Just Diagnosed -- Looking for Advice

Hello,

So, I have literally ALWAYS had problems with my periods. Started early, they never "evened out"--the longest period I had was almost 9 weeks and the longest between was 4 months, and I have never been regular. I've also had intensely painful periods with heavy bleeding. I was diagnosed with PCOS early on (in my early 20s) because of the heavy, irregular cycles.

In December, things took a turn. I went to the ER because I had level 10 pelvic pain. And I am no stranger to what level 10 pain feels like--I have herniated disks and have been left without painkillers after surgery, broken teeth, etc. And this was bad, level 10 stabbing pains every 10-20 seconds. So I went to the ER, after taking 1600 mg ibuprofen and two midol in under 6 hours with no change to my pain levels. They gave me a non-opiate painkiller, which did nothing for my pain, then did a CT with contrast and a transvaginal ultrasound, both of which turned up nothing. Then the ER doc gave me a shot of dicyclomine, and the pain didn't go away, but the stabbing jolts of level 10 pain went from every 10-20 seconds to every 1-2 minutes. The doctor impressed on me, multiple times, that I needed to see an OB/GYN. And it had to be a doctor, not a NP or PA.

The pain hasn't gone away since that day. Sometimes it's a dull ache, and sometimes it feels like my guts are being torn out (usually around my very-unpredictable period, which had come 4 times between December and February. ) In early January, I saw my GP. In late January, I saw a new OB/GYN and had an endometrial biopsy. In mid-February, the OB/GYN performed an ablation, removed my fallopian tubes, and then did some exploring. A week after the surgery, I got a call: My fallopian tubes were normal. No other info. So, I thought everything she saw was normal.

I had my follow-up visit, and everything is not, in fact, normal. The OB/GYN showed me pictures of the various endometrial lesions she found, as well as removing a benign cyst. She said she was able to cauterize most of the lesions, but there were "a few" she couldn't due to placement. She had hoped that the others being cauterized would have helped with the pain, but my pain level hadn't decreased. So, she prescribed Orilissa. Also, I've had rectal bleeding just before my period, every time, for years. A gastroenterologist said he found a "lesion" during my colonoscopy. I think it's likely The lesion is endometrial.

I read up about it. I'm taking calcium to combat bone loss. I haven't had any side-effects besides some dizziness. But every night about an hour or two before my dose is due, I start having the pain again.

So, questions:

1. What does it mean that I had a cyst? She wasn't clear on what it was, or even where it was.
2. Why is my pain coming back at night? And will that stop after using the medicine for longer?
3. Will I still need to get a hysterectomy/ovarectomy?
4. How long can someone take a drug like Orilissa?
5. What does it mean now that I have this diagnosis? Is there anything special I should be more aware of/paying attention to?
6. I know this is a long shot, but is it possible endometriosis is related to the cysts I've gotten in my skin ever since I was about 10 (when I started having my period)? I have them on my arms and legs, non-cancerous, and very gross.

Thanks in advance.

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