Is there any birth control (besides the pill and copper IUD) that doesn't worsen hormonal acne?

I'm 32 now and need to come off the pill due to stroke risk once you enter your 30s. I also have a large family history of stroke.

I'm on Femme-Tab pill which doesn't help my hormonal acne at all anyway - in fact it's worse than ever for the last 6 months.

Tried to get the copper IUD this week and the pain was unbearable, even with Penthrox/Methoxyflurane, and the doctor could not get it in. Said my cervix was too small.

I also don't think I could handle spironolactone as I already experience chronic fatigue/weakness and an overactive bladder.

Sterilisation not an option at this stage. Although we plan to adopt, want to keep the option open in case adoption doesn't work out.

Are there any contraceptive options that won't give me stroke risk, acne or traumatic pain? This acne is completely destroying my self esteem and I feel helpless.

(If sharing based off personal experience, please note if your acne is not hormonal acne, or if you do not get hormonal acne normally).