Polycystic Ovarian Syndrome With High DHEA
Q: I recently got a pelvic transabdominal ultrasound to exclude PCOS. It was found that I have a large left-sided adnexal cyst 10.2×9.0×7.5 cm. My family doctor suggested I get another ultrasound. But I am worried. Can this be a tumor? I am in my early 20s and have high dhea-s levels. I also have signs of hirsutism. Thank you.
-By Julia
Reply:
Doesn’t look like a tumor. This appears to be a case of PCOS.
What Is PCOS?
Polycystic ovarian syndrome is a condition where numerous small cysts are present on the outer margins of the ovary. They give this organ a poly (i.e. many) cystic appearance.
The ovary swells up and become big and bulky.
Signs and Symptoms
The patient may have any of the following symptoms:
- Menstrual irregularities– This shows disturbed functioning of the ovary. The cycles may be long or there may be missed menses.
- Increased amount of male hormones in the blood. This includes testosterone and DHEA. These hormones are responsible for hirsutism. You may have acne, excess of hair on the body, deepening of the voice etc.
What is Dehydroepiandrosterone or DHEA?
DHEA is normally produced by the adrenal glands in our body. It is an anabolic hormone helping the body overcoming conditions of stress.
Its values are higher in young people (due to increased sex drive), stress related situations, illness or any other condition where the body needs an extra boost.
Why Patients With PCOS Have Increased DHEA?
This is somewhere linked with the hormone prolactin, which is produced by the pituitary. The production of the hormone is controlled, through suppression, by the hypothalamus.
A rise in prolactin leads to reduced production of reproductive hormones and increased levels of circulating DHEA.
You need to follow-up with your doctor for further treatment.
Usually, such conditions are managed by medicines. Rarely, surgery is required.
Take Care,
Buddy M.D.
Thank you for your reply to my question.
What sort of treatments are common for treating PCOS?
My doctor suggested taking birth control pills. Would this be effective? Would this affect fertility in the long-run?
Your question has been answered here.
I am 28 yrs old house wife. I have done my USG test of whole abdomen. The report is Liver mildly enlarged. Normal homogeneous echo-texture is seen. No Focal lesion is noted. Intra-hepatic biliary channels are not dilated.
Gall-bladder: Wall is smooth and regular. No Intra-luminal echo is seen.
Common Duct: Measures 3.7mm. at porta.
No intra-luminal echo is seen in supra-duodenal part
Portal Vein: Measures 10.7mm.at porta
Pancreas: Normal homogeneous echo-texture is seen. No focal lesion is noted Pancreatic duct is not dilated.
Spleen: Normal homogeneous echo-texture is seen. No focal lesion is noted Pole to pole length is 8.31cm.
Kidney: Both kidneys show normal parenchymal echo – texture with sinus echo-complex. No calculus, SOL or hydronephrotic change is seen (Rt) kidney measures 10.53cm & (Lt) kidney measures 11.30cm.
Ureter: Not dilated
U-Bladder: Wall is smooth and regular. No intra luminal echo is seen
Uterus: Uterus measures 8.87cm. x 4.29cm x 4.22 cm. Normal myometrial echo-texture with mid line endometrial echo is seen. No focal lesion is noted
Ovary: (Rt) ovary is bulky measures 3.83 cm x 2.06cm
(Lt) ovary of normal in size and echo-texture. No focal lesion is noted
(Lt) ovary measures 2.51cm x 1.44cm
Pouch of Douglus —clear.
No ascites or para-aortic lymphadenopathy is seen.
Sir my height is 5.6 cm and weight is 67kg and look bulky, surrounding my eye is dark shadow.
Please advice me the good path.
Bulky ovary needs to be evaluated further. You need to go to a gyne with all your reports.
The enlargement of the ovary may be due to some cyst formation or even malignancy. To be on safer side, get a blood test done to check the levels of CA-125. This is a tumor marker.
What are your chief symptoms/ problems? Do you have any abnormal bleeding, back ache or any other problem? Let us know for further evaluation.
There are many pcod (7-8) in my ovary but unfortunately all pcod dies.. not a single pcod rupture. I got treatment from many doctors but I couldn’t get any benefit from any side. I got nervousness from all where. So what should I do for making a strong pcod in ovary?
Are you having normal menstrual cycles?
Which is bigger when you have PCOS 13cc or 22mm? I know they were 22 mm and the last ultrasound I did was 13 cc for polycystic ovaries.
What does this say please?
The uterus was normal in size and morphology measuring 7.2 x 4.2 x 3.5 cm. Bilateral normal sized polycystic ovaries seen.
Right 13 cc Left 15 cc
Your U/S shows the presence of cysts in both your ovaries. Are you having menstrual problems?
Cyst get formed in the ovaries when there is some hormonal problem. You need treatment for this. Read above in details about the condition.
Dear Sir,
I got married in Jan this year and my mensuration cycle is normal with a cycle of 28 days. Have not yet conceived. In month of Nov, I got ultrasound done of my abdomen and the report said the following :
Uterus is Anteverted (size 6.8×3.6×4.2 cm) Shape and Echo Texture is normal. Uterine Cavity is normal. Endometrial thickness 7mm. No evidence of Uterine Mass Lesion seen.
Adenexae : There is cystic lesion measuring 5.2×3.8 cms in the RT Adenxal Area >>>> Ovarian Cyst RT
LT Ovary is normal in size. No evidence of Adenexal mass seen. Follicle of 27mm seen. POD is clear.
I am worried if I can ever get pregnant or not? I had no symptoms but is the formation of cyst of this size dangerous and life threatening? What should be the way ahead? Planning to go to a Gynecologist, but wanted to have your opinion on the same so that can ascertain if the line of treatment of Gyne is correct.
Regards
Get the cyst treated before planning conception.
The treatment would be easy. Your doctor may first try some hormonal pills and allow the cyst to regress on its own.
I am postmenopausal and had a CT scan due to ongoing right side low back pain as well as episodic pain In lower abdomen and pain in right side pelvic pain . CT scan identified this:
Left adnexal cyst measures 6.0 x 4.6 cm.
Cyst arising from the lower right kidney measuring 3.3 cm.
(I had dermoid cysts over 30 years ago ) I have an MRI scan with contrast scheduled in one week. Wondering if I should also get bloodwork for CA-125 and transvaginal ultrasound. What are the chances this is malignant?
Correction–episodic pain on left side
Considering your age, it’s better to get it done, though chances are meager.