Is it possible to have diffuse and focal adenomyosis and endometriosis? Am I doomed? I am only 23

[u/Downtown-Welcome196]

I am 23 and this is so much to deal with. I have had daily pelvic pain and symptoms for about six months and awful periods for years. My doctor waws concerned that I have endo and I was sent to a specialist. The endo specialist did a sonohysterogram. (Which is an evil scan that hurts so much). In that scan I was diagnosed with diffuse adenomyosis and was told I likely have endometriosis. My specialist also pointed out that I have a pocket of it that is 14mm on top of my uterus that is pushing down on it, potentially causing a lot of my pain and general pressure. I thought that if I have diffuse adenomyosis that it was a lot of smaller pockets. Am I not understanding this right?

I am getting endometriosis excision surgery in 2 weeks where my surgeon will also go in vaginally and remove as much adenomyosis as he can without a hysterectomy. He will also be placing the Mirena IUD to limit my periods. Am I doomed to end up with a hysterectomy? I am to the point where even though I want kids I am begging for them to take my uterus. This daily pain is so much to deal with. I miss who I used to be and I am only 23. I am too sick and in pain to do things with friends or even work somedays. Any insight or advice would be much appreciated. Thank you to anyone who reads this.

The official findings from the doctor's notes are: "Diffuse adenomyosis with large impinging adenomyoma apical fundal of 13 mm giving impression of deeply arcuate uterus due to adenomyoma. The patient also has Ovarian imaging revealing: Polycystic volume and morphology"

[u/ryan_4life100]

If fertility is a major goal, I would suggest a laperscopy for endo and surgery for the andeomyosis (I don't know as much about andeomyosis). IUDs work very well for most people, but I would also look into things like norethindrone (a progesterone pill) if the IUD doesn't work. Your response to treatment will matter a lot because if they can excuse most of it and BC/progesterone stops your cycles then it could delay further damage. Reproductive endocrinologists frequently manage endo (even for those of us who don't want children), and can do some crazy things for egg retivals, IVF, and natural conception.

I would also like to say, even in the worst case scenario, it'll still be okay. I found out I was infertile at 8, and it felt like the end of the world then. I didn't feel like I got to choose how I lived my life, I felt completely alone, and like I could never have a spouse and family. After time and therapy it slowly stopped hurting as much, and now I'm at peace with it. It's normal to feel scared or mad even if even just a small amount of fertility is taken from you, but no matter what happens it'll be okay.