A 25-year-old female reports constant premenstrual pelvic pain and dysmenorrhea. What is the most likely diagnosis?

The diagnosis of endometriosis is supported by the symptomatology presented by the patient. Endometriosis is characterized by the presence of endometrial-like tissue outside the uterus, leading to chronic pelvic pain and dysmenorrhea, particularly during the premenstrual phase of the menstrual cycle.

The patient’s constant premenstrual pelvic pain is a hallmark symptom of endometriosis, as the ectopic endometrial tissue responds to hormonal changes during the menstrual cycle, causing inflammation and pain. Dysmenorrhea, or painful menstruation, is also commonly associated with endometriosis due to the contractions of the uterus and the surrounding inflammatory process.

In contrast, uterine leiomyoma typically causes heavy menstrual bleeding and may lead to pressure symptoms but is less likely to present primarily with cyclical pelvic pain. Endometrial polyps can lead to irregular bleeding but are not commonly associated with severe dysmenorrhea or premenstrual pain. Ovarian cysts may cause pelvic discomfort or pain when they rupture, but they do not typically produce the consistent premenstrual symptoms as seen in endometriosis. Therefore, given the specific symptomatology of premenstrual pelvic pain and dysmenorrhea, endometriosis emerges as the