36F looking for advice

Hello! I’m a 36F. I’ve always had pretty regular cycles. According to the app I use to track it’s typically between 25-31 days. My period is just extremely heavy. My periods last about 6-7 days and from day 2-5/6 I’m passing huge clots constantly. I have to wear an ultra tampon plus a pad throughout my entire period and I’m changing both frequently. I have anemia and am requiring iron transfusions due to my period. Last year I had an unrelated abdominal CT scan that showed several fibroids. I was seen by my gyn and had a TVUS. It did pick up fibroids but much smaller than what the CT said. It also found a polyp. So I had a polypectomy. I’ve seen virtually no change in my periods since the polypectomy and will be returning soon to my gyn to discuss.

Along with the heavy periods they’re very painful. During my period I have debilitating back pain and my legs just ache constantly. I also can’t terrible groin pain that I’m thinking is ovulation pain because it happens between periods, but sometimes it has me doubled over in pain. I’ve also recently noticed increased urinary frequency almost like a constant pressure. It’s definitely worse while I’m on my period. I don’t have pain with sex but inserting tampons can be painful. I don’t have sex on my period so not sure if there’s a difference with insertion while on my period.

All of this to say I just find myself frustrated and looking for guidance on what to talk to my doctor about. Last time they just wanted to give me an IUD, which I really have never been a big fan of birth control. But I feel like somethings wrong and bleeding this heavy isn’t normal. So I don’t like the idea of just throwing birth control at it and never knowing what the real issue is. Should I ask for a pelvic MRI? Is something like endo a possibility even though my periods are regular? I’m just feeling lost and confused and frustrated and hoping someone can give me some advice. Thank you to anyone who took the time to read all of this. 💛