Detecting Endometriosis in Adolescents

Abstract

Endometriosis is characterized by the presence of endometrial glands and stroma external to the uterus. Up to 17% of postmenarcheal females and nearly 40% of adolescents with chronic pelvic pain are found to have endometriosis. While endometriosis traditionally was thought to be a disease of adulthood, two-thirds of adult women with endometriosis report symptoms beginning before 20 years of age. While endometriosis in adults often presents with cyclic pelvic pain, dysmenorrhea, dyspareunia, infertility, and ovarian lesions, such predictive signs and symptoms are rare in the adolescent. Endometriosis in adolescents is no exception and is certainly a common subject for debate in the relevant circles. These controversies relate to its prevalence, natural course and treatment. Diagnostic delay represents a major problem for endometriosis patients including adult women and adolescent girls. Symptomatic endometriosis should be detected at an early stage, if required also during adolescence, as a longer delay before surgical diagnosis is associated with more advanced stages of endometriosis and with a higher likelihood of fertility problems. Therefore, understanding the origins and progression of adolescent endometriosis is needed to screen all female adolescents and to identify female adolescents at risk to develop endometriosis. Here, I present 1) origins and prevalence of adolescent endometriosis, 2) pathophysiology and risk factors of adolescent endometriosis, and 3) clinical course, diagnosis and treatment of adolescent endometriosis.