I am in the same position for years with bipolar, endometriosis, and methods that help keep the endo under control without aggrevating the BP. I cannot afford the IUD or implant; it is cheaper to go with pills with my current insurance since the insurance will not cover the either of others. It took some trials to find the one that works best and adjusting the BP meds accordingly. I have gone with a higher dose progesterone than estrogen BC pill to control the endo and it seems to work better with the BP symptoms as well; but the BP meds did need adjusting, typically needing to be increased. Then it took a pack or sometimes two packs of the pills/cycles to level out when increasing the BP meds to regulate the cycle, and would have some breakthrough bleeding during these adjustments. It would eventually level out.

However everyone's body chemistry is so different, unfortunately, that there is no knowing until trying which ones will work and giving them some time to level each other out. It helped to work closely with the docs to get things adjusted and in timely manner to stay on top of all the symptoms.

Both the OB/GYN and pdoc have recommended the IUD over the implant as it delivers the hormones directly where they need them and gets them out of the bloodstream to less affect the BP symptoms and better help endo; if I were to go IUD or implant, IUD would be the way I would go.

I wish you the best in finding the combination that works best for you. It is not easy and there is some trial and hopefully less error involved. If you ever want to talk, feel free to PM me. Sending hugs and patience meanwhile.