A 32-year-old woman presents with chronic pelvic pain and dysmenorrhea. She also reports difficulty getting pregnant. Her pelvic ultrasound is normal. What could be the issue?
Endometriosis can cause chronic pelvic pain, dysmenorrhea, and infertility. Even though the ultrasound is normal, endometriosis cannot be ruled out because it may not be visible on ultrasound. A diagnostic laparoscopy may be considered. If endometriosis is confirmed, treatment options include hormonal therapy, pain management, and possibly surgery. Fertility treatments may be discussed depending on the patient's desire for pregnancy.