I am taking bc pills continuously for endometriosis and have been having increased pelvic pain. the sonogram shows heterogenous uterus with 8mm endometrium? what is next step?

Endometrial Biopsy : Your gyn may want to stop the pills and rescan or collect an endometrial biopsy next. Other options may include a d;c or endometrial ablation depending on your medical history.

Adenomyosis?: It's possible the heterogeneous uterus that was shown on ultrasound is adenomyosis. This is when there are glands in the uterus itself (similar to endometriosis inside the uterine muscle- the myometrium). Ask your doc about a "gnrh agonist" like Depo-Provera lupron (leuprolide). This would simulate menopause, but it can also help greatly with the pain of endometriosis or adenomyosis. You may need a hysterectomy if bad.