Brief Answer: Do not worry Detailed Answer: Hello and welcome to HCM, I am Dr Nilajkumar a consultant gynecologist and I will be helping you in your queries. The lump in the labia can be a bartholins cyst [ cyst of the bartholins gland due to blocked duct of the gland], Infection of the hair follicle [folliculitis], a viral wart due to HPV or any other lump unrelated to genital organs like a lipoma [ non cancerous tumor of fat cells]. So it will need an examination to confirm the diagnosis. The bulky ovaries are most likely due to endometriosis. Endometriosis if involves the ovaries leads to thickening of their surface and hence trapping of follicles leading to anovulation. The pain in intercourse and during periods is also due to endometriosis as well as may be due to post surgical adhesions. The treatment of endometriosis depends upon the patients desires. If a pregnancy is desired, laproscopy to remove implants and release tubes is resorted to. Pregnancy most of the time cures the implants and hence is a very good treatment for enodmetriosis. However conception may be difficult due to adhesions and ovulation problems. If pregnancy is not deisred but want the uterus to be kept, drugs like progesterone preparations, danazole and Gn Rh analogues are used to decrease the implants. Danazole causes hirsuitism and Gn Rh analogues produce symptoms of menopause and osteoporosis hence are used only for a short term. If child bearing is not desired, hysterectomy offers the best treatment. It is slightly difficult as there are adhesions but provides a lot of pain relief. I suggest that you visit your gynecologist, get an examination and a vaginal swab test to look for reason of white discharge. Most likely it may be due to an infection of a cervical erosion [ inflammed cervix]. Antibiotics will help in treatment and will be prescribed by your doctor. The labial lump will also be examined by her. If it is a bartholins cysts it will need surgical removal. Folliculitis may need drainage or just be managed with antibiotics that will also help in the vaginal discharge. Also discuss the treatment option for endometriosis and choose the best one suited for you. Do not worry. I understand that you have multiple issues. But they can be managed. Endometriosis must be managed aggressively as every menstrual cycle aggravates it. So just visit your gynec early and choose a treatment option best suited for you. Thanks for using HCM. Have a good day. Dr Nilajkumar Bagde Consultant Obstetrics and Gynecology

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Brief Answer: Follicles are small Detailed Answer: Hello and welcome back, The follicles in the ovary as I have already explained are most likely due to ova trapping leading to non ovulation or due to endometriotic implants producing cysts. The size of the biggest follicle is 3.6 cm which is not very big. Any cyst larger than 5 -6 cm needs investigation. Cysts below this size are common and do not need an investigation. Also abnormalities like presence of excresences, papillae, irregular contour, septae favor malignancy. So see if these are mentioned in the report. They are most likely chocolate cysts seen in endometriosis. Other tests to detect cancer in the cysts like a blood CA 125 may not be helpful in your case as it is also positive in endometriosis. However if you are very much concerned and feel that something might be wrong, get a CA 125, alpha feto protein, beta HCG and LDH test done. These are all markers of ovarian cancer. The results of the CA 125 must be interpreted with caution in your case. If you are having weakness and fatigue, other conditions like hyperthyroidism, anemia must be ruled out. Weakness and fatigue, weight loss, breast pain are all very non specific and are seen almost in any disease including cancer which may not necessarily be in the ovary. So an examination will be able to better diagnose the condition. The loss of balance however is a thing of concern. It may be due to anemia or blood pressure issues, ear problems or a nervous system abnormality. Again only an examination will help in this case as possibilities are many. So I suggest that you get an examination by a doctor [and be sure to narrate all your symptoms to help in diagnosis ]at the earliest and then decide the line of investigations out of the list I have mentioned that would be most relevant to the examination findings. Hope this helped. I understand that you are having problems. But please get an examination and investigations and you will be alright. Dr Nilajkumar Bagde

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