A case study and comprehensive differential diagnosis and care plan for the three Ds of women's health: Primary dysmenorrhea, secondary dysmenorrhea, and dyspareunia

Purpose: To provide a case study for the discussion, diagnosis, management, and comprehensive plan of care for primary dysmenorrhea, secondary dysmenorrhea, and dyspareunia for the advanced practice registered nurse (APRN) working in primary care. Data sources: Selected text, research, clinical articles, and personal communication with expert APRNs. Conclusions: Three of the most commonly presenting women's health related conditions include primary dysmenorrhea, secondary dysmenorrhea, and dyspareunia. These conditions can present a challenge in developing an accurate differential diagnosis and appropriate plan of care. This article presents the reader with a detailed case study that provides an analysis of each potential differential diagnosis with rationale. A recommended diagnostic and therapeutic plan of care is included for the reader's review. Implications for practice: If left untreated, primary dysmenorrhea, secondary dysmenorrhea, and dyspareunia can result in pain, suffering, and impaired fertility and sexual function. Patients frequently experience symptoms for months to years prior to accurate diagnosis.