Hysterectomy? Surgery? What was helpful to you?

Hi everyone. I’m writing because I’m exhausted and overwhelmed and could really use advice from people who understand. I have severe pelvic pain about 15 days out of every month, starting at ovulation and lasting through the end of my period. I’m lucky if I get about 6 good days total each cycle. Living like this is wearing me down. I have a pelvic ultrasound on the 27th due to concern for fibroids, with a follow-up appointment immediately after. My doctor gave me these options: Pelvic floor PT Hormones Exploratory laparoscopy Hysterectomy She has done laparoscopic surgery before and does not deny care, but she was honest that she is not an endometriosis specialist and rarely finds endo, which scares me. The only specialist in my area doesn’t accept insurance and is unaffordable. I’m very hesitant about hormones because I’ve tried them before and had severe side effects: depression, daily bleeding, painful breast swelling, and worse cramping. I’m also a smoker, which adds to my fear. For context, I do not plan on having children, and my husband has had a vasectomy, but a hysterectomy still feels like a huge, irreversible step. Is the risk worth it? I feel stuck between options that all scare me, and my main goal is simply relief from this much pain.