Many thanks for the helpful response.

Many thanks for the response that is helpful.

What tests are recommended for a 42 year old to determine if there is an imbalance in hormones that might be related to irregular bleeding or irregular periods ? How can you tell if symptoms are due to perimenopause ?

Are there any non invasive treatment options available to manage adenomyosis other than the mirena IUD as an alternative due to the associated side effects of the IUD ?