Endometriosis — DRCOG MCQ

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HardObstetrics & GynaecologyEndometriosisDRCOG

A 32-year-old woman reports severe dysmenorrhea and chronic pelvic pain. Pelvic ultrasound is suspicious for endometriosis. According to NICE, which management is first-line for suspected endometriosis-related pain?

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Correct answer: E — Oral combined hormonal contraceptive pill

The best answer is “Oral combined hormonal contraceptive pill”. NICE advises an empirical trial of hormonal treatment (often the combined oral contraceptive pill) for women with suspected endometriosis-related pain before invasive investigations. NSAIDs can be adjunctive, but hormone therapy is first-line for pain control. Antenatal decisions combine gestation, maternal stability, fetal risk and whether care can safely remain in the community. Screening, diagnostic testing and urgent assessment are not interchangeable. The UK pathway should be followed with clear safety-netting whenever symptoms may evolve before the next routine appointment.

Reference: NICE NG73: Endometriosis diagnosis and management: https://www.nice.org.uk/guidance/ng73/chapter/recommendations