Treatment of Endometriosis in Adolescents: A Narrative Literature Review

Objective: Endometriosis in adolescents is challenging to diagnose in its early stages, yet it is widespread among adolescent girls with chronic pelvic pain, posing a significant risk to their physical and mental health, as well as subsequent fertility. The treatment of endometriosis in adolescents primarily involves surgery and pharmacologic therapy, each with distinct advantages and disadvantages. Currently, there is no consensus on selecting the optimal treatment approach. Therefore, this study aimed to review the literature on the management of endometriosis in adolescents. Mechanism: We conducted a narrative literature review to identify studies evaluating treatments for endometriosis in adolescents, using PubMed, MEDLINE, and Cochrane Library databases between January 2005 and December 2025. The final search was conducted on December 31, 2025. Findings in Brief: Our review offers a critical analysis of current therapeutic strategies for endometriosis in adolescent populations and summarizes the characteristics of various management approaches, with an emphasis on comprehensive care and long-term management. Conclusions: Although oral contraceptive therapy remains the first-line treatment for endometriosis in adolescents, surgery is indicated for those individuals unresponsive to pharmacologic therapy. Clinicians are advised to adopt a personalized approach combining pharmacological and surgical interventions, as well as to provide long-term follow-up to reduce disease recurrence and promote fertility.