Severe fear of endometrial cancer in 28 year old with spotting and potential PCOS

I was put on the birth control pill (Aviane-28) about 5 or 6 months ago due to abnormal uterine bleeding. I have chin hair and my total and free testosterone used to be high. My DHEA was slightly low and prolactin was slightly high.

I've had chin hair for a few years before my hormones were tested to be imbalanced -- they were very normal, even despite the hair, until a year ago.

I'm 28 years old, a virgin, and mildly obese. I'm not sure if I have PCOS because my doctor and different specialists all give me different answers, hesitantly, yet PCOS is documented in my medical records now.

I always had regular periods since I first began menstruating. They were heavy and I had to always wear the thickest pads, but they weren't so extreme as to soak pads every hour or anything.

With PCOS, isn't there usually an absence of periods? I never had amenorrhea. Is it possible to have regular monthly periods and still not ovulate?

I started spotting in between periods about a year ago or less. One time I spotted daily for about 3 weeks.

My estrogen levels were never flagged as being high and my progesterone levels were never considered low by the test's standards.

I had another blood test for hormones very recently. My hormonal imbalances have since been corrected, and my estrogen is at the higher end of normal, I guess, and yet is higher than it was before I started birth control. My progesterone isn't flagged as being low.

My estrogen level is 555.4 pg/ml. The standard range for this test is Follicular Phase (1-12 days) 90-590 pg/mL. On the Internet, it usually mentions standard estrogen levels as being much lower, but I suppose the lab that does my tests has a different standard.

My progesterone level is 0.18 ng/mL.

Is it possible that I have estrogen dominance, even though my levels aren't flagged?

Also, I still have some intermittent spotting, though it is extremely light and mixed with normal discharge. My doctor doesn't seem concerned, even though I've been on my birth control 5-6 months now. Why would I be spotting like that? Should I be concerned?

I'm worried about this being something dangerous like endometrial cancer. I can't do transvaginal ultrasounds due to being Autistic and a virgin who has severe anxiety. I've had 2 transabdominal ultrasounds though and they didn't find any evidence of malignancy. My uterus was a normal size, my ovaries were normal, and my endometrial stripe was 7mm thick, which is normal. My only issue was that some very small fibroids were noted.

How common is endometrial cancer in younger patients with PCOS? I'm so afraid due to the higher risk of endometrial cancer that comes with having PCOS.

I had hair on my chin for years and never addressed it because I'm very gender non-conforming in appearance (despite being straight) and it made me feel comfortable physically. Yet I had hormone tests done in the recent past that were normal, despite the facial hair. Only a year ago did my hormones start getting out of whack, and with that came the abnormal uterine bleeding.

Though I had symptoms before of vulvodynia and IBS-like problems, which still occur, and warranted my first transabdominal ultrasound, which came back perfectly. The second ultrasound I had was during last summer, and although I had more very small fibroids, it was also normal.

I have severe health anxiety, which my doctor says could contribute to the spotting. He also says that besides stress, the pills themselves aren't perfect and spotting can be expected sometimes. Is Aviane-28 (ethinyl estradiol and levonorgestrel) a common pill to experience spotting with, even after the initial 3 cycles?

I have withdrawal bleeding during my bleed week on birth control that is still as heavy as my regular menstrual periods. Is this normal?

I'm in constant fear and riddled with uncertainty, despite all reassurances from health care professionals. I'm terrified of cancer, and that I was too stubborn about my appearance to address the issue before it turned worse. My mother always wanted to address the hair growth to the doctor, just to see what he said, but I always refused her wishes. I'm also terrified that the doctors are wrong, or that the tests may have missed something.

Am I too late? Do I have endometrial cancer, or can all of this be reversed before it ever leads into cancer? I'm taking much better care of my health now. I'm eating better and exercising more. I'm taking the birth control pills every day at the same time as prescribed. I just want to be OK. I'll never mess with my health again. I used to eat a lot of junk food and now that I've stopped, my cholesterol and triglycerides have gone down to being borderline high, rather than high like they used to be. I'm trying to lose some weight. I've been a vegetarian since I was 12 due to ethical issues. For quite a few years though I've been eating a lot of fake meats that are soy-based. I'm not sure whether or not these are healthy for me.

I know that this is a lot of information to process, and I didn't mean to write a book, but I'm very afraid and I need help. Is there anyone here with the medical expertise to answer my questions and address my concerns properly? Please help me. I want to stop living in fear and get on with my life. I really don't want to die from endometrial cancer. I just want to be able to treat my hormonal imbalance and be happy and healthy. Thank you in advance for your help.

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