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What Does My Ultrasound Scan Test Report Indicate?
Question: My daughter is 19 years old and for the first time her periods are delayed by 6 days. she does not have any heaviness or pain or any other discomfort. Her height is 5 feet 5 inches and weight is 58.5 KG. The gynaecologist suggested an ultra sound pelvic scan. The scan report reads like this : Both Ovaries show multiple small peripherally arranged follicles. Right ovary measures 49x28 mm and shows a clear cyst measuring 27x27 mm retention cyst. No evidence of internal septation/solid mural nodule seen. Left ovary measures 27x25x17mm ( Volume 5.5CC. No free fluid seen in the pouch of XXXXXXX Impression: Bilateral polysystic Ovaies and right ovarian retention cyst.
Is there any cause to worry? Or these cysts may disappear on their own? Please let me know.
Is there any cause to worry? Or these cysts may disappear on their own? Please let me know.
Brief Answer:
more or less a normal scan...no PCOS
Detailed Answer:
Hello,
Thanks for the query to HCM for an opinion,
At 19yrs of age , if this is the first time when your daughter has had delay of 6 days in her menses then considering the ultrasound report ( which i believe is being done recently after the menses had stopped, i.e in follicular phase), the presence of small peripherally arranged follicles can be a common finding and don't really relate to PCOS unless there are other clinical parameters of diagnosis like hirsutism, hyperandrogenemia and even obesity induced insulin resistance are present.
The volume of the left ovary is less than 10cc which is normal and the presence of a retention cyst less than 3 cm don't require any intervention as it may resolve itself in next few cycles.
The delay at her age can be due to hormonal maturation or most commonly due to stress induced hormonal imbalance ( which is high at this age- emotional, physical, mental, social , psychological stressors all can contribute to the delay).
It is suggested that she should maintain a calendar and chart her next 2 cycles to actually arrive at a diagnosis if the present delay was hormonal or organic. A repeat ultrasound after 2 months advised to evaluate the size to the retention cyst ( it may just have resolved naturally by then).
So presently no active intervention required and also she cannot be labelled as PCOD case either with the USG findings. A wait and watch approach is advised for next 2 months at present.
Regards
more or less a normal scan...no PCOS
Detailed Answer:
Hello,
Thanks for the query to HCM for an opinion,
At 19yrs of age , if this is the first time when your daughter has had delay of 6 days in her menses then considering the ultrasound report ( which i believe is being done recently after the menses had stopped, i.e in follicular phase), the presence of small peripherally arranged follicles can be a common finding and don't really relate to PCOS unless there are other clinical parameters of diagnosis like hirsutism, hyperandrogenemia and even obesity induced insulin resistance are present.
The volume of the left ovary is less than 10cc which is normal and the presence of a retention cyst less than 3 cm don't require any intervention as it may resolve itself in next few cycles.
The delay at her age can be due to hormonal maturation or most commonly due to stress induced hormonal imbalance ( which is high at this age- emotional, physical, mental, social , psychological stressors all can contribute to the delay).
It is suggested that she should maintain a calendar and chart her next 2 cycles to actually arrive at a diagnosis if the present delay was hormonal or organic. A repeat ultrasound after 2 months advised to evaluate the size to the retention cyst ( it may just have resolved naturally by then).
So presently no active intervention required and also she cannot be labelled as PCOD case either with the USG findings. A wait and watch approach is advised for next 2 months at present.
Regards
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Dear Doctor,
thank you for this clear reply. It makes a lot of things clear to me. However, today I met her gyn with the report and she is asking me to give her pills for 5 days to induce bleeding. She said it is a life long condition and her ovulation will be very erratic. I need your opinion on this. I consulted today itself another gyn and she said like you have advised to wait and watch and not to worry since it is the first time she has skipped her period.
Please let me know how I go about it. Should I or should I not go in for induced bleeding at this stage. Today is the 7 day of her missed period.
Thank you very much
Regards,
thank you for this clear reply. It makes a lot of things clear to me. However, today I met her gyn with the report and she is asking me to give her pills for 5 days to induce bleeding. She said it is a life long condition and her ovulation will be very erratic. I need your opinion on this. I consulted today itself another gyn and she said like you have advised to wait and watch and not to worry since it is the first time she has skipped her period.
Please let me know how I go about it. Should I or should I not go in for induced bleeding at this stage. Today is the 7 day of her missed period.
Thank you very much
Regards,
Brief Answer:
answered
Detailed Answer:
Hello,
Thanks for the follow up.
The best would be to wait for another week i.e 15 days post missed period to allow her menses to start naturally . if they don't then she may have to be given a withdrawal bleed with progesterone pills to resume her menses.
but the crux in PCOS is to maintain a healthy lifestyle with balanced eating habits, exercise, adequate hydration and weight loss. This helps reduce insulin resistance and promote ovulation and regularises menses naturally. This can be tried for 6 months and if still doesn't work then she may have to be placed on low dose oral contraceptive pills like TAB GINETTE for atleast 6 months to view a desirable response.
Regards
answered
Detailed Answer:
Hello,
Thanks for the follow up.
The best would be to wait for another week i.e 15 days post missed period to allow her menses to start naturally . if they don't then she may have to be given a withdrawal bleed with progesterone pills to resume her menses.
but the crux in PCOS is to maintain a healthy lifestyle with balanced eating habits, exercise, adequate hydration and weight loss. This helps reduce insulin resistance and promote ovulation and regularises menses naturally. This can be tried for 6 months and if still doesn't work then she may have to be placed on low dose oral contraceptive pills like TAB GINETTE for atleast 6 months to view a desirable response.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Thanks for your prompt reply. She has gotten her menses today without any help of any pill. So the delay was for 7 days. As in earlier response you indicated that there is no PCOS for my daughter and the report is more or less normal. Do you think her getting menses naturally further substantiate your interpretation of the reports. Also shall I go for another scan to compare the results? If so , can you suggest when? We will take care of her life style changes, thanks for alerting us.
Look forward to hearing from you,
Regards
Thanks for your prompt reply. She has gotten her menses today without any help of any pill. So the delay was for 7 days. As in earlier response you indicated that there is no PCOS for my daughter and the report is more or less normal. Do you think her getting menses naturally further substantiate your interpretation of the reports. Also shall I go for another scan to compare the results? If so , can you suggest when? We will take care of her life style changes, thanks for alerting us.
Look forward to hearing from you,
Regards
Brief Answer:
answered
Detailed Answer:
Hello,
Good to know that she has started with her menses. Truly speaking just one single episode of delayed menses by 7 days doesn't qualify for a diagnosis of PCOS when other clinical criteria are not met. So this delay is probably stress induced and hence it is suggested that she should maintain a menstrual calendar for at least next 3 months and this shall help in understanding her menstrual pattern in a much better way.
There is no active treatment which is required for her as of now, just watch for next few cycles and the pattern is continued then she would require a hormonal profile, but maintain a healthy lifestyle for her. It would be indeed helpful and she should be well hydrated, water is the best stress buster.
Regards
answered
Detailed Answer:
Hello,
Good to know that she has started with her menses. Truly speaking just one single episode of delayed menses by 7 days doesn't qualify for a diagnosis of PCOS when other clinical criteria are not met. So this delay is probably stress induced and hence it is suggested that she should maintain a menstrual calendar for at least next 3 months and this shall help in understanding her menstrual pattern in a much better way.
There is no active treatment which is required for her as of now, just watch for next few cycles and the pattern is continued then she would require a hormonal profile, but maintain a healthy lifestyle for her. It would be indeed helpful and she should be well hydrated, water is the best stress buster.
Regards
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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