Endometriosis in adolescents
The history of endometriosis is the natural history of a chronic illness that accompanies women throughout their lives, the diagnostic and therapeutic management can vary at different stages of life.
In this post we are going to focus on endometriosis in adolescents. The main problem at this age is that many adolescents do not go for gynecological checkups, therefore, there is a lot of ignorance and misinformation about the importance of seeing a specialist if they are suffering from irregular cycles, abundant bleeding or intense pain during menstruation.
Studies on endometriosis in adolescence
According to the studies by Zannoni (1) and Martire (2), around 12-13% of adolescents present symptoms suggestive of endometriosis. According to the review by Chapron (3), the clinical signs related to endometriosis in the adolescent population are:
- Long-term use of non-steroidal anti-inflammatory drugs.
- Family history of endometriosis.
- School or work absenteeism
- Use of birth control before the age of 18 to treat your dysmenorrhea.
It is estimated that adolescents around the age of 17 have a history of dysmenorrhea (cramps and abdominal pain during menstruation) and pelvic pain of more than two years. Typically, they might have seen at least three different specialists before being diagnosed with endometriosis.
The main symptom for which they attend a checkup and to which they refer to in a consultation is dysmenorrhea followed by heavy menstrual bleeding, pelvic pain and less frequently dysquecia (constipation), gastrointestinal transit disorders or dyspareunia (pain when having sexual intercourse).
Thus, in the study by Martire (2) of a total of 270 adolescents referred for ultrasound control for various clinical reasons, 20% of the girls with dysmenorrhea, 33% with dyspareunia and dyschecia, and 44% with gastrointestinal symptoms presented ultrasound results suggestive of endometriosis.
The most frequent finding was the presence of endometriomas (a type of ovarian cyst produced from the growth of ectopic endometrial tissue), although 4-5% also had adenomyosis (endometrial tissue that develops in the muscular wall of the uterus) and endometriosis infiltrating (at the intestinal and urinary tract level).
Early diagnosis of endometriosis in adolescents.
It is therefore very important to carry out studies and examinations on endometriosis in adolescents who suffer pain, dysmenorrhea, excessive use of analgesics during menstruation or school absenteeism. The ultrasound findings that can make us suspect endometriosis, will allow its early diagnosis and refer these patients to specific specialists for their appropriate medical or surgical treatment and follow-up appointments.
We should not normalize intense menstrual pain, nor irregular periods, it is an important health issue. Many teenagers experience discomfort and pain every month and endometriosis could also affect their fertility if they decide to become mothers in the future, it must not go untreated.
In our fertility clinic we are specialized in highly complex cases such as endometriosis, each year we diagnose patients who have been suffering from this disease for years and who have always normalized their symptoms. Thanks to a personalized and detailed study of their medical records and cutting-edge techniques, we have been able to diagnose them and help many of them fulfill their dream of becoming mothers.
Let’s stop normalizing menstrual pain, it must not go untreated. Contact our team and book your first consultation at our clinic.
References:
- Zannoni L, Giorgi M, Spagnolo E, Montanari G, Villa G, Seracchioli R. Dysmenorrhea, absenteeism from school and symptoms suspicious for endometriosis in adolescents. J Pediatric Adolesc Gynecol.2014;27:258-265.
- Martire FG, Lazzeri L, Conway F, Siciliano T,Pietropolii A, Piccione E, Solima E, Centini G,Zupi E, Exacoustos C. Adolescence and endoemtriosis: symptoms, ultrasound signs and early diagnosis. Fertil Steril. 2020;114:1049-1057
- Chapron C, Lafay-Pillet MC, Monceau E,Borghese B, Ngo C, Souza C. Questioning patients about their adolescent history can identify markers associated with deep infiltrating endometriosis.Fertil Steril. 2011;95:877-888.
