You wrote:





"Current medical status: A month back my friend had a minor accident bruised her toe and kness..nothin much to it..it started swelling in 2 days time..After a week the doctor said the knee wounds infected so put her on an antibiotic course...he changed the antibiotic 3 times in the course of a month..cos the swelling didnt come down(meanwhile she was also on medication for hormonal imbalance..once her periods start it doesnt stop so 1 years back he put her on estrogen and then after some time progestrone for 3 months and then later since nothin worked she started with ayurvedic tablets which were helping but she had to keep on takin it so she used to take both the antibiotic as well as the ayurvedic tabs) Well the wounds healed completely but the swelling never came down we went to the ortho hes asked for a scan..when the scan reports came back he asked us to consult a vascular surgeon..He diagnosed it as extensive DVT..he told us both both the major blood vessels h! ad clotted in the injured leg all the way upto the tummy and it had spread to the next leg as well..got her admitted..heparin injection were adminstered, stocking on both legs were put and we went for a scan again the next day...this time they found a cyst 5cm in diameter in the ovary...The vascular surgeon said a minor accident couldnt be the cause for such an extensive DVT not to the extent to reach upto the tummy and spread...they have doubts on whether the cause being because of all medicines shes been taking...and how should we go about the cyst treatment since the tablets she on now are blood thinners...should the cyst be treated surgically or on medication?





Current medical treatment: heparin injections for next 3 days and blood thinner tablets for next 6 months and compressed stockings to be worn on both the legs for next 2 years"





A small injury on the lower extremity can’t cause deep vein thrombosis (DVT) but when combined with large doses of estrogen and progesterone, DVT can manifest. In fact, DVT is the worst side effect of estrogen and progesterone therapy. Be sure to consult your doctor, but it seems pretty clear that you stopping the use of hormones immediately!





The ovarian cyst you are experiencing has been recently discovered but we can't be sure when it developed for the first time. If the cyst first started a long time ago it could be the reason for your prolonged and heavy periods (menorrhagia). Did your doctor take an ultrasound examination before start giving you hormonal therapy? Hormonal therapy is given for treating menorrhagia only if the reason is functional and not organic. Did your doctor exclude any organic reason (polypus, myoma, infection…) for menorrhagia before starting with hormonal therapy? When hormonal therapy showed no results the next step is curettage. The other possibility is that the hormonal therapy itself has caused the ovarian cyst.





No matter the cause, a cyst with such a large diameter (5 cm) should be removed surgically. Any surgical intervention (except for an urgent one) is contraindicated while on therapy with heparin and blood thinners because there is a risk of heavier bleeding. When therapy for DVT is finished you can remove the ovarian cyst. In the meantime, the ovarian cyst should be monitored on ultrasound. Heparin and blood thinners can make menstruation heavier than previously. You can consult your gynecologist and transfusiologist about these and other procedures.