Sexual and reproductive health among adolescents and young adults with pelvic pain or endometriosis: a scoping review

This scoping review aims to map the existing evidence on sexual and reproductive health (SRH) experiences, concerns, healthcare experiences and information needs among adolescents and young adults (aged ≤25 years) with pelvic pain, dysmenorrhoea, or suspected or diagnosed endometriosis. Endometriosis affects approximately 10% of women and people assigned female at birth during their reproductive years, with symptom onset frequently beginning in adolescence. While a growing body of research has examined the condition’s impact on quality of life, pain and diagnosis, far less attention has been given to the broader sexual and reproductive health experiences of younger populations living with pelvic pain or endometriosis. Preliminary qualitative data from the AD-IMAGENDO study’s adolescent and young adult focus groups identified a wider range of SRH concerns than anticipated, including sexual pain, fertility worries, hormonal treatment experiences, privacy in clinical encounters, relationship challenges, identity-related barriers to care and inadequate reproductive health education. These findings suggest that current clinical practice and research may underestimate the scope and significance of SRH needs in this population. The review is guided by the question: What is known about the sexual and reproductive health experiences and needs of adolescents and young adults with pelvic pain, dysmenorrhoea, or suspected or diagnosed endometriosis? Using the Population–Concept–Context (PCC) framework, the review will include qualitative, quantitative and mixed-methods primary research examining any of the following SRH domains: sexual pain and sexual wellbeing; relationships and intimacy; fertility knowledge and concerns; reproductive intentions; contraception and hormonal treatments; pregnancy-related knowledge or concerns; privacy, autonomy and parental involvement; communication with healthcare professionals; sexual and reproductive health education; gender identity, sexual identity and inclusive care; and unmet information, healthcare and support needs. Studies from any healthcare, community, education or research setting worldwide will be eligible. A systematic search will be conducted across seven databases: Medline (Ovid), Embase (Ovid), Emcare (Ovid), PsycINFO (Ovid), CINAHL (EBSCO), Web of Science, Scopus and the Cochrane Library (CENTRAL). Search terms combine three concept blocks — condition (endometriosis, pelvic pain, dysmenorrhoea), age (adolescents and young adults) and sexual and reproductive health — using both controlled vocabulary and free-text terms. Title and abstract screening, followed by full-text review, will be conducted independently by two reviewers using Covidence. Data will be charted on study characteristics, participant demographics, study design, SRH domains examined, questionnaires or outcome measures used, key findings, participant-reported information and support needs, and gaps in the available evidence. The review will follow the JBI methodology for scoping reviews and will be reported according to the PRISMA extension for Scoping Reviews (PRISMA-ScR). Expected outcomes include a structured overview of what is currently known about the SRH experiences and needs of young people with pelvic pain or endometriosis, identification of the SRH domains most and least studied in this age group, a summary of outcome measures and instruments used, and identification of evidence gaps to inform future research. The findings will directly inform the development of a sexual and reproductive health survey for the cohort study.