Hi all, first time poster. tldr; I'm at my wit's end with the amount of pain I've been in for years, and it's starting to make life unbearable. My gynos keep not suspecting any reproductive condition. I've had a liletta for a year, and now been on low dose testosterone and finasteride HRT for 2 months, I'm now having extreme cramps 5 of 7 days of the week. Could this be endo, what should I be doing?

I have had very painful cramps for the entire time I've had a period. These were never the kind that made me throw up or need to stay home, but they definitely distracted me during school. I'd feel like I was being impaled. Birth control helped a little.

I developed Hidraadenitis Suppurativa in early adulthood. The only thing that worked was spironolactone, and it helped a little bit with the pain. I had stopped taking BC by the time I started spiro.

2 years ago while still on spiro, my menstrual cramps started to get progressively worse and I'd have them for more days than I used to. At one point when I was out and about, the cramps struck and I was unable to think or stand upright from the pain, so I had to call a friend to pick me up. I almost went to the ER, it was that bad. Ibuprofen and acetaminophen never did anything for my pain.

My gyno suggested I get an IUD to lessen the pain, so I got the liletta last spring. The pain has become even worse since then. I also get random pelvic pain now on non period days. One time I was bloated during my period and felt difficulty drawing breath, but normally I don't look bloated. As far as I know, the IUD is not dislodged.

It's also worth mentioning that every single pelvic exam I've ever had has been painful, especially when I am being palpated through my abdomen. It made the first gyno I had think I had gono, which I didn't. No gyno has suspected I had endo, and I have had an ultrasound of my uterus done 4 years ago.

I am now almost 2 months on gender affirming HRT, I'm taking a half dose of testosterone gel and finasteride. My hormone labs the day I got my script said I was in the normal range for a cis woman other than low testosterone from spiro. At this point in time I am now experiencing random extreme uterine cramps on random days accompanied by slightly pink discharge. These seem to be happening very often, I have had uterine cramps about 5 days per week the past 2 weeks. I had a period about a month ago where I was having issues with both poo and pee, where I constantly felt like I had to go but couldn't.

I'm in so much pain, but I don't know how to get my gyno to do anything other than "wait and see and take painkillers". Back in July I called to make an appointment with her, but the next available wasn't until the end of September. I've notified her of all these things, tried to impress on her that I am in extreme pain and it is continuing to get worse by the week. All I got was messages from her nurse saying "you should be taking ibuprofen," trying to convince me I should see a gastroenterologist because "it sounds like a GI issue," and finally had me schedule an ultrasound on the day of my appointment. I feel extra lost because this gyno is a gender affirming gyno and does seem to listen to me, but hasn't really done anything.

At this point it seems to me like I can't not have endo or something.

Does anyone have advice for me? Particularly regarding how to talk to my gyno, because I can't keep just waiting to see what happens. It's really affecting my life.