I am a 54-year-old woman, most likely postmenopausal with no way to tell for sure as I had an endometrial ablation in the middle of menopause 2.5 yrs. ago (due to a long history of menorrhagia that continued to worsen). I have been on HRT for about 2 years, using a 0.075 mg/day estradiol patch with a transdermal compounded progesterone cream 100 mg/day, 15 days/month. I also have a 16-year history of ovarian cysts on the right ovary, which were never specifically diagnosed as to type, even though I'd had several ultrasounds in previous years.
I have now developed and been diagnosed with a "chocolate cyst" in the right ovary, which I am told is generally caused by endometriosis. Interestingly, I have been checked for endometriosis numerous times in the past due to the ongoing menorrhagia. However, it was never seen on any ultrasounds and I had no symptoms other than the menorrhagia, so it was ruled out.
Also, my recent ultrasound revealed a few areas of slight thickening in my uterus, which the Dr. feels is related to my HRT. He wasn't worried about it just yet, but advised me to change to oral Prometrium vs. the transdermal cream, as he feels the cream may not be getting fully absorbed by my body. I have had no spotting, but did experience some mild cramping for a few days just recently.
Overall, my GYN feels the cyst will resolve on its own, and unless I experience any further pain or symptoms, he ordered a followup ultrasound in 3 mos. to check it. He explained that if the cyst hasn't resolved or has returned, he will want to remove the ovary then. He also wants to check the thickening of the lining at that time to see if there is any change.
My questions now are:
1. Is it possible to develop a chocolate cyst by any other means than endometriosis? What might cause such a cyst in a menopausal or postmenopausal woman?
2. And with regard to the endometrium, it is wise to do nothing at this point and wait to see how it looks in 3 mos.? With a history of having had a blood clot in my leg some-30 years ago (related to my birth control pills at the time), is it even wise to consider taking Prometrium? I did continue on lower-dose BC for several years after the blood clot with no recurrence, and had 2 normal, uneventful pregnancies since then, so I don't know if clotting is even a concern anymore. I also take 2 low-dose aspirin/day for general health, and wonder if that gives me any added protection against potential clots.