I'd like to add a comment about the pill:

There are many different formulations of pills out there- you may need to just switch to a different type. Several of them (usually advertised as "acne reducing") will reduce the amount of testosterone available in the bloodstream. Women only have a little bit of circulating testosterone, so that reduction can get rid of acne (if it's acne related to hormonal fluctuations), BUT it can diminish sex drive and cause athletic performance to suffer.
If the pill worked for you before (aside from the emotional effects), you may want to try a different one.

I switched from Lo-ovral to ortho tri-cyclin very briefly when I switched doctors and noticed within two weeks that I was very emotional and that my performance on the bike was getting horrible (which made me more emotional!) I went back to the lo-ovral, and everything returned to normal within a few weeks.

May be worth a shot. A cautery in the cooter doesn't sound like much fun
Sorry, I had to add that last one in...