Adolescent endometriosis

Abstract

The prevalence of endometriosis is estimated to be about one-third of adolescents with chronic pelvic pain and increase to 80% in adolescents with chronic pelvic pain who fail to respond to medical treatment. The most common presenting symptom is dysmenorrhea and chronic pelvic pain. Acyclic pain is more common in adolescents than in adults. Atypical and subtle lesions are seen with red lesions being the commonest. The majority have early stage disease but a significant proportion (up to 30%) have advanced disease. An ovarian endometrioma is the most common presentation with advanced disease. Management is challenging and includes distraught parents and patient. Surgery is beneficial in treating pain with all stages of endometriosis and improving fertility in adolescents with infertility. Optimal and complete laparoscopic excision might slow disease progression. Postoperative medical therapy may have benefit to treat endometriosis pain but is not conclusive with regard to preventing disease progression or recurrence.