1155: 26-year-old female presents with reports of dyspareunia, heavy menstrual bleeding, and pelvic pressure that intensifies during her menstrual cycle. The client states that the symptoms started four months ago and have intensified to the point where she refuses to have intercourse because of the pain. She has no children and reports fertility problems despite seeing two specialists. She reports that she has been treated for two urinary tract infections, but it still is occasionally painful when she urinates, especially during menstruation. She denies any vaginal odor or discharge other than heavy menstrual bleeding. She denies having any sores or lesions around her labia. She reports pelvic pain, described as a pressure rated as 4 on a scale of 0 (no pain) to 10 (severe pain) that is intensified during menstruation and sexual intercourse. She takes a daily multivitamin and denies any drug or alcohol use. She has no reported medical problems.

T 97.5° F (36.4° C), P 81, RR 18, BP 138/84, pulse oximetry reading 96% on room air