A 45 year old waitress complains of pelvic pain which worsens pre-menstrually and on standing and walking. She also complains of post-coital ache. Select the most likely cause leading to her symptoms?

The key is C. Pelvic congestion syndrome. [Women with pelvic congestion syndrome experience a

constant pain that may be dull and aching, but is occasionally more acute. The pain is worse at the end

of the day and after long periods of standing, and sufferers get relief when they lie down. The pain is

worse during or after sexual intercourse, and can be worse just before the onset of the menstrual

period. Cause is attributed to female hormone estrogen induced vascular (venous) changes. So it is

usually seen in females].