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Complex Cyst: Surgery or hormones? What to do? Scared!

Hi, everyone. First-time poster (on any message board...ever!) here. I've been reading lots of posts on this site and it is comforting to see that I'm not going through this alone.  Sorry for the long rambling but here goes:

Some background: I'm 24 and have a history of irregular and painful periods (cramping that makes me bed ridden, nausea/vomiting, etc.). Though doctors have suggested endometriosis, etc. before, I have only pursued treatment in the past few months. I have recently been experiencing moderate to severe pain on the left side of my pelvis that interferes with my daily life and wanted some answers.

At my annual physical (late July, 2012), my PCP was concerned about a mass she felt on my left ovary area during my pelvic exam. My PAP also came back with irregular cells. She ordered an US (both pelvic and transvaginal) and that showed a small (2cm) complex hemorrhagic cyst on my left ovary. She said these things usually resolve themselves but I feel as though the pain is getting even worse and I'm terrified (perhaps for no reason, but still) because of the possibility of it being something more serious. (I know that 99% of cysts are benign and I'm on the younger side of things, but my family tree is riddled with colon and breast cancer as well as female reproductive difficulties).

I was referred to an OB/GYN who did another manual exam and said the mass felt bigger than the ultrasound (at this point the US was ~3weeks old). She guessed it was around 4cm and said that the previous US suggested that I had endometriosis as well. She also explained that because the cyst is interfering with proper ovulation I am estrogen-dominant and that might explain my other symptoms (depression, fibrocystic breasts, irregular periods, etc.) She ordered another US for two weeks from now and said I had a couple of treatment options. She also assured me that she wants to take a conservative approach because I do not fit the profile of anything more serious (like OVCA or PCOS). However, I'm not sure how I feel about any of my options. She said I could:

--take low-dose estrogen BC (she specifically recommended LoEstrin) to keep the endometriosis from getting worse and to prevent pregnancy (which may not be necessary as my S.O. and I barely have sex because it is so painful for me)

--take progesterone only to balance out the extra estrogen I'm making (this would not prevent pregnancy)

--undergo a laparoscopy to remove the cyst and endometrial tissue

--do nothing

I'm not sure how I feel about these options. Everything I'm reading online is confusing me. I've never taken birth control before and am terrified of the side effects (such as blood clots and stroke, which also run in my family). I'm also worried about the surgery. While I want the pain to go away, I'm not sure how well I would be able to handle a long recovery. I'm very active both at work and at play (I'm an elementary school teacher and I run 70+ miles per week in addition to ballet and tennis) and in generally good health apart from the recent pelvic problems.

I'm really scared about taking synthetic hormones and making my other symptoms (such as depression and weight gain) get worse. I'm also concerned about not being able to exercise and live my life (running is, so far, the best cure for my sad moods). Already I'm convinced I'm a crying machine and that I've gained weight from the extra estrogen even though I've been working out just as much as I always do (every day for more than an hour) and eating the same diet as before, if not less (I feel so full and bloated after I eat anything).

Maybe I'm just being a whiny baby about everything, but I figured that maybe you ladies could help me by sharing your own experiences? My female friends and relatives whom I've consulted all are giving me different advice.

SHORT VERSION: My question is this: Should I go for the surgery, take the BC, or see about getting some more tests done first?

Thanks so much to anyone who reads/responds to my post. I'm keeping everyone here in my prayers and hoping for healing and happiness to you all.

1 Responses
3185070 tn?1344704177
I went on low dose BC for irregular and painful periods and it helped a lot!  It reduces the cramping tremendously and I only bled for 3-4 days.  You are at very low risk for blood clots and/or stroke due to your age.  I had to go off the pills due to being over 40 and having high blood pressure (THAT puts you at risk for strokes!)  Hope this helps.  I have a 5 cm ovarian cyst that we are watching for a month.
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