I am 44 years old. i have a strong family history of ovarian/breast cancer and braca2 of unknown significance. i getvery painful menstrual cramps. could i have ovarian cancer?

Painful Menses are: Not a sign of ovarian ca but need regular exams, inculding mammogram. Depending on the chances of your variant, some consider a hysterectomy with ovarian removal. Low dose estrogen only hormone replacement would be much less estrogen than u are making, getting off too quick can have other problems, including cv disease and osteoporosis. If u consider ov removal, low dose hrt need 2B considered.

Ovarian cancer: It is very hard to screen for ovarian cancer. If you are done having children it would be possible to consider having the ovaries removed. This should be discussed with an ob, genetic counselor, and oncologist to get all the information.

The curse of the VUS: Personal and family history trumps genetic testing. If you have strong family history of breast/ovarian cancer, it could be that the vus is truly a deleterious mutation yet to be identified as such or have another gene involved besides brca. I would advise you see your gyn and a specialist with expertise in genetic testing/risk assessment. They will go over ways to reduce cancer risk for you.