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Endometriosis — MCCQE Part 1 MCQ

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ModeratePelvic PainEndometriosisMCCQE Part 1

A 27-year-old woman has chronic cyclic pelvic pain, deep dyspareunia and dysmenorrhoea not relieved by NSAIDs. Pregnancy test is negative and pelvic examination is non-acute. Which of the following is the most appropriate initial management option?

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Correct answer: B — Offer hormonal suppression such as combined hormonal contraception or progestin therapy if no contraindication

Cyclic pelvic pain and deep dyspareunia suggest endometriosis, and empiric hormonal suppression is an appropriate initial option when acute pathology is excluded. Surgery is reserved for diagnostic uncertainty, infertility concerns or refractory symptoms. Long-term opioids are not first-line and antibiotics are not indicated without infection features.

Reference: SOGC endometriosis guideline