Period Issues No One Can Solve

I am 21. For the last 4 years, I have had PMS like symptoms every month for a week to week and a half before my period. They have progressively been getting worse. I would get breast tenderness that had begun waking me up middle of the night and then hot flashes that made me feel like I had a fever (never did). I also have a history of a breast mass, biopsied December 2024 and found to be a fibroadenoma. The same breast with the biopsy has nipple discharge. In August I finally went to primary care about it. They wanted to put me on birth control pills, but they all have lactose and I can't handle any lactose. I ended up having some heart issues so the PMS got put on the back burner while I got diagnosed with POTS in November. After trying a new primary care doctor a friend referred me to and being dismissed again and told it's normal, I went to an OBGYN. One of the worst doctors I have ever seen (and I've seen a share with all my issues), didn't spend more than 5 minutes with me, and told me I'm young and fine. I was at a loss and finally decided to try one more OBGYN in mid December. He listened and told me he believes my symptoms and will figure it out. He was upset the other OBGYN hadn't checked my hormones or remeasured my breast mass. My prolactin was 44.4 and my FSH was 2.7. The breast mass was re-ultrasounded and nothing changed, although they found some small cysts. He had me get a brain MRI with contrast last week to check for prolactinoma, nothing was found on that. He also put me on the off brand Xulane patch all the time (no break week) to try to regulate everything, but my period has been longer than ever, I've had the worst cramps, and I've had breast tenderness since I put my first patch on 3 weeks ago. I'm waiting for him to contact me about the next steps after the MRI results just came back. That being said, I'm at a loss for where to go from here. Does anyone have any similar experiences and can suggest things I could talk to him about? What have you found to relieve any of these symptoms? What other tests should I advocate for? Thanks in advance for any suggestions!!