It is so important to diagnose endometriosis early in life–catching it early provides the important opportunity to prevent the consequences of the disease’s later stages. However, endometriosis in young women is especially challenging to diagnose because it differs from that of adults. Support, compassionate care, and empathy are all necessary when a young woman is suffering from symptoms of endometriosis, but are not enough. We must do more, including early and accurate diagnosis, education, and early intervention of the early stage lesions in order to halt the progress of the disease. My whole goal in my practice and in the establishment of the Endometriosis Foundation of America is to increase awareness and availability of proper treatment so we can catch this disease in time to limit the damage it does to the body.
For the purpose of clarity on this page, I want to define some terms. I use the word "teenager" to describe a woman between the ages of 13-18, "young woman" for women between approximately 19-23 years old, and adolescents as encompassing both of these age groups. Most girls initially do not ovulate (anovulatory cycle), and therefore their periods are irregular. See the ovulation video clip above as it is relate to period cycle.
Prevalence and symptoms
Most women with endometriosis started experiencing symptoms in their teenage years (Nnoaham, 2011)
Endometriosis has been found in girls as young as 8 years old (Laufer, 2003)
According to an interesting theory, endometriosis may start forming in girls as young as newborns (Brosens, 2013)
The most common symptoms in adolescents differ from those of adults, and include:
NSAIDs can be used for pain management (Laufer, 2003)
often results in bone density loss and severe side effects (Laufer, 2003)
often result in dependency and addiction
analgesic (pain-killing) properties often decrease over prolonged periods of use (decreased efficacy)
prolonged use may actually increase the intensity of perceived pain (opioid-induced pain sensitivity) (Ballantyne, 2008; Mao, 2006)
Ballantyne, Jane C., and Naomi S. Shin. "Efficacy of opioids for chronic pain: a review of the evidence." The Clinical journal of pain 24.6 (2008): 469-478.
Brosens, Ivo, and Giuseppe Benagiano. "Is neonatal uterine bleeding involved in the pathogenesis of endometriosis as a source of stem cells?." Fertility and sterility 100.3 (2013): 622-623.
Brosens, Ivo, Patrick Puttemans, and Giuseppe Benagiano. "Endometriosis: a life cycle approach?." American journal of obstetrics and gynecology 209.4 (2013): 307-316.
Dovey, Serena, and Joseph Sanfilippo. "Endometriosis and the adolescent." Clinical obstetrics and gynecology 53.2 (2010): 420-428.
Doyle, J. O., S. A. Missmer, and M. R. Laufer. "The effect of combined surgical-medical intervention on the progression of endometriosis in an adolescent and young adult population." Journal of pediatric and adolescent gynecology 22.4 (2009): 257-263.
Laufer, Marc R., Joseph Sanfilippo, and Gillian Rose. "Adolescent endometriosis: diagnosis and treatment approaches." Journal of pediatric and adolescent gynecology 16.3 (2003): S3-S11.
Mao, Jianren. "Opioid-induced abnormal pain sensitivity." Current pain and headache reports 10.1 (2006): 67-70.
Shah, Divya K., and Stacey A. Missmer. "Scientific investigation of endometriosis among adolescents." Journal of pediatric and adolescent gynecology 24.5 (2011): S18-S19.
Smorgick, Noam, et al. "Prevalence of pain syndromes, mood conditions, and asthma in adolescents and young women with endometriosis." Journal of pediatric and adolescent gynecology 26.3 (2013): 171-175.
Yeung Jr, Patrick, et al. "Complete laparoscopic excision of endometriosis in teenagers: is postoperative hormonal suppression necessary?." Fertility and sterility 95.6 (2011): 1909-1912.
Vicino, Mauro, et al. "Endometriosis in young women: the experience of GISE." Journal of pediatric and adolescent gynecology 23.4 (2010): 223-225.