GYNECOLOGICAL SYNDROMES AND REPRODUCTIVE HEALTH: DIAGNOSTIC APPROACHES TO MENSTRUAL DISORDERS, PELVIC PAIN, AND INFERTILITY

Background.  Menstrual  disorders,  pelvic  pain,  and  infertility  are  among  the  most  clinically  important  presentations  encountered  in  gynecology  and  reproductive  medicine.  Although  commonly  approached  as  separate  problems,  they  frequently  coexist and may arise from shared structural, endocrine, inflammatory, or functional  mechanisms. Endometriosis, adenomyosis, polycystic ovary syndrome (PCOS), pelvic  inflammatory  disease  (PID),  uterine  structural  disease,  and  disorders  of  the  hypothalamic-pituitary-ovarian  axis  can  produce  overlapping  combinations  of  abnormal bleeding, pain, ovulatory dysfunction, and impaired fertility.