Early-Onset Endometriosis

In: The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology · 2021 · pp. 72–80 · doi:10.1017/9781108582322.011 · W3216764085
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This paper discusses early-onset endometriosis, focusing on its presentation with pelvic pain, diagnostic imaging, and individualized treatment strategies favoring medical management.

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This chapter reviews what is known about early-onset endometriosis, noting that classic disease is described after menarche but has been reported in girls as early as age 10, with limited evidence on progression and fertility effects. It describes typical presentation (dysmenorrhoea and cyclic or acyclical pelvic pain), outlines common clinical approaches such as NSAIDs and combined oral contraceptives for nonspecific pelvic pain, and discusses imaging in which ultrasound is first-line while MRI better visualizes deep infiltrating disease. It emphasizes an individualized, patient-centered management approach that may favor medical treatment, with surgery reserved for selected cases, while also caveating that knowledge remains limited regarding disease course and reproductive outcomes. This paper is centrally about endometriosis — a dedicated overview of early-onset endometriosis in children/adolescents and its clinical management.

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Abstract

Classically endometriosis develops sometime after menarche and has been reported in girls as early as 10 years. There is limited knowledge about early-onset endometriosis, particularly about disease progression and its effect on fertility. Patients often present with prevailing symptoms of dysmenorrhoea, cyclic or acyclical pelvic pain. NSAIDS and COCs are often used to treat non-specific nature of pelvic pain. Ultrasound is the first-line imaging modality but MRI offers better visualization of deep infiltrating endometriosis. A patient-centred approach with detailed explanation of treatment options incorporating the patient’s wishes should individualize the management plan. Medical treatment is the most preferred option and surgical intervention may be necessary in selected cases.
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- The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology - The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology - Copyright page - Dedication - Contents - Videos - Contributors - Preface - Section 1 Basic Sciences in Gynaecology - Section 2 Menstrual Disorders - Chapter 6 Paediatric and Adolescent Gynaecology - Chapter 7 Heavy Menstrual Bleeding - Chapter 8 Management of Uterine Fibroids - Chapter 9 Early-Onset Endometriosis - Chapter 10 Chronic Pelvic Pain - Section 3 Reproductive Endocrinology and Infertility - Section 4 Contraception and STIs - Section 5 Post-Reproductive Care - Section 6 Vulva and Vagina - Section 7 Cervix - Section 8 Uterus - Section 9 Ovary and Fallopian Tubes - Section 10 Operative Gynaecology - Section 11 Public Health Issues in Gynaecology - Section 12 Miscellaneous - Index - Plate Section (PDF Only) - References from Section 2 - Menstrual Disorders Published online by Cambridge University Press: 24 November 2021 Book contents - The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology - The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology - Copyright page - Dedication - Contents - Videos - Contributors - Preface - Section 1 Basic Sciences in Gynaecology - Section 2 Menstrual Disorders - Chapter 6 Paediatric and Adolescent Gynaecology - Chapter 7 Heavy Menstrual Bleeding - Chapter 8 Management of Uterine Fibroids - Chapter 9 Early-Onset Endometriosis - Chapter 10 Chronic Pelvic Pain - Section 3 Reproductive Endocrinology and Infertility - Section 4 Contraception and STIs - Section 5 Post-Reproductive Care - Section 6 Vulva and Vagina - Section 7 Cervix - Section 8 Uterus - Section 9 Ovary and Fallopian Tubes - Section 10 Operative Gynaecology - Section 11 Public Health Issues in Gynaecology - Section 12 Miscellaneous - Index - Plate Section (PDF Only) - References Classically endometriosis develops sometime after menarche and has been reported in girls as early as 10 years. There is limited knowledge about early-onset endometriosis, particularly about disease progression and its effect on fertility. Patients often present with prevailing symptoms of dysmenorrhoea, cyclic or acyclical pelvic pain. NSAIDS and COCs are often used to treat non-specific nature of pelvic pain. Ultrasound is the first-line imaging modality but MRI offers better visualization of deep infiltrating endometriosis. A patient-centred approach with detailed explanation of treatment options incorporating the patient’s wishes should individualize the management plan. Medical treatment is the most preferred option and surgical intervention may be necessary in selected cases. - Type - Chapter - Information - The EBCOG Postgraduate Textbook of Obstetrics & GynaecologyGynaecology, pp. 72 - 80Publisher: Cambridge University PressPrint publication year: 2021 Brosens, I, Gordts, S, Benagiano, G. 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Fertil Steril 1996;66:517–521.Google Scholar Accessibility compliance for the HTML of this chapter is currently unknown and may be updated in the future. To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle. Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. 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