A 26-year-old nulligravid woman presents with concerns of heavy menses and pelvic pain. Her last menstrual period was one week ago. She describes a long history of cyclic heavy menses which were initially improved on combination oral contraceptive pills but have worsened in the last two years. On her heaviest days, she soaks through a tampon in 1 hour and has soiled her clothes. She notes worsening pelvic pain which was previously limited to her menses but now feels like a constant fullness in her lower abdomen. She reports urinary frequency and denies dysuria or malodorous urine. She is not sexually active and denies a history of pelvic infections. She had a negative Pap test last year. She has a history of anemia, but no other medical problems. She has never had surgery. She desires future childbearing. She takes no medications other than her contraceptive pills.