Decisions, decisions..

Hello!
I've been guided to this site in the past for endometriosis-related questions, and here I am again - now faced with the dreaded hyst.
My quickly-summarized story: I am 36 yrs old, and was finally diagnosed with stage 4 Endo in 2004.
I was going thru fertility treatment (unsuccessful), in 2005, and my RE had seen structures in my lower ab on ultrasounds that he kept thinking were blocked tubes. My HSG tests kept showing that they were not. He suggested we just keep an eye on them and not do anything b/c they could only be investigated via surgery - which would eliminate any possibility of conceiving.
We stopped the fertilty care, and I basically forgot the structures (he thought they were fluid from past surgery). A few weeks ago, I went to my primary care doc for a yearly exam and asked if we could do another u/s to ensure they were gone.
Had the u/s and, lo and behold, they did not show - but a 5 cm complex cyst/endometrioma on the left showed.
I was referred to a gyn, and she talked hyst, hyst, hyst.
A couple days after our meeting, I had to visit the ER with severe lower ab pains (first time in my long bout with endo). The pain subsided after a couple hrs (and morphine!).. and the CT scan showed nothing - no cysts, etc.
I had a follow-up u/s a few days later to ease my mind, as I figured the cyst ruptured (so did my gyn, who I'm sure thought I was being completely over-concerned), but I was afraid the fluid structures might now show up.
The u/s showed a host of new problems. Or rather, probs that were probably there and not found during the first u/s because this u/s was done at the gyn's office and not a random imaging location.

Now they found: the 4 cm complex endometrioma (left), a smaller 2-3 cm cyst (left), at least one complex endometrioma on the right (I saw the u/s and it looked like there were more than one - but maybe they were small normal cysts), and 2 structures that look like fluid-filled fallopian tubes (but as we know, they might not be).
So now.. I have an MRI scheduled on Tuesday to get a better idea of what is going on. My gyn said 'hyst' or MRI. I said MRI!! Hello - not rushing into a hyst.

So here I am. Trying to squelch fears that anything is cancerous (as reproductive cancers run in my family).. and wondering what in the world is going on inside my body. I know it's Endo-related, but criminy. I really don't want to have a hyst and go on HRTs (as req'd at my age from what my gyn has told me). My in-laws are docs and are terrified of my doing that. They have terrified my hubby also - telling him that my personality will change, sex will stop, I will lose my femininity.
Now no worries - I know they are a bit dramatic here.. but I've read up on HRTs, etc.. and I don't look forward to taking them for a longer period of time than they have ever been tested. Scary stuff.

Any helpful thoughts, calming ideas, etc?
I'm feeling calm now, but I will be terrified again soon when we start planning the surgery date. No matter what, the gyn wants to do a laparotomy to remove the left side. Just a matter of how much will be involved.

Sorry for the super-long post!

I am glad you found our site and I hope we can offer you some support and information!

Doing research and not jumping into a major surgery are wise decisions. We have several Endometriosis Resources you might want to read through.

I had my hyst at the age of 25 for stage IV endo. I retained my ovaries so HRT has not been a personal issue for me. However, because I could end up with a BSO in the future, I keep an eye on information regarding endo and HRT.

Estrogen is believed to feed endo, whether it be from your own ovaries, HRT, natural products with plant estogen, stored estrogen in your body fat, or even if your endo makes its own estrogen. Thus, some drs do not recommend nor will write scripts for HRT for their endo patients even if their ovaries are removed. Others have their endo patients wait a space of time before starting HRT. Thus, it is very important that you find a dr who is very experienced with endo and HRT, prior to ever having surgery. Your family background will also need to be taken into consideration as well as your own health. An endometriosis specialist might be a very good option for you, along with second opinions.

There are also many forms of HRT and it can take time to find the right balance for you, if you need it. Each of us are unique when it comes to what levels of hormones make us feel "right."

There are women who find having a lap with a skilled surgeon who can remove as much endo as possible can buy them some time before having a hyst. Others have used Lupron, Depo Provera, or other medications to treat endo.

Endo affects each of us different so there is no perfect answer or solution. And while a hyst might be right for you, as it was for me, it does not cure endo.

Many best wishes to you as you have testing and sort through information to see what is best for you. Try not to panic and in there!

s