Evaluation includes a history, pelvic examination, hCG measurement, tests for chlamydial and gonococcal infections, and pelvic ultrasound. Laparoscopy or laparotomy is indicated in some cases of pelvic pain of undetermined cause.
Treatment: Pelvic Pain Primary dysmenorrhea is best treated with NSAIDs or oral contraceptive agents. Secondary dysmenorrhea not responding to NSAIDs suggests pelvic pathology, such as endometriosis. Infections should be treated with the appropriate antibiotics. Symptoms from PMS may improve with selective serotonin reuptake inhibitor (SSRI) therapy. The majority of unruptured ectopic pregnancies are treated with methotrexate, which has 85-95% success rate. Surgery may be required for structural abnormalities. |
Section 13. Endocrinology and Metabolism