Endometriosis in adolescence

Abstract

Endometriosis is a chronic disease with endometrial-like tissue located outside the uterus, resulting in inflammation, pelvic pain and infertility. Laparoscopic exploration is the only accurate diagnostic aid for disease recognition, and the time between symptom onset and final diagnosis can be up to 10 years. Endometriosis can already start in adolescence, and in order to make an earlier diagnosis, researchers are beginning to look for an association between specific characteristics, or markers, encountered during adolescence and the later development of the disease.

The purpose of this assignment is to examine the disease mechanism and characteristics of endometriosis, and to review the presumably predictive features during adolescence. The management and effect of treating adolescents with endometriosis will also be discussed.

Some relevant markers for endometriosis are: 1) chronic pelvic pain, cyclic and noncyclic, 2) severe dysmenorrhea, 3) noncontracptive use of oral contraceptives for dysmenorrhea resistant to NSAIDs and 4) pain interfering with daily living. Being especially alert to these markers, clinical questioning may be one of the most useful tools for identifying girls with endometriosis. Treatment involves NSAIDs, oral contraceptives, surgery, GnRH agonists and mental support. Hopefully, early recognition and treatment in young girls will lead to less extensive surgery and sequealae in adults. However, we still lack strong trials among the adolescent population to prove these hypotheses. Nevertheless, the public and health professionals’ knowledge of adolescent endometriosis has to improve, so that affected girls can be taken seriously and not be unnecessarily burdened in a very important phase of life.