Eleanor Tan

A 30-year-old woman presents to your GP clinic with a 3-month history of severe pelvic pain, worst during her periods, with heavy menstrual bleeding, dyspareunia and concerns about fertility. Take a focused history, perform a relevant examination, and formulate a management plan.

1. 1Take a focused history of the pelvic pain including SOCRATES and menstrual history
2. 2Explore associated symptoms including dyspareunia, dyschezia and fertility concerns
3. 3Take a sensitive sexual and gynaecological history
4. 4Verbalise a focused abdominal/pelvic examination with chaperone and consent
5. 5Order and justify appropriate investigations
6. 6Provide a working diagnosis with relevant differentials
7. 7Discuss management including pharmacological, hormonal and surgical options, and arrange referral