A 35-Year-Old Woman Without a Previous History of Dysmenorrhea Reports

A 35-year-old woman without a previous history of dysmenorrhea reports lower pelvic pain and irregular bleeding between periods. What is the initial action in managing this patient?

A) Obtaining a pelvic transvaginal ultrasound with saline infusion
B) Ordering a CBC, erythrocyte sedimentation rate, and cultures
C) Performing an abdominal, pelvic, and rectovaginal examination
D) Prescribing a trial of nonsteroidal anti-inflammatory medications (NSAIDs)