paraphrase and avoid AI patterns: Although less likely in this case, endometriosis remains a consideration, especially if symptoms persist or worsen despite initial treatment. Endometriosis often presents with chronic pelvic pain, dysmenorrhea that may begin earlier and last longer than typical menses, dyspareunia, and possible infertility. In this patient, the absence of dyspareunia, abnormal bleeding, or signs of pelvic mass lowers suspicion. However, if NSAIDs and hormonal therapy are ineffective, a referral for further evaluation, possibly including pelvic ultrasound or laparoscopy, may be warranted