1st April 2022

You are a foundation doctor on your GP rotation

You are a foundation doctor on your GP rotation. Miss Harrison is a nulliparous 27-year-old solicitor; she previously presented due to having painful periods (dysmenorrhoea). She was advised to take ibuprofen, but she mentions the pains have not only continued but worsened. She described the pain as cramping in nature. She mentions that the cramping pains are sometimes present even when she is not having her periods. These pains have been going on for the last 5 months, and they sometimes prevent her from carrying out her daily activities. 

On examination, she experiences tenderness and guarding on palpation. She has had no changes in bowel habit or problems with water-works. She has not experienced any weight loss, but her BMI is 20. She is currently sexually active with a regular partner, and experiences no pain during intercourse. Her periods are regular (between 28-30 days) and have not been heavier than usual, they usually last only one day, with one pad required.

Based on Miss Harrison’s symptoms, what is the likely diagnosis?

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