Hi, I'm so sorry to here about your experience with doctors. It's unfortunately common experience here :'(.

It is not okay that you are in as much pain as you are. It really isn't, and I am just so upset at your circumstances for you.

Here is my take on your situation:

Firstly, I think the benefits of seeking out legitimate treatment far outweigh the cons. And I think you should see a endo specialist, not just get an IUD.

Birth control- any birth control, may help soften some of the symptoms of endo, mostly because most of them will shorten periods and reduce cramps in anybody (disorder or not). In endo, they mostly help slow endo's growth or spread - they don't really get rid of existing endo growths. But what makes mirena better for both endo and adeno? Mirena IUD is continuous, meaning it doesn't have a week of "placebo pills" or no-hormone pills that cause a sudden drop in hormones. In other BC forms, that sudden drop in hormone levels incites the period to start - it's actually called "withdrawal bleeding." With the mirena IUD or any other continuous BC form, by instead keeping the hormone levels completely constant, this is far less likely to occur, and most women have less periods, shorter periods, and/or eventually no periods (after their bodies adjust). I am a huge fan of continuous birth control to stop periods, because, jeesh - who likes them anyway! I used to take seasonique, now I have nexxplannon, but either way it's been a few years since I've had an actual period. But anyway, a lot of the benefit people get on mirena IUD is just from not having periods. But here's the key: you can do this with any form of BC, really (except the low-dose forms).

Are you on hormonal birth control currently? If you are, here's what you can do about that business trip: when you get to the "reminder" pills at the end of your BC pack, the ones that you take the week of your "period" - don't take them! Start a new pack instead. That is, in lieu of taking that last week of pills (which actually have no or low hormones), start taking the new pack of (hormone-containing) pills immediately. You can do this to postpone your period (or skip it) so that you're not on it during your business trip. If you want more information on using hormonal birth control to delay and/or skip periods - just ask!

So, here's why I think it's imperative to see a specialist, rather than just settle for mirena:

Firstly, while the mirena can help, it doesn't help near as much as other treatments. As I said above, like all other hormonal birth control methods, it helps prevent endo from getting worse. But many women with endo don't see a huge improvement on birth control. And, BTW, if you're already on a form of BC, it's unlikely that just starting to skip periods (as you would on mirena) is going to make a huge difference. I personally have confirmed endometriosis... AND MY SYMPTOMS ARE NOT NEAR AS BAD AS YOURS. I have never blacked out from pain. I could walk on my period. I needed a lap to get my symptoms under control, and I take BC mainly as a way to keep it from coming back - based on my own experience, I would never recommend hormonal contraceptive of any kind as singular treatment. It worries me deeply that you, with the symptoms you have, are not getting more agressive treatment.

I have had very painful periods ... They have been progressively getting worse

I mean, you say it's consistently getting worse, and honestly, it sounds like shit as is. WHY WOULD YOU LET IT CONTINUE? Rationally, what can you expect, except more pain? Worse pain? More days off? More difficulty with your every day life?

But, also, I think you need to realize the time-commitment part of this.

To get the mirena IUD, you're going to need at least another appointment with a doctor, and then probably a follow up. You can reasonably expect 2 appointments. But.. what if instead of seeing that same doc for mirena... you saw a specialist, who would screen you for endo and adeno? Wouldn't you get further, then? By the time you would be having your 2nd appointment if you got mirena, you could be getting a conclusive test, such as a endometiral biopsy, to rule out adeno. Maybe even a lap and a D&C at the same time, which could treat endo if they found it. Basically, what I'm saying is that in the time you go to a follow-up appointment after geting mirena fitted, you could be so much further into treatment. Use your time wisely... don't put off getting adequate care.

And then, consider who is treating you.

Where would you go for a mirena? Back to the same doctor? The doctor that doesn't seem to take your issues very seriously, who doesn't see an issue with you BLACKING OUT FROM PAIN, and who is just gonna "try" birth control rather than run a single freaking test in case something else is going on!? I mean, holy fuck, does that not bother you at all? It's like if somebody went into a doctor and was like "my leg hurts so badly I black out from pain when I try to walk" and the doc went "well, it sounds like you're a candidate for somebody with arthritis!" and wrote you a script for that instead of looking at the damn leg. Without checking that it's not, idk, a broken bone or something.

I mean, there's always the small chance that it's something crazy like ovarian cancer, in which case mirena (or other birth controls) can be dangerous!

I'm doing well at my job but am afraid that taking time off will catch up to me unless I can get an accurate diagnosis.

I understand that. But think of this - how much time off of work are you taking because of your pain? How much of the time you are at work are you suffering from pain, or being held back by it? I bet this is taking a major toll on your productivity already. Whats a week off for the laproscopy compare to it? Especially if you get better because of it?! We've already covered that you're getting worse every week without it... what can you expect without accurate, conclusive diagnosis and treatment but more of the same? Can you really chance it?

You don't deserve pain. You deserve a better doctor. And the costs of you not getting treatment are getting higher and higher each week. You don't sound like a woman who has the time to be in so much pain. You don't sound like you have time to mess around with inconclusiveness and doctors who just want to throw birth control at you instead of looking into your issue.

See a specialist. The first thing they will probably do is an ultrasound to check for cysts. It's a quick out-patient procedure. Frankly, I think it's ridiculous this hasn't been done yet already! From there, your doc can discuss options of treatment and probably a laproscopy to conclusively diagnose you and (hopefully!) treat you at the same time.