A 29 year old, white female presents to her gynaecologist complaining of severe lower abdominal cramps that were poorly responsive to ibuprofen. She has been married for 9 years and has 2 sons,
ages 3 and 6 years. Menses began yesterday and the pain has lasted for about 72 hours. She reports that she had a similar episode of pain just before her last menses but that pain subsided with the
end of her period. She also complains of sharp, deep pain during sex, mild lower back pain and pain during urination during the past 2 weeks.
1. Describe endometriosis, emphasising the signs and symptoms, and potential future complications.
2. How would you confirm the diagnosis and explain why it is so difficult to diagnose?
3. What would be the pharmacological treatment options and explain how they work in this condition?
4. Describe the different treatments for mild or severe endometriosis?
5. She also wants to have more children. What information and advice can you provide her and explain fully your rationale?