| Acyclic or cyclic pelvic pain, often with radiation to back or lower extremities |
| Dysmenorrhea |
| Abnormal uterine bleeding and associated cramping |
| Deep dyspareunia |
| Gastrointestinal symptoms- abdominal pain, nausea, diarrhea, constipation |
| Symptoms are usually severe enough that the adolescent has missed school or other activities. |
| Many of these patients have previously presented to an emergency department or another physician because of the pain. |