Adenomyosis-related symptoms: Given the patient's history of adenomyosis and the exacerbation of symptoms during menstruation, it is likely that her current symptoms are related to adenomyosis, possibly causing pressure on nerves or blood vessels, leading to numbness and tingling.

Hormonal fluctuations: Stopping birth control after taking it for a year could lead to hormonal imbalances, which might exacerbate symptoms like numbness and tingling, especially if they are influenced by the menstrual cycle.
Anemia: Heavy menstrual bleeding with clots could lead to anemia, which might cause symptoms like numbness and tingling due to decreased oxygen delivery to tissues.
Migraine-related neuropathy: Although the patient's migraines are managed with Tylenol, there could be a neuropathic component to her migraines that contributes to her symptoms of numbness and tingling.

Multiple Sclerosis (MS): Although less likely, MS could present with numbness and tingling, especially if the symptoms are intermittent and worsen with certain activities or during the menstrual cycle. MS is a diagnosis that could have significant implications if missed.
Spinal Stenosis or Disc Herniation: These conditions could cause pressure on nerves, leading to numbness and tingling. Given the patient's symptoms are localized to one leg and worsen during menstruation, it's crucial to consider spinal causes, especially if there's a history of back pain or trauma.
Deep Vein Thrombosis (DVT): Although the patient's symptoms do not classically present as DVT, any condition that causes significant leg swelling or pain could potentially lead to numbness and tingling. Given the patient's history of heavy menstrual bleeding, she might be at increased risk for thrombotic events.

Nutritional Deficiencies: Deficiencies in vitamins like B12 could cause neuropathic symptoms. Although less likely given the patient's age and presentation, it's a consideration, especially if she has a restrictive diet or malabsorption issues.
Vasculitis or Autoimmune Disorders: Conditions like lupus or rheumatoid arthritis could potentially cause neuropathic symptoms, although they would typically be accompanied by other systemic symptoms.
Tumors: Rarely, tumors pressing on nerves could cause localized numbness and tingling. This would be an unlikely first consideration without other symptoms like weight loss or persistent pain, but it remains a possibility in a comprehensive differential diagnosis.