Which diagnosis is suggested by symptoms of painful menstruation preceding menses, dyspareunia, and nodularity on examination?

The symptoms described—painful menstruation that occurs before menses, dyspareunia (painful intercourse), and nodularity upon examination—are characteristic of endometriosis. This condition occurs when endometrial-like tissue grows outside the uterus, often leading to inflammation and the formation of nodules or adhesions in pelvic areas. The pain associated with endometriosis typically arises because this tissue responds to hormonal changes during the menstrual cycle, leading to symptoms that can intensify before menstruation.

Dyspareunia is commonly reported among individuals with endometriosis, as the abnormal tissue can make pelvic structures more sensitive and result in discomfort during intercourse. The presence of nodularity on examination, which can indicate the development of endometriomas or other endometrial lesions, further supports the diagnosis of endometriosis rather than other conditions.

While other conditions such as endometrial cancer, fibroids, and premenstrual syndrome might also relate to menstrual issues, they do not align specifically with the combination of symptoms presented. Endometrial cancer typically involves abnormal bleeding and does not primarily feature painful menstruation in the same way. Fibroids can cause heavy menstrual bleeding and pelvic pressure but are less likely to present with the specific pattern of pain detailed in this