Hello,
Surgery will only be an option here if medical management is unsuccessful.The report says that the uterus is bulky,which is common in adenomyosis. If your symptoms cannot be managed,then surgery can be an option. Medical management is usually composed of hormone treatment. Since you are only 39,you can try medical management first,and if no use,then you can consider srugery.

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Normally hormonal treatment doesnt high BP. But in certain cases,if there is any underlying cause,resulting in high BP like anxiety, MS etc then its should not be given.But otherwise hormones like progestrone can be given in most pts.If any cardiac history is presnt in your family then it may be cautiously used. However,hormones are not given on long term basis. Just 3-6 cycles at a time and reviewed. Another option is MIRENA insertion,which is a intrauterine device containing hormone which also controls symptoms. As for hormonal effects on the body,the dosage of the medication used,wont have that much effect on the rest of the body. It will help to control bleeding. But if you consider surgery,and your ovaries are removed,you may have some menopausal symptoms due to sudden changes in the hormone levels.Your doctor will explain the possibilities depending on the surgery done.

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