28th June 2023

A 52-year-old lady presents with a ‘deep’ pelvic pain. She believes she is perimenopausal having started having irregular cycles a year ago.

A 52-year-old lady presents with a ‘deep’ pelvic pain. She believes she is perimenopausal having started having irregular cycles a year ago. Her last bleed was heavy, approximately six weeks ago. The pain is present intermittently and is relieved when she opens her bowels. She has no relevant past medical history and first noticed the pain five months ago. She does not believe the pain is related to intercourse and she has had the same sexual partner for 35 years. Her diet has not changed recently, and she otherwise feels well. What investigation should be done first?

Select the SINGLE most appropriate option from the list below. Select ONE option only.