Large (?) dominant follicle, no free fluid seen, etc

I recently had ANOTHER ultrasound done with the following results:
Findings:  The uterus measures 12.9 x 6.6 x 4.7 cm.  The endometrial stripe is 2.2 cm.  The right ovary measures 3.3 x 3.7 x 1.5 cm and the left ovary measures 3.8 x 4.1 x 3.1 cm.
The uterus has a normal echotexture.  There is a subserosal mass off the left side of the uterus, measuring approximately 3 x 2.7 x 2.7 cm.  This is essentially stable in size compared to the previous exam.  There are small follicles see in both ovaries.  There is a dominant follicle noted on the left side measuring 2.7 x 2.1 cm.  No free fluid seen.  There is a small paraovarian cyst seen adjacent to the right ovary measuring 13 x 15 mm.

CONCLUSION:  1. Stable uterine fibroid ; 2.  Bilteral ovarian cysts

I have an appt with the gyn, but I would like to be as prepared as possible for appt.  Other symptoms: HEAVY menstruation for over a week and strong, localized pain on the left side with menstruation.  I have found multiple references online, but still, my questions are these:

1. Related to fibroid:  I know with the size of my uterus, I am not a good candidate for oblation (ablation).  Being diabetic, I am not a good candidate for birth control.  The doctors are not keen on doing a hysterectomy (41 years old).  If the fibroid is relatively stable, is it reasonable to just tolerate the pain and heavy bleeding with menstruation?
2.  Dominant follicle seems abnormally big related to what I've read as normal.  Is this an accurrate assessment?
3.  "No free fluid seen." -- Does this refer to inside the dominant follicle or outside the organ structures?
4.  My understanding is that paraovarian cysts are relatively innocuous.  Is this correct?
5. Can a fibroid cause abnormal hormone fluctuations and/or levels?
6.  Can either/both of these types of cysts cause abnormal hormone fluctuations and/or levels?

WOW!  I didn;t realize I had so many questions.  Thank you in advance for any information/answers you can help me with!

[Annekathryn Goodman, M.D.]

Hi There
first of all you need a biopsy of the lining of your uterus. An endometrial stripe of 2.2 is too thick.With your history of heavy bleeding, you may have a poly or a precancerous condition in the lining


1. Related to fibroid:  If the fibroid is relatively stable, is it reasonable to just tolerate the pain and heavy bleeding with menstruation?
yes

2.  Dominant follicle seems abnormally big related to what I've read as normal.  Is this an accurrate assessment?
no, seems fine

3.  "No free fluid seen." -- Does this refer to inside the dominant follicle or outside the organ structures?
that is a normal finding. if you had a lot of fluid, that would be abnormal and would be called ascites. Ia little bit of fluid around the time of ovulation is fine


4.  My understanding is that paraovarian cysts are relatively innocuous.  Is this correct?
yes

5. Can a fibroid cause abnormal hormone fluctuations and/or levels?
no

6.  Can either/both of these types of cysts cause abnormal hormone fluctuations and/or levels?
if the cysts are not related to ovulation, yes they might cause more estrogen secretion

best wishes

[Jenzer]

Thank you for your response!  i actually had a biopsy done a little while ago, but I will follow up with my gyn.  Thank you again, so much!