Dear Robin: “My recent ultrasound showed cysts in both ovaries and a huge mass behind my uterus. I have history of ovarian cysts, had one drained a few years back. My obgyne recommended hormone pills to address the cysts & mass. I am afraid of using these pills. What to do?” ~ Angela
Dear Angela: PCOS cannot be diagnosed with ultrasound. Cysts are undeveloped follicles that grow slightly larger than normal instead of reabsorbing back into your ovaries because no ovulation happened that month.
So most women could have an abnormal ultrasound at any given time in her life if she didn’t ovulate that month. But that doesn’t mean she has PCOS because polycystic ovaries are not specific to PCOS.
Your ovaries change every month depending on what’s going on with your cycle, although it sounds like you have been monitoring them for quite some time. I am curious as to what other symptoms you are noticing?
You do not specify enough about the “huge mass” behind your uterus for me to give you specific information here.
here are three possible things happening:
1. Uterine fibroids: a growth of uterine muscle (it’s benign) caused by too much estrogen for the amount of progesterone you have.
2. Adenomyosis: parts of your uterine lining actually grow into the muscle of your uterus.
3. Endometriosis: when bits of uterine tissue actually grow outside or your uterus – actually anywhere in the body including your bowel and bladder.
Symptoms of uterine fibroids may include heavy bleeding, pelvic discomfort and frequent urination due to pressure on the bladder.
Symptoms of adenomyosis may include more severe pelvic pain, abdominal distention and very heavy periods.
Symptoms of endometriosis may include severe period pain, or pain throughout your pelvis to include your legs, bladder or rectum. You could have pain all the time, or none at all. In this case look for other symptoms like low-grade fever, abdominal bloating, bladder problems, bleeding between periods, infertility and frequent miscarriage, and nausea and vomiting.
It’s important to work with a doctor who can identify exactly what you have going on so you can address it appropriately.
In all cases, though, you have to reduce inflammation, balance insulin and blood sugar, and clean up your gut (digestive tract).\
This means removing foods that cause inflammation like dairy, gluten, sugar and alcohol.
Replacing missing nutrients that can help to build progesterone, reduce stress and support lowering inflammation are all very important – zinc, magnesium, vitamin D, probiotics, B vitamins, fiber and many more are critical to supporting your body to get balanced.
Testing your hormones will give you some critical information as to what hormone pathways may be driving the recurring cysts and mass. For example, low progesterone, high insulin, poor estrogen metabolism, etc. Take a look at the DUTCH Complete webinar here (you’ll have to sign in) as it will be super helpful in making a decision on nutrients, lifestyle and hormones.<
One example that the DUTCH test would be critical for is knowing how you are metabolizing your estrogens. This information alone could make a huge difference for you as it has for me and many others.
Bioidentical hormones can be helpful but it depends on which condition, and it also depends on how you take care of yourself.
Keep me posted Angela. You’re on your way to figuring this out. ~ Robin
Wondering if the symptoms you are suffering with could be PCOS?
If you’re not sure, click here to take the PCOS test
Next Steps
- Take the PCOS Quiz!  Get your score and assess your hormone health risks.
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