of the progesterone) that the egg (even if fertilized) cannot embed itself in the uterine lining and begin to grow. So as you can see, ovulation can definitely still be happening despite your being on the pill.
In my case, I suspect that all of those pains and sensations that I was experiencing when I switched to the ultralow dose pill and quite recently when my regular pill began to fail and cause breakthrough bleeding problems, had to do with ovulation and that my now rather large cyst actually formed (or at least began) while I was on the pill and not as soon as I got off of it. Of course, not having had an ultrasound prior to going off the pill, I have no way of proving this but having lived inside this body for over 40 years, I think I know what feels normal and what does not (of course aging can present new challenges). I have heard that in such cases and in cases of breakthrough bleeding, doctors sometimes give stronger anti-ovulants or supplement with more estrogen .. there are even estrogen hormone pills that can be given during the 7 day breakthrough bleeding period to reduce ovulation. I am definitely not happy with this option as we all know of the cancer causing effects too much estrogen can cause. How do they know how much estrogen is enough or too much ? Too much of even a good thing is still too much and our bodies need to maintain the right balance in order to work properly.
In regards to my current cystic situation, my general practioner left a message on my machine yesterday saying that the most recent followup ultrasound is not something to worry about because there has been no increase in size (true this is definitely a plus). I am still waiting to hear from my gynecologist and I suspect that we will most likely end up opting for further monitoring before deciding to go to surgery. Since I suspect that this cyst occurred around mid to end of August (when I had that bout of pain and discomfort), I have no problem with giving it a little more time to resolve on its own, provided we can keep an eye on it. In addition, I have only been off the pill for the past three cycles so if the pill was the cause of some sort of hormone imbalance that caused the cyst to form, then it is only fair to give my body a chance to try to correct the problem on its own first. If the problem began as soon as I got off the pill (ie. overstimulation of the ovaries) then again I need to give the body a chance first.
The sooner the medical profession decides to begin to monitor women for hormone imbalances and to study how these factors influence gynecological problems the better off we will ALL be. I hope this has helped to shed some light on your own situation. Keep us posted.