A 45yo waitress complains of pelvic pain which worsens pre-menstrually and on standing and
walking. She also complains of post-coital ache. Select the most likely cause leading to her
symptoms?
a. PID
b. Endometritiosis
c. Pelvic congestion syndrome
d. Adenomyosis
e. Premature ovarian failure
Ans. The key is C. Pelvic congestion syndrome. [Women with pelvic congestion syndrome experience a
constant pain that may be dull and aching, but is occasionally more acute. The pain is worse at the end
of the day and after long periods of standing, and sufferers get relief when they lie down. The pain is
worse during or after sexual intercourse, and can be worse just before the onset of the menstrual
period. Cause is attributed to female hormone estrogen induced vascular (venous) changes. So it is
usually seen in females].