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Adenomyosis — DRCOG MCQ

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ModerateGynaecologyAdenomyosisDRCOG

A 42-year-old multiparous woman has heavy painful periods and a bulky tender uterus on bimanual examination. There are no adnexal masses and pregnancy test is negative. What is the most likely diagnosis?

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Correct answer: B — Adenomyosis

Heavy painful periods with a bulky tender uterus in a multiparous woman suggests adenomyosis. Bacterial vaginosis causes discharge and odour rather than a tender enlarged uterus. Ectopic pregnancy is unlikely with a negative pregnancy test. Stress urinary incontinence presents with leakage on coughing or exertion.

Reference: NICE NG88; NICE CKS dysmenorrhoea