Question:medium
Teenage patient with transverse vaginal septum with dysmennorhea & chronic pelvic pain. Diagnosis?
Teenage patient with transverse vaginal septum with dysmennorhea & chronic pelvic pain. Diagnosis?
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Consider how an outflow obstruction leads to retrograde menstruation and ectopic endometrial implantation.
Updated On: Jun 23, 2026
- Endometriosis
- Tubovarian abscess
- Dermoid cyst
- Theca lutein cyst
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The Correct Option is A
Solution and Explanation
Clinical reasoning: A transverse vaginal septum creates an outflow obstruction. Obstruction leads to $\text{retrograde menstruation}$ -- endometrial cells travel backward via the fallopian tubes into the peritoneal cavity.
These cells implant and respond to cyclic hormonal changes, producing the classic triad of endometriosis:
- Dysmenorrhoea (painful periods)
- Chronic pelvic pain
- Infertility (in long-standing cases)
Secondary dysmenorrhoea in an adolescent with an obstructive Mullerian anomaly strongly points to endometriosis.
Distractors eliminated:
- Tubo-ovarian abscess: requires PID history
- Dermoid / Theca lutein cysts: unrelated to outflow obstruction or CPP pattern
\[\boxed{\text{Endometriosis}}\]
These cells implant and respond to cyclic hormonal changes, producing the classic triad of endometriosis:
- Dysmenorrhoea (painful periods)
- Chronic pelvic pain
- Infertility (in long-standing cases)
Secondary dysmenorrhoea in an adolescent with an obstructive Mullerian anomaly strongly points to endometriosis.
Distractors eliminated:
- Tubo-ovarian abscess: requires PID history
- Dermoid / Theca lutein cysts: unrelated to outflow obstruction or CPP pattern
\[\boxed{\text{Endometriosis}}\]
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