Hi. I was just diagnosed with adenomyosis via transvaginal ultrasound. I am trying to research treatment options and weighing the pros and cons and would love inputs from others here.

Option 1- Do nothing. Wait until it gets worse. Currently experiencing constant mild pelvic pain and irregular periods. Some heavy bleeding and clotting. Occasional debilitating cramping. If it gets worse is it harder to reverse the symptoms? Better to treat early I think?

Option 2- birth control pills - are there specific ones that are better suited for this? I'm on the mini pill (progesterone only) but that doesn't seem to do anything. I have been on combination type pills in the past and found they killed my libido and caused weight gain so I'm anxious about those.

Option 3- merina iud - I've had this twice in the past. First time I still got my periods regularly and the strings got lost inside. Second time, periods stopped but I wondered if it contributed to my migraines and weight. Also, both times I'd occasionally get painful cramping from orgasms which I thought felt like the iud stabbing my uterus because it contracted too hard on it. I'm not firmly against trying merina again, but not particularly eager either 😕

Option 4- hysterectomy - I also have hypermobile Ehlers-Danlos Syndrome and with that it's generally advised to avoid surgeries due to poor healing. It also puts me at increased risk to prolapse, which I am concerned about with this surgery.

I think that's it? Or am I missing an option? I haven't really thoroughly researched these yet and would appreciate any experiences or insights from others.