Adolescent Endometriosis: An Overview of an Overlooked Condition(The ELEMI Programme)

Adolescent endometriosis is an often underdiagnosed and misunderstood chronic gynecological condition characterised by chronic pelvic pain. Presentation among adolescent girls often comprise of severe dysmenorrhea, gastrointestinal disturbances, and fatigue. Unlike in adults, the disease among the adolescent may display atypical or non-classic symptoms, complicating timely recognition and diagnosis. Early onset of symptoms is often dismissed as normal menstrual discomfort, leading to significant diagnostic delays, averaging 4 to 10 years that could lead to fertility issues and poor quality of life.The pathophysiology of adolescent endometriosis is not well understood although it is thought to involve genetic, immunologic, and hormonal factors. Notably, early lesions in adolescents may appear as clear, red, or vesicular rather than the typical black or blue lesions seen in adults, necessitating experienced surgical evaluation.Management strategies are multifaceted, incorporating nonsteroidal anti-inflammatory drugs (NSAIDs), hormonal therapies including oral contraceptives and progestins, and, when necessary, laparoscopic surgery. A multidisciplinary approach is recommended to address the physical, emotional, and psychological aspects of the disease although this may vary across high income and low to middle income countries. Raising awareness among healthcare providers and promoting early intervention are critical to mitigating the long-term consequences of adolescent endometriosis. Ongoing research into non-invasive diagnostic tools and individualised treatment options are essential to improve health outcomes and enhance the quality of life later in life .