Request a high resolution pelvic MRI. Have them look for adenomyosis. It causes abnormal uterine bleeding and severe pelvic pain that gets worse during bleeding. It can be focal in certain spots or diffuse throughout the uterus. It can also cause weight gain and anemia. Adenomyosis sets off a vicious cycle of bleeding through locally high estrogen levels. Like endometriosis, abnormal cells grow in the uterine wall causing bleeding, setting off increased hormone levels which in turn make it worse.

If you have adenomyosis, it is treatable WITHOUT a hysterectomy using Mirena. Alternatively, high doses of Prometrium can work but the side effects of Mirena are easier to tolerate.

Find a good reproductve endocrinologist. Where are you located?

I have diffuse adenomyosis of the entire uterus, and also tend to get ovarian follicular cysts too. It took going to Mayo Clinic to have it diagnosed. Once diagnosed, my local reproductive endocrinologist who is quite good too, has been able to treat it. It was overlooked because I had a massive pelvic hematoma, so rare no one knew what it would do.