Tamoxifen and Ovarian Cysts

I've been on Tamoxifen for about four years now.  I've been dealing with intermittent hip/back pain for the past 2 1/2 years or so.  In May, I figured out the pain is more then likely coming from ovarian cysts.  That is when I had a cyst rupture and ended up in the ER for severe abdominal/hip pain.  Same pain I've been dealing with for over two years, just 10 times worse.  At the ER, they threw an enormous amount of prescription pain killers at me and sent me home to follow up with my doctor with ultrasounds.  A month later the cyst was gone.  Another month later and I have a new large painful cyst, that has not ruptured (yet), but I have been in daily pain for two weeks.  Again, they gave me yet another prescription for pain killers and set me up for ultrasound monitoring to make sure the cyst goes away.  Pain/cyst has always been on the right side.  I'm kind of sick of being in pain, and no one really seems to know how to help me.

I'm convinced the cysts are from taking Tamoxifen, as I'd never had a painful cyst before.  My regular doctor is considering putting me on progesterone, but since my cancer was PR+, that makes me and my oncologist's nurse practitioner nervous.  When I visited with my oncologist's nurse practitioner about my cyst problems, her advice was to have the ovary that is giving me issues, removed.  That seems extreme to me.  I'm hoping we have another option, but no one in the medical community seems concerned enough to look into finding another solution at this time.

Has anyone dealt with ongoing painful ovarian cysts while on Tamoxifen?  If so, are hormones or surgery really my only options?