I am 36 years old. For the last eight years, I have had three laparoscopies to remove many ovarian cysts. Two years ago, my uterus was removed due to excessive bleeding and endometriosis. Since then, I have felt great physically and mentally -- until eight weeks ago. I began experiencing mood swings, acne breakouts, abdominal swelling and bloating and a ten-pound weight gain. My blood work came back normal, but an ultrasound showed half-a-dozen fluid-filled cysts, each about an inch, on both ovaries. My OB/GYN wants to put me on low-dose birth control pills, primrose oil and B6. But enough is enough -- I want my ovaries taken out! What do you think? --Renee

When you are feeling horribly is NOT the best time to be making such major decisions as having surgery: it's difficult to think clearly and to make an informed decision if that decision is motivated by poor self-image. Your current symptoms began eight weeks ago, and you do not say you are in pain, so you have time to consider what will be best for you in the long run.

A better approach would be to at least *try* medical therapy first. Your symptoms certainly sound like androgen excess -- did you have testosterone and other hormone levels drawn? If this is the case, and it is not due to a tumor secreting high levels of androgens, then birth control pills may take care of your problems completely and without the risks of surgery. If you try the pills and they don't work, then you can always have the surgery later. Once your ovaries are gone, they are gone forever.

Ultimately the decision on what to do is yours -- it is your body, after all. There are many ramifications to having both ovaries removed, including menopause at age 36, with all that goes with it. Hormone replacement therapy is good, but it is not exactly the same. I would encourage you to sit down and talk to your doctor about what is going on. Agree on a time frame for a trial of medical therapy and on a plan for what to do if that fails. Three months is usually a reasonable amount of time to try something before moving on.