Thanks for your query.Based on the facts that you have posted it appears that you have multiple small fibroids in uterus
along with Ovarian cyst
with adhesions to the uterus.
This is suggestive of Tubo-Ovarian mass mostly infective in origin.
In view of the possibility of getting malignant changes and you being in pre menopausal age group it is advisable to get Hysterectomy
There are no side effects of the removal of uterus at this age,