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Endometriosis — DRCOG MCQ

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HardGynaecologyEndometriosisDRCOG

A 27-year-old woman has dysmenorrhoea, deep dyspareunia and cyclical bowel pain. Pelvic examination is normal. She has tried NSAIDs with limited benefit and wants to preserve fertility. What is the most likely diagnosis?

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Correct answer: E — Endometriosis

Cyclical pelvic pain with deep dyspareunia and bowel symptoms is typical of endometriosis, even with a normal pelvic examination. Irritable bowel syndrome may coexist but does not explain cyclical dyspareunia. Ovarian torsion is acute rather than chronic cyclical pain. The pearl is that normal examination or ultrasound does not exclude endometriosis.

Reference: NICE NG73