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Ask Dr. Norm S. Your Own Question
Dr. Norm S.
Dr. Norm S., Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 11252
Experience:  Over 30 years of experience in OB/GYN practice, including teaching students. Fellow of American Board of Obstetrics and Gynecology.
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I was diagnosed with pcos in 1994, after struggling to

Resolved Question:

I was diagnosed with pcos in 1994, after struggling to conceive I now have 2 healthy boys aged 8 & 5.
My periods got heavier and more painful to point of labour pains and was diagnosed with adenomyosis in 2014, although the ovaries looked to be free of pcos.
I had the mirena coil fitted in Jan 2015 and get light bleeding and about a 50% reduction in cramping, since early this year, I've had lower right lumbar pain which comes into my hip and right pelvis. Had bloods done including CA125 which came back at 94 (blood test on day 1 of "period"). I'm now having transvaginal and pelvic US & being referred back to GYn, should I be concerned?
Submitted: 1 year ago.
Category: OB GYN
Customer: replied 1 year ago.
I've also gained 10lbs in the past year and seen an increase in unwanted facial hair growth.
Expert:  Dr. Norm S. replied 1 year ago.

When was your last pelvic ultrasound, and how did the ovaries look?

How was the adenomyosis diagnosed?

Have you had a laparoscopy?

Do you take any medications?

Have you seen an orthopedic doctor? Thank you.

Customer: replied 1 year ago.
Last scan was 2014 in October, diagnosed adenomyosis by MRI with "Venetian blind" type lines in uterus. Never had a laparoscopy although did have a camera inserted into uterus in Jan 2015 and a sample of lining taken at the same time as mirena coil fitted. I don't take any medications and I haven't seen an orthopaedic doctor. Many thanks
Customer: replied 1 year ago.
Sorry not MRI, the early pregnancy ultrasound scanner at the hospital
Customer: replied 1 year ago.
Ovaries were normal
Expert:  Dr. Norm S. replied 1 year ago.

Thanks for all that information.

The CA 125 test is very non-specific. Usually we do it after finding an ovarian tumor, to help to guess whether the tumor is cancer or not. Most women with an elevated CA 125 don't have cancer, since many things can cause it to be elevated. However, 94 is high, so it's at least worrisome.

An ultrasound will tell you a great deal, since if there is no ovarian enlargement, then ovarian cancer is highly unlikely.

Endometriosis is one of the many conditions associated with an elevated CA 125, and endometriosis cannot be diagnosed or ruled out by ultrasound or MRI. It requires looking into the pelvis by laparoscopy.

Increased facial hair growth and weight gain are more suggestive of PCOS than of cancer.

Even doing the CA 125 blood test during a period can cause elevation, although not to that level. However, endometriosis plus doing the test during a period could, I believe.

So the ultrasound will help you to know whether you should be concerned.

Customer: replied 1 year ago.
I have booked a private ultrasound this afternoon, I was hoping you could confirm if the adenomyosis would possibly contribute to an increased CA125 reading, many thanks.
Expert:  Dr. Norm S. replied 1 year ago.

There was a report of a woman with adenomyosis and a CA 125 level of 6000. She had hysterectomy and removal of her ovaries, and no cancer was found.

Expert:  Dr. Norm S. replied 1 year ago.

I think that level was unusual, but adenomyosis more typically can cause CA 125 levels near 100.

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