Sola had been told her pelvic pain was stress-related for two years. When she finally insisted on a scan, a 4 cm ovarian endometrioma was found. Mascot Healthcare coordinated her diagnosis and management with clarity she had never received before.
Lab scientist, Ikeja. Presented with left-sided pelvic pain worsening around periods, painful intercourse, and fatigue. Self-referred after reading about endometriosis online. Pelvic ultrasound revealed a 4 cm left ovarian endometrioma.
Ovarian Endometriosis (Endometrioma)Sola had always been a high achiever. Night shifts in the lab, NYSC obligations, a postgraduate application. When pelvic pain started at 27, her GP said: "You're under a lot of pressure — it's probably stress." She was prescribed buscopan and sent home. The pain returned next month.
The following year, the pain had a left-sided focus. She returned to the clinic and was told her ovaries "felt normal" on examination. No scan was ordered. By year two, the dyspareunia was affecting her relationship. She researched her symptoms thoroughly and arrived at Mascot Healthcare specifically requesting a transvaginal ultrasound to look for endometriosis.
The scan was performed the same day. The sonographer found a 4 cm left ovarian cyst with a characteristic "ground-glass" internal echo pattern — the ultrasound hallmark of an endometrioma (chocolate cyst).
Ovarian endometriosis (endometrioma) produces characteristic symptoms — but they overlap with so many common conditions that diagnosis is often delayed by years.
Constant dull pain in the left iliac fossa that spiked severely in the days before and during her period.
Deep dyspareunia — sharp pain with deep penetration — causing her to avoid intimacy.
Dysmenorrhoea that had worsened progressively over 3 years; required 2 days off work per cycle.
Persistent fatigue that she and others attributed to her demanding lab shift schedule.
Significant abdominal bloating in the premenstrual week, resolving after periods began.
Buscopan (hyoscine) — antispasmodic; no effect on endometriosis-related pain.
Ibuprofen during periods — partial relief; insufficient for the degree of pain.
Dietary changes (reduced red meat, increased fibre) — minimal impact.
Stress management techniques — well-intentioned; not addressing the underlying pathology.
The transvaginal ultrasound confirmed a 4 cm left ovarian endometrioma with characteristic ground-glass echoes and no internal vascularity on Doppler — consistent with a benign endometrioma rather than a malignant ovarian mass. CA-125 was mildly elevated at 48 U/mL (normal < 35), consistent with endometriosis rather than malignancy.
Mascot Healthcare initiated management with combined oral contraceptive pills to suppress endometrial lesion activity and reduce dysmenorrhoea. A formal gynaecology referral was made for specialist assessment regarding the endometrioma — whether to manage conservatively with hormonal suppression or proceed to laparoscopic cystectomy.
Sola was counselled on the fertility implications of endometriosis and advised to have an anti-Müllerian hormone (AMH) assessment — a marker of ovarian reserve — given her age and the presence of an ovarian endometrioma.
Left Ovarian Endometrioma 4 cm (transvaginal ultrasound — ground-glass pattern); CA-125 mildly elevated; clinical endometriosis
COCP for hormonal suppression; analgesic ladder for breakthrough pain; gynaecology referral for endometrioma cystectomy assessment; AMH testing
Gynaecology review arranged. Laparoscopic left ovarian cystectomy recommended and planned. The contraceptive pill providing 50% pain reduction in the interim.
On the COCP, Sola's dysmenorrhoea improved significantly pending definitive surgical management. She is on a gynaecology surgical waiting list for laparoscopic cystectomy.
The average time to diagnosis for endometriosis in Nigeria is 5–8 years. "Probably stress" should not be the default explanation for left-sided pelvic pain, deep dyspareunia, and worsening dysmenorrhoea in a young woman.
A transvaginal ultrasound — ordered early — can identify an ovarian endometrioma in under 30 minutes. Demanding appropriate investigation is not being difficult; it's being your own best advocate.
Pelvic pain plus painful periods plus painful intercourse in a young woman demands a scan — not reassurance without investigation.
Walk in to Mascot Healthcare, Akoka — same-day consultation, transparent pricing, 4.9★ rated.