The Evaluation of pain during sexual intercourse

A previously healthy 30 years old woman comes with the physician for the evaluation of pain during sexual intercourse for 6 months. She also reports frequent episodes of intense crampy pelvic pain that starts one day before menses and last for 8 days. Her symptoms are not relieved with pain medications. Menses occur at regular 28 day intervals and last 8 days.

Her last menstrual period was 2 weeks ago. She is sexually active with her husband; she denies using any type of contraceptive method since getting married 2 years ago. She hasn’t been pregnant. The physical examination \& vital signs are within normal limits, but in the gynecological exam rectovaginal tenderness was found.

Cervical and urethral swabs are taken and came back negative. Relevant laboratory findings are as followsà-hCG: Negative Transvaginal ultrasonogramà no abnormalities.

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