Adölesan Endometriozisin Yönetimi

In: Tüp Bebek Okulu Klinik ve Embriyoloji Eğitim Kitabı · 2026 · pp. 247–256 · doi:10.37609/akya.3886.c5054 · W7164026862
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This review and reference list addresses the management of adolescent endometriosis, referencing studies on its prevalence, diagnosis, symptoms, and association with other conditions.

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The paper focuses on the management of adolescent endometriosis, drawing on a broad range of earlier research and clinical guidance, with attention to diagnosis, symptom patterns, imaging indicators, and medical and surgical treatment approaches. At a high level, it synthesizes evidence from prevalence studies, diagnostic investigations (including ultrasound findings), and treatment-related literature such as hormonal therapies and add-back approaches, as well as longer-term outcomes like recurrence and quality of life. A key limitation is that, as an overview/perspective-style article, it does not present new original data and instead depends on heterogeneous prior studies and guideline statements. This paper is centrally about endometriosis — specifically, it addresses how adolescent endometriosis is managed, including diagnostic and therapeutic considerations.

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Adölesan Endometriozisin Yönetimi Özet Referanslar Laufer MR, Goitein L, Bush M, et al. Prevalence of endometriosis in adolescent girls with chronic pelvic pain not responding to conventional therapy. J Pediatr Adolesc Gynecol. 1997;10:199–202 Goldstein DP, De Cholnoky C, Emans SJ. Adolescent endometriosis. J Adolesc Health Care. 1980;1:37–41 Benagiano G, Guo SW, Puttemans P, et al. Progress in the diagnosis and management of adolescent endometriosis: an opinion. Reprod Biomed Online. 2018;36:102–114 Janssen E, Rijkers AC, Hoppenbrouwers K, et al. Prevalence of endometriosis diagnosed by laparoscopy in adolescents with dysmenorrhea or chronic pelvic pain: a systematic review. Hum Reprod Update. 2013;19:570–582 Matalliotakis M, Goulielmos GN, Matalliotaki C, et al. Endometriosis in adolescent and young girls: report on a series of 55 cases. J Pediatr Adolesc Gynecol. 2017;30:568–570 Dun EC, Kho KA, Morozov VV, et al. Endometriosis in adolescents. JSLS. 2015;19:e2015.00019 Martire FG, Lazzeri L, Conway F, et al. Early noninvasive diagnosis of endometriosis: dysmenorrhea and specific ultrasound findings are important indicators in young women. Fertil Steril. 2023;119:455–464 Fallon J. Endometriosis in youth. JAMA. 1946;131:1405–6 Clark AH. Endometriosis in a young girl. J Am Med Assoc. 1948;136(10):690 Lévy JM, Rosenthal R, Dellenbach P, et al. [Genital crisis in the newborn. repercussion of certain maternal or pregnancy factors on the frequency of neonatal metrorrhagia]. Arch Fr Pediatr. 1964;21:819–27 Bryant AE, Laufer MR. Fetal ovarian cysts: incidence, diagnosis and management. J Reprod Med. 2004;49:329–37 Becker CM, Bokor A, Heikinheimo O, et al. ESHRE guideline: endometriosis. Hum Reprod Open. 2022;2022(2):hoac009 Nnoaham KE, Webster P, Kumbang J, et al. Is early age at menarche a risk factor for endometriosis? A systematic review and meta-analysis of case-control studies. Fertil Steril. 2012;98:702–712.e6 Treloar SA, Bell TA, Nagle CM, et al. Early menstrual characteristics associated with subsequent diagnosis of endometriosis. Am J Obstet Gynecol. 2010;202:534.e1–534.e6 Steinmacher S, Bösmüller H, Granai M, et al. Endometriosis in patients with Mayer-Rokitansky-Küster-Hauser-Syndrome-histological evaluation of uterus remnants and peritoneal lesions. J Clin Med. 2022;11:6458 Asaturova AV, Faizullina NM, Bobkova MV, et al. Morphological features and the functional state of connective tissue of the uterine rudiments in reproductive age patients with Mayer–Rokitansky–Küster–Hauser syndrome. Clin Experimental Morphology. 2020;9(4):24–30 Boujenah J, Salakos E, Pinto M, et al. Endometriosis and uterine malformations: infertility may increase severity of endometriosis. Acta Obstet Gynecol Scand. 2017;96:702–706 Brosens I, Gargett CE, Guo SW, et al. Origins and progression of adolescent endometriosis. Reprod Sci. 2016;23:1282–1288 Malinak LR, Buttram VC Jr., Elias S, et al. Heritage aspects of endometriosis. II. Clinical characteristics of familial endometriosis. Am J Obstet Gynecol. 1980;137:332–337 Yang Y, Wang Y, Yang J, et al. Adolescent endometriosis in China: a retrospective analysis of 63 cases. J Pediatr Adolesc Gynecol. 2012;25:295–299 DiVasta AD, Vitonis AF, Laufer MR, Missmer SA. Spectrum of symptoms in women diagnosed with endometriosis during adolescence vs adulthood. Am J Obstet Gynecol. 2018 Mar;218(3):324.e1-324.e11. doi: 10.1016/j.ajog.2017.12.007. Greene R, Stratton P, Cleary SD, et al. Diagnostic experience among 4,334 women reporting surgically diagnosed endometriosis. Fertil Steril. 2009;91:32–39 Kaplanoglu M, Cetin C, Kaplanoglu D, et al. Adolesan Endometriozis. Turkish Journal of Reproductive Medicine and Surgery. 2020;4(1):29–38 ACOG Committee Opinion No. 760. Dysmenorrhea and endometriosis in the adolescent. Obstet Gynecol. 2018;132:e249–58 Martire FG, Lazzeri L, Conway F, et al. Adolescence and endometriosis: symptoms, ultrasound signs and early diagnosis. Fertil Steril. 2020;114:1049–1057 Seckin B, Ates MC, Kirbas A, et al. Usefulness of hematological parameters for differential diagnosis of endometriomas in adolescents/young adults and older women. Int J Adolesc Med Health. 2018 Sep 26;33(2). doi: 10.1515/ijamh-2018-0078. Albee RB Jr, Sinervo K, Fisher DT. Laparoscopic excision of lesions suggestive of endometriosis or otherwise atypical in appearance. J Minim Invasive Gynecol. 2008;15(1):32–7 Özyer S, Uzunlar Ö, Özcan N, et al. Endometriomas in adolescents and young women. J Pediatr Adolesc Gynecol. 2013;26(3):176–9 Suvitie PA, Hallamaa MK, Matomäki JM, et al. Prevalence of pain symptoms suggestive of endometriosis among Finnish adolescent girls (TEENMAPS study). J Pediatr Adolesc Gynecol. 2016;29:97–103 Zannoni L, Giorgi M, Spagnolo E, et al. Dysmenorrhea, absenteeism from school, and symptoms suspicious for endometriosis in adolescents. J Pediatr Adolesc Gynecol. 2014;27:258–265 Söderman L, Edlund M, Marions L. Prevalence and impact of dysmenorrhea in Swedish adolescents. Acta Obstet Gynecol Scand. 2019;98:215–221 Smorgick N, Marsh CA, As-Sanie S, et al. Prevalence of pain syndromes, mood conditions, and asthma in adolescents and young women with endometriosis. J Pediatr Adolesc Gynecol. 2013;26:171–175 Ventolini G, Horowitz GM, Long R. Endometriosis in adolescence: a long-term follow-up fecundability assessment. Reprod Biol Endocrinol. 2005;3:14 Audebert A, Lecointre L, Afors K, et al. Adolescent endometriosis: report of a series of 55 cases with a focus on clinical presentation and long-term issues. J Minim Invasive Gynecol. 2015;22:834–840 Chapron C, Lafay-Pillet MC, Monceau E, et al. Questioning patients about their adolescent history can identify markers associated with deep infiltrating endometriosis. Fertil Steril. 2011;95:877–88 Galinkin J, Koh JL. Recognition and management of iatrogenically induced opioid dependence and withdrawal in children. Pediatrics. 2014;133:152–5 Allen C, Hopewell S, Prentice A, Gregory D. Nonsteroidal antiinflammatory drugs for pain in women with endometriosis. Cochrane Data-base of Systematic Reviews 2009, Issue 2 Marjoribanks J, Ayeleke RO, Farquhar C, et al. Nonsteroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database Syst Rev. 2015;(7):CD001751 Proctor M, Farquhar C. Diagnosis and management of dysmenorrhoea. BMJ. 2006;332(7550):1134–8 Brown J, Crawford TJ, Datta S, et al. Oral contraceptives for pain associated with endometriosis. Cochrane Database Syst Rev. 2018;5:CD001019 Harada T, Momoeda M, Taketani Y, et al. Low-dose oral contraceptive pill for dysmenorrhea associated with endometriosis. Fertil Steril. 2008;90:1583–1588 Zorbas KA, Economopoulos KP, Vlahos NF. Continuous versus cyclic oral contraceptives for the treatment of endometriosis. Arch Gynecol Obstet. 2015;292:37–43 Olive DL. Medical therapy of endometriosis. Semin Reprod Med. 2003;21(2):167–78 Practice bulletin no. 114: management of endometriosis. Obstet Gynecol. 2010;116:223–236 Brown J, Kives S, Akhtar M. Progestagens and anti-progestagens for pain associated with endometriosis. Cochrane Database Syst Rev. 2012;CD002122 Flores VA, Vanhie A, Dang T, et al. Progesterone receptor status predicts response to progestin therapy in endometriosis. J Clin Endocrinol Metab. 2018;103:4561–4568 Chronic Pelvic Pain: ACOG Practice Bulletin, Number 218. Obstet Gynecol. 2020;135(3):e98–e109 Gallagher JS, Missmer SA, Hornstein MD, et al. Long-term effects of gonadotropin-releasing hormone agonists and add-back in adolescent endometriosis. J Pediatr Adolesc Gynecol. 2018;31:376–381 Sadler Gallagher J, Feldman HA, Stokes NA, et al. The effects of gonadotropin-releasing hormone agonist combined with add-back therapy on quality of life for adolescents with endometriosis. J Pediatr Adolesc Gynecol. 2017;30:215–222 DiVasta AD, Feldman HA, Sadler Gallagher J, et al. Hormonal add-back therapy for females treated with gonadotropin-releasing hormone agonist for endometriosis. Obstet Gynecol. 2015;126:617–627 Ashfaq S, Pellegrini MV, Can AS. Danazol. In: StatPearls [Internet]. 2024 Laufer MR, Sanfilippo J, Rose G. Adolescent endometriosis: diagnosis and treatment approaches. J Pediatr Adolesc Gynecol. 2003;16(suppl 3):S3–S11 Shi J, Tan X, Feng G, et al. Research advances in drug therapy of endometriosis. Front Pharmacol. 2023;14:1199010 Chwalisz K. Clinical development of the oral gonadotropin-releasing hormone antagonist elagolix. F S Rep. 2023;4(2 Suppl):65–72 Nothnick WB. The emerging use of aromatase inhibitors for endometriosis treatment. Reprod Biol Endocrinol. 2011;9:87 Abbott J, Hawe J, Hunter D, et al. Laparoscopic excision of endometriosis: a randomized, placebo-controlled trial. Fertil Steril. 2004;82:878–884 Tandoi I, Somigliana E, Riparini J, et al. High rate of endometriosis recurrence in young women. J Pediatr Adolesc Gynecol. 2011;24:376–379 Berlanda N, Vercellini P, Fedele L. The outcomes of repeat surgery for recurrent symptomatic endometriosis. Curr Opin Obstet Gynecol. 2010;22(4):320–5 Seo JW, Lee DY, Yoon BK, et al. The efficacy of postoperative cyclic oral contraceptives after gonadotropin-releasing hormone agonist therapy to prevent endometrioma recurrence in adolescents. J Pediatr Adolesc Gynecol. 2017;30:223–227 Doyle JO, Missmer SA, Laufer MR. The effect of combined surgical-medical intervention on the progression of endometriosis in an adolescent and young adult population. J Pediatr Adolesc Gynecol. 2009;22:257–263

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