{"paper_id":"2b3fbfc7-923a-4ae5-89c0-30eb55ccef85","body_text":"DOI: https:/ /doi.org/10.3399/bjgp24X737685 \n \nIncidence of menstrual symptoms suggestive of possible endometriosis in adolescents: and \nvariance in these by ethnicity and socio-economic status \n \nBackground \nDysmenorrhoea affects up to 94% of adolescents who menstruate; approximately one third \nmiss school and activities. Dysmenorrhoea can occur without identified pelvic pathology \n(primary dysmenorrhoea) or in association with other conditions (secondary dysmenorrhoea). \nIn adolescence, the commonest cause of secondary dysmenorrhoea is endometriosis. The \nincidence of symptoms in adolescence suggesting possible endometriosis has not been \npreviously documented in GP records. \nAim \nTo document incidence of adolescent endometriosis and symptoms associated with \nendometriosis in English GP records. \nMethod \nData from the QResearch primary care database were used for adolescent females aged 10–\n19 years between 1 January 2011 and 30 June 2021, reported using descriptive statistics. \nResults \nThe population cohort included 2 843 347 female adolescents; 98 887 participants had \ncoded dysmenorrhoea (3.48%) and 1994 (0.07%) had documented endometriosis. The \ncumulative incidence for the cohort who turned 10 years old in 2011 was 7.2% for \ndysmenorrhoea and 0.12% for endometriosis. The period prevalence of coded symptoms \nduring adolescence potentially associated with dysmenorrhoea and endometriosis includes: \nheavy menstrual bleeding (3.73%), irregular menstrual bleeding (2.21%), pelvic pain (0.63%), \ndyspareunia (0.40%), premenstrual syndrome (PMS)/premenstrual dysphoric disorder \n(PMDD) (0.22%), cystitis (8.45%), and irritable bowel syndrome (IBS) (1.00%). Disparities in \ncoding were observed for these variables by ethnicity and socioeconomic status. Incidence of \nprescribed hormonal medication, with and without coded dysmenorrhoea, varied by \nethnicity. This was less apparent for non-steroidal anti-inflammatory medications. \nConclusion \nPrevalence of coded dysmenorrhoea in GP records is significantly lower than community \nsurveys suggest; however, adolescent menstrual symptoms are commonly encountered in \nprimary care, and deserve specific guidance and resources. There are demographic patterns, \nlikely structural, that warrant further exploration. \n \nSharon Dixon, University of Oxford  \nKaty Vincent, University of Oxford \nJennifer Hirst, University of Oxford \nJulia Hippisley-Cox, University of Oxford  \n \nSharon Dixon, University of Oxford  \nEmail: sharon.dixon@phc.ox.ac.uk \n \nSubmission ID \n214","source_license":"public-domain-us","license_restricted":false}