At the beginning of last year (about 3 years into my Mirena) I started getting some pains in my lower left quadrant. I’ve never really had cramps, so it was a new sensation for me. At first I thought it was gas, since I am very prone to that lol, and just ignored it and toughed it out. Then I started to bleed a bit. Nothing too much, but more than what I consider spotting. This went on for about 3 weeks and then the pinching and pulling pain started to increase. Finally I called the doctor. I was worried that my IUD had migrated and was wreaking havoc on my insides.
The doctor sent me for an ultrasound – “an” in this case refers to 2 different types: abdominal (external) and pelvic (internal). I had to go to the appointment with an empty stomach and a full bladder. Since it was fairly early in the morning the empty stomach wasn’t a big deal. The full bladder was. I followed my instructions about how much to drink and when and also the last time to pee before the ultrasound. When I arrived they confirmed that I had a full bladder. Oh boy was it ever. I felt ready to burst. It was super uncomfortable to move. Of course they were a bit late and finally it was my turn. I got all situated on the exam table for the external portion. Right away the tech tells me “Your bladder is too full”. Well no shit. I can barely move here, but followed the instructions on the sheet. She gave me a cup (which I thought was quite small) and told me to go to the bathroom, fill the cup and then stop peeing and come back. Say what?… Stop?? I gave it a shot. The pressure release was so great, but man oh man was it hard to stop. I went back to the room and she said that it was still a bit too full but she could work with it. I made a mental note to change my prep if I had to do this again. After the external portion was done she sent me back to the bathroom to void my bladder completely. Omg heaven. I was a bit worried I might end up with a UTI after this whole thing, but that’s another ballgame. The internal exam is again kinda like a PAP – knees up and open. The difference here was that I had a sheet covering me, no clamp, and the tech put the jelly directly on the camera and then handed it to me for insertion. This was nice since there were no surprises with me being the driver. Once it was in we did an under-the-sheet handover and she took her images by moving it up, down and around. Once we were done she told me I could get dressed but to wait in the room cuz she had to go talk to the dr about the images before I could go. My heart rate went through the roof. I’ve had other ultrasounds before and I know that no matter how you ask, the tech cannot and will not tell you what they see. They usually tell you the images will be sent to your physician and then you can discuss the results with them. All sorts of things went running through my head in the 5 minutes she was gone. When she returned though she said that he said it was all good and I could leave.
When I went to my doctor for follow up she said that the ultrasounds showed that my Mirena was still perfectly in place but I had a large hemorrhagic cyst on my left ovary and a smaller one on the right. The way that different fluids show in ultrasound images was how they knew it was hemorrhagic – ie. full of blood. She told me that the pain I was feeling was likely due to the extra weight tugging on the ovary as the cyst grew and the continuous bleeding would be from burst blood vessels. I was relieved that my IUD was fine, but now I had a whole new thing to start googling. The treatment plan was pretty much nothing. We would do a follow up ultrasound (oh joy) in 6-8 weeks, but unless the pain became unbearable we would leave it. Generally hemorrhagic ovarian cysts keep growing and growing until they essentially strangle themselves. Then once they “die” the body reabsorbs all of the material. Many many women have these types of cysts and never know because they usually stay small and resolve themselves in 1-2 menstrual cycles. If my pain turned up to the unbearable level it was an indication that the cyst had gotten too heavy and was potentially twisting my ovary. I crossed my fingers that I wouldn’t get to feel that phenomenon.
After my follow up I googled a bunch of things to learn more about ovarian cysts, their causes, symptoms, frequency, size etc. I also decided I would name the big one Mary – as in Bloody Mary. I felt that this was a fitting name since she was full of blood 🙂 it also made it less weird to talk about. If I was chatting with the gals at work and got a big pain I could be like “man Mary is in a mood today!” And we could laugh and it didn’t seem like I was talking about a medical condition. I could also say I was going to get Mary’s picture taken when I went for ultrasounds so that people eavesdropping didn’t start rumours that I was pregnant when they heard the mention if “ultrasound.” Mary stuck around through my follow ups and I estimated that she had been there for probably 6 months.
Then one day at work something happened. We had these rolling carts that we use for supplies and they are all over the place. I can be a bit of a klutz I admit, and I don’t always pay attention to where I am going. On this particular day I was carrying a big box and didn’t see the supply cart in front of me and I walked right into it. There was another cart and wall behind it and so instead of rolling away I got a hard stab to my left side. It stunned me for a minuted and then me and the girls had a good laugh. Not much later I was standing at a counter and felt a gush. This was a type of gush I has not felt in a long time (I stopped getting a period all together with Mirena). I made my way to the bathroom quickly and with very tight legs and small steps. At the door I avoided small talk with a friend and pretty much barged in. I looked and it was a mess. I was totally unprepared for this. I hollered through the door hoping that’s my friend was still there and had some supplies she could lend me. I ended up having to raid someone’s stash in the communal cupboard, but really I had to. I was quite concerned since I had brand new turquoise pants on and didn’t want them ruined, or my ego. I waited for a bit to see what was happening but then had to go ask my manager to leave work. When I got home I called the dr and she sent me for another ultrasound.
Well surprise surprise, this time it showed that Mary was shrinking. I told my doctor about the bleeding incident. She said it could have been burst blood vessel or a puncture. If the cyst had actually ruptured there would have been some intense pain. After that we stopped talking about Mary and talking her photo.
Fast forward a year. This is where my blog story really starts. I recently started getting pains again which told me that Mary was back from her extended vacation. At first it was more like gas again but then I noticed some bad ones when I was working out. I called the office to ask about an ultrasound but they told me they would rather I came in to talk to my dr first. While waiting on my appointment I started doing some research regarding connection between hormonal IUDs like Mirena and Jaydess with ovarian cysts. It seemed like quite a few women had both the IUD and the cysts. I honestly couldn’t find much concrete evidence, but found plenty of individual testimony. I came across one article that stated ovarian cysts as a common (greater than 10%) side effect of Jaydess, but not Mirena. I took all of my reading into consideration started wondering if Mary would move out forever if I removed my IUD. I have friends with PCOS (poly cystic ovarian syndrome) and they have to start taking hormonal forms of birth control, not stop it. Now I know that this is a different condition, but it still made things even more confusing for me. I really started leaning towards the removal. I thought that if I started having regular cycles again maybe my body would get back on track and Mary would only visit in small unnoticeable capacity like what “Normal” cysts do.
Now to my conundrum- To Remove or Not to Remove?