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Dr. C.
Dr. C., Board Certified
Category: OB GYN
Satisfied Customers: 3064
Experience:  30 years of experience and an award-winning educator.
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I have been having some pelvic pain on my lower right side

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I have been having some pelvic pain on my lower right side for about a month now. I can tell its the ovary area. I've had ovarian cysts in the past so the pain is familiar. I went to my PCP who discovered my right ovary is twice the size of my left ovary and I have an ultrasound next week. Although my pain has mostly been on the lower right, I have felt it on my left a few times as well. I know that an enlarged ovary is the first sign of ovarian cancer, and I am concerned that since I have felt it on both sides, it could be a cancer that already metastasized. I'm 40 years old and have 2 children (1 at 27 & 1 at 31). My period have been pretty short and light for at least a year (about a day to day and a half). I previously went for bio-identical hormone therapy and have been told that I have almost no progesterone and extremely low testosterone (which contributes to the light periods).

My health background: no surgeries, I do have ulcerative colitis that I take Remicade I.V. infusions for, Wellbutrin for anxiety, Vyvanse for A.D.D., Xyzal for allergies, synthroid for hypothyroidism. The only other symptom I have had is hair loss for a number of years.

Any info is appreciated!

Dr. C. :

I am glad to help you. Answers are intended to provide general medical information only.

Dr. C. :

There are many explanations for pain in the pelvic area besides ovarian cancer. Unless there is a family history for ovarian and other related cancer especially at early age, the other reasons are much more likely and ovarian cancer would be last on the list of possibilities. Of course it is the most worrisome and hard not to think about until the question is settled.

Dr. C. :

Lower abdominal and pelvic pain can be hard to diagnose where it's coming from because of the way the nerves run in the area and the various organs and tissues that are located there.

Dr. C. :

Usually we do a comprehensive evaluation which includes considering causes that are gynecological, related to the ovaries and uterus. But also possibilities are referred pain from the bladder, bowel issues, scarring, ligaments, muscle spasms and back issues. Spasms of the inner back muscles located just behind the ovary are often mistaken for coming from the ovary.

Customer:

Can you give me an idea of what else could cause pain in this area as well as an enlarged ovary (twice the size of left ovary).

Dr. C. :

Also there is a valve located in the right lower quadrant that connects the small bowel with the large bowel. Often there will be pain from that.

Customer:

but if there is a finding of an enlarged ovary in the area where the pain is coming from doesn't it seem that the ovary would be causing the pain?

Dr. C. :

Differences in ovarian size are common but also it is quite possible that there actually is a cyst there. Even so, it is MUCH more likely to be benign than cancerous at this age.

Dr. C. :

Yes if there is a cyst, it may be causing the pain.

Customer:

That IS reassuring! Can a benign cyst cause the ovary to double in size

Dr. C. :

But even if there is a cyst, it may not be causing pain and other things are causing the pain.

Dr. C. :

Absolutely, non-cancerous cysts can double and triple and quadruple the size.

Dr. C. :

I have removed many benign cysts the size of grapefruits.

Customer:

Thank you!! One last question, if a cyst is causing the pain on one ovary, what could be the cause of occasional pain in the other ovary?

Dr. C. :

The most common types of cysts if you have one would be "functional", meaning the type that is supposed to release the egg each month. Sometimes the egg doesn't release and the cyst keeps growing.

Dr. C. :

Other times after the egg is released, the cyst fills with blood and enlarges.

Dr. C. :

Sometimes if there is a cyst on one side it can cause pulling of the ligaments on the other side because it pushes on the anatomy in the area.

Dr. C. :

Also bowel can be displaced by a benign large cyst changing the normal location of everything.

Customer:

okay, you have definitely helped to relief some of my anxiety!

Dr. C. :

Also if a cyst is leaking fluid or blood, the irritation can be felt on the other side.

Dr. C. :

Good. I know whenever there are cysts on the ovary people think cancer but in this age group with no family history other causes are MUCH more likely for both a cyst and pain.

Dr. C. :

Anything else?

Customer:

I just wanted to know if there could be another cause aside from cancer, because that's the only possibility my PCP gave me!

Customer:

No, that's all, thank you!

Dr. C. :

oy!

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