Endometriosis in the Adolescent Patient

Mallory Stuparich, Mallory A Stuparich, Nicole Donnellan, Donnellan NM, Joseph S Sanfilippo, Nicole M Donnellan, Sanfilippo JS
Seminars in reproductive medicine · 2016 · vol. 35(01) , pp. 102–109 · doi:10.1055/s-0036-1597121 · PMID:27992932 · W2562234281
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

Endometriosis in adolescents presents with acyclic pelvic pain and risk factors include obstructive Mullerian anomalies and family history, with empiric medical therapy or laparoscopy being treatment options.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 · read from full text ⓘ

The paper reviews recognition and management of endometriosis in adolescents, focusing on clinical features and risk factors, and discussing diagnostic and treatment approaches at a high level. It states that clinicians should maintain strong suspicion in adolescents with acyclic pelvic pain accompanied by school absenteeism and reduced daily activity, with risk factors including obstructive Müllerian anomalies, family history, and conditions that prolong estrogen exposure; it also describes empiric therapy with NSAIDs and combined oral contraceptive pills for many adolescents. It reports that failure of empiric medical therapy may lead to diagnostic laparoscopy, where adolescent endometriotic implants can appear more atypical (e.g., red/flame-like, clear/polypoid, or vesicular), and notes that recurrence is more frequent than in adults while the role of postoperative suppression is not fully clear. The paper’s discussion is centrally about endometriosis in adolescent patients and therefore directly relates to endometriosis, not adenomyosis.

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Abstract

The recognition and management of endometriosis in the adolescent patient is challenging. A strong clinical suspicion for endometriosis should be maintained in the adolescent who suffers from acyclic pelvic pain as well as absenteeism from school and lack of participation in daily activities. Risk factors include the presence of an obstructive Mullerian anomaly, a family history of endometriosis, and conditions that prolong exposure to endogenous and exogenous estrogens. Empiric medical therapy with nonsteroidal anti-inflammatory drugs and combined oral contraceptive pills may be considered in most adolescents with endometriosis. Failure of empiric therapy may warrant diagnostic laparoscopy, which affords a concomitant opportunity for treatment via excision of endometriosis. Endometriotic implants in the adolescent tend to be more atypical, appearing red/flame-like, clear/polypoid, or vesicular. Endometriosis tends to recur more often in adolescents when compared with adults, and the role of postoperative medical therapy for the suppression of disease progression is not entirely clear. Current knowledge on the impact of adolescent endometriosis on future fertility is limited but overall reassuring.
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Abstract

The recognition and management of endometriosis in the adolescent patient is challenging. A strong clinical suspicion for endometriosis should be maintained in the adolescent who suffers from acyclic pelvic pain as well as absenteeism from school and lack of participation in daily activities. Risk factors include the presence of an obstructive Mullerian anomaly, a family history of endometriosis, and conditions that prolong exposure to endogenous and exogenous estrogens. Empiric medical therapy with nonsteroidal anti-inflammatory drugs and combined oral contraceptive pills may be considered in most adolescents with endometriosis. Failure of empiric therapy may warrant diagnostic laparoscopy, which affords a concomitant opportunity for treatment via excision of endometriosis. Endometriotic implants in the adolescent tend to be more atypical, appearing red/flame-like, clear/polypoid, or vesicular. Endometriosis tends to recur more often in adolescents when compared with adults, and the role of postoperative medical therapy for the suppression of disease progression is not entirely clear. Current knowledge on the impact of adolescent endometriosis on future fertility is limited but overall reassuring. -

References

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Pelvic Pain Pelvic Pain Pelvic Pain Pelvic Pain Pelvic Pain Adolescent Age of Onset Anti-Inflammatory Agents, Non-Steroidal Anti-Inflammatory Agents, Non-Steroidal Contraceptives, Oral, Hormonal Contraceptives, Oral, Hormonal Female Humans Laparoscopy Predictive Value of Tests

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