Ive Been Having Bad Cramps For The Last Year. Things

Ive been having bad cramps for the last year. Things have continued to get worse. It hurts to have sex it hurts to even orgasm. My periods are haywire and the pain is debilitating. I have been on my period now for 13 days and earlier this evening I passed a piece of uterine lining with two black spots and the black areas are thicker than just the skin in the other areas. Should I be concerned?