Box 1.

Clinical scenario of patient with symptoms suggestive of endometriosis

Clinical scenario: Alice is 28 years old. She has made an appointment to talk to you because she is ‘fed up’ with having very painful periods. She has not seen a doctor about this before. She describes her periods as feeling ‘like knives stabbing from the inside’. She says that the pain has been so bad recently that she has had to take time off work. Extensions to the clinical scenario: Alice becomes tearful when she describes the impact of her period pain on her quality of life. Alice says she has looked online about her painful periods and is worried about what might be causing them. Would you do or approach anything differently if Alice was aged 17?