Consider discussing patient's condition with GYN to evaluate the need for pelvic ultrasound if history or exam is accompanied by pain or palpable mass (to exclude structural causes, such as fibroids, polyps, and/or ovarian tumors)
These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.