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Endometriosis — DRCOG MCQ

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ModerateGynaecologyEndometriosisDRCOG

A 28-year-old woman has worsening dysmenorrhoea, deep dyspareunia and pain opening her bowels during periods. Pelvic examination is normal. She is trying to conceive in the next year. What is the most appropriate investigation?

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Correct answer: A — Arrange transvaginal ultrasound and consider referral if symptoms persist

Endometriosis should be suspected from cyclical pelvic pain, deep dyspareunia and dyschezia, even when examination is normal. NICE recommends transvaginal ultrasound to identify endometriomas, deep disease or other pathology, but a normal scan does not exclude endometriosis. CA125 is not used to diagnose endometriosis. Management should consider fertility goals and referral when symptoms persist.

Reference: NICE NG73