Academic Master

Health Care

Diagnosing and treating Gynecological Conditions

According to the clinical picture portrayed in the case scenario, the patient is most probably suffering from endometriosis. The presence of gradually worsening dysmenorrhea and infertility after five years of trying are all indicators of endometriosis. The presence of nodules along the cul de sac is a confirmatory symptom of endometriosis.

Endometriosis is a medical condition in which endometrial tissue identical to the tissue that lines the inside of the uterus grows outside the uterus. The tissue responds to the hormonal cycle in the woman and sloughs off during menstruation, though it does not have an avenue to get out of the body. Endometriosis causes painful menstrual cramps and can cause hardships in conception in the affected women (Signorile, 2015).

Another possible diagnosis for the patient in the case scenario is primary dysmenorrhea. Primary dysmenorrhea is the presence of abdominal cramping due to menstruation without the presence of an existent infection or abnormality that could lead to painful cramps. Since the patient has no signs of infection or abnormalities in her genital-urinary system, it is almost convincing that the case is due to primary dysmenorrhea. Infertility can be due to other factors not related to the presenting complaint of the patient. Primary dysmenorrhea is, however, disqualified by the presence of nodules in the cul de sac of the uterus (Iacovides, 2015).

The other possible diagnosis is uterine malformation. Even though it is normal to have a retroverted uterus, it can also be a sign of other possible underlying pathologies such as endometriosis and pelvic adhesions. Uterine malformation cannot be used as the definitive diagnosis since the presence of gradually worsening dysmenorrhea would not be explained. There are no other signs to support the possibility of uterine malformation. Uterine malformations can also be the cause of infertility (Hassan, 2010).

The treatment options for endometriosis include drugs or the surgical removal of the extra-uterine endometrial tissue. The severity of the attack and the prospect of the patient getting pregnant are the basis for choosing the most appropriate care for the condition. In most clinical settings, clinicians opt to use a conservative approach, with surgical intervention being the last option (Mettler, 2014).

Most clinicians recommend NSAIDs like ibuprofen and naproxen as treatment options. These drugs relieve the pain associated with endometriosis without improving the underlying pathology overall. If the maximum dose of a given drug does not offer adequate relief from the pain, the patient should consider other options for treatment. Ibuprofen is given in a dosage of 400-600mg three times per day, while naproxen is given in a dosage of 250mg up to four times daily.

Hormonal therapy and conservative surgery are other possible ways of dealing with endometriosis. Hormonal therapy involves the use of birth control options that use hormone mimicry to prevent ovulation and menstruation. Hormonal therapy prevents the proliferation of the extrauterine endometrial tissue with an additional reduction in its hormonal activation during menstruation. Surgery that targets the extrauterine endometrial tissue can also help eradicate them. Conservative surgery preserves the ovaries and the uterus which leads to increased chances of conception in patients who could not give birth due to the condition. Surgery is also a great option for patients who have severe dysmenorrhea due to endometriosis.

Educating the patient about the condition is crucial in enabling them to take the right medication for it. It is also important to offer facts and clear out myths and misconceptions about endometriosis.


Hassan, M.-A. M. (2010). Congenital uterine anomalies and their impact on fertility. Women’s Health, 6(3), 443-461.

Iacovides, S. I. (2015). What we know about primary dysmenorrhea today: a critical review. Human reproduction update, 21(6), 762-778.

Mettler, L. R. (2014). Impact of medical and surgical treatment of endometriosis on the cure of endometriosis and pain. BioMed research international.

Signorile, P. G. (2015). New evidence in endometriosis. The international journal of biochemistry & cell biology, 60, 19-22.



Calculate Your Order

Standard price





Pop-up Message