Endometriosis In Teens: Symptoms, Risks And Treatment

Identifying the cause and signs of endometriosis facilitates timely and appropriate treatment in teens.

Medically reviewed by Dr. Arva M Bhavnagarwala, DNB Dr. Arva M Bhavnagarwala Dr. Arva M BhavnagarwalaDNB twitter_iconinsta_icon Specialty: PediatricsExperience: 7 years
Written by Anshuman Mohapatra
Last Updated on

Endometriosis in teens is a painful condition in which the endometrial tissues grow outside the uterus. The endometrium tissues line the uterus in healthy women, which grow and bleed in a regular menstrual cycle. In the case of endometriosis, the endometrial tissues can be seen growing in the fallopian tubes, intestines, and ovaries. Although endometriosis tissues follow the same menstrual cycle, it causes extreme cramping and pain. The treatment for endometriosis is a complex process, and complete recovery might not be possible. Read through the post to know about the causes of endometriosis in teens and ways to manage it.

Read through the post to know about the causes of endometriosis in teens and ways to manage it.

Signs and symptoms of endometriosis in teens
Image: Shutterstock

Are Teenagers Prone To Endometriosis?

Endometriosis is a common problem among teens and adults. A review of 19 studies reveals that over 64% of the more than 1,000 adolescents had endometriosis when a laparoscopic examination was performed (1). However, due to the delayed appearance of symptoms, the diagnosis and medical treatments of the disease are delayed in most cases (2).

What Are The Signs And Symptoms Of Endometriosis In Teenagers?

Endometriosis is a non-cancerous overgrowth of tissue. The overgrowing tissue is similar to the endometrium (the lining of the uterus). According to the US Department of Health & Human Services, endometriosis in teens can have the following common symptoms (3) (4).

  • Excruciating menstrual cramps
  • Persistent pain in the lower back and pelvis region
  • Pain during intercourse
  • Chronic pain while urinating during the menstrual period
  • Blood in urine or stool
  • Separate bleeding other than those seen during regular menstrual periods
  • Indigestion, constipation, diarrhea, uncontrollable bloating, and nausea

What Are The Risk Factors And Complications Of Endometriosis?

Endometriosis takes time to manifest, and teens usually are not aware of the developing health hazards. The American Society of Reproductive Medicine classifies endometriosis into four stages. Stage 1 begins with minimal symptoms, while a patient with stage 4 comes with severe endometriosis.

The following are the potential risk factors for endometriosis in teens (5) (6).

  • Start of the menstrual period at an early age
  • Use of oral contraceptives
  • Daily pain in the pelvis region
  • Intensified menstrual symptoms and heavy bleeding
  • Short menstrual cycle
  • Alcohol use
  • High levels of estrogen hormone
  • Hereditary links
  • Reproductive tract disorders
  • Low body weight
  • Intercourse during menses

Some complications associated with endometriosis may include (7)

  • Fertility problems.
  • Ovarian cysts and adhesions.
  • Surgery complications.
  • Bladder, bowel, and intestine problems.

How To Diagnose Endometriosis in Teens?

The diagnosis of endometriosis in teens is challenging since the onset of symptoms is mild and overlaps with general menstrual pain. The pain may intensify over time; however, it is still difficult to diagnose using non-invasive methods (4). It generally takes up to nine years to make the correct diagnosis (8).

The diagnosis can only be confirmed by taking internal tissue samples and examining them under the microscope.

Laparoscopy is the gold standard for diagnosing endometriosis. It tells about the extent of growth and location of endometrial growth. However, ultrasound, CT scans, and MRI scans are also used in some cases.

What Are The Treatment Options For Endometriosis In Teens?

Endometriosis is a complicated condition, and there is no available cure for it (8). An early diagnosis and management of endometriosis can help ease the life of the teen.

  • Laparoscopic surgery: The overgrown tissue can be removed using laparoscopic surgery.
  • Non-invasive alternatives: Teens may choose to ease their symptoms by taking guidance from a gynecologist. Medicines, hormonal suppression of periods, and IUDs are used to help teens manage menstrual pains.
  • Exercise and physical therapy: An exercise routine can help ease the pain and strengthen the pelvis muscles.
  • Pain management: Teens can be taught ways to cope with the intense pain.

What Are The Risks Associated With Endometriosis Surgery?

Endometriosis surgery is generally performed laparoscopically, which has the following associated risks (9).

  • Possible pelvic infection
  • Severe bleeding during surgery
  • Adhesions
  • Damage and thinning of the walls of associated organs such as bowels, bladder, or ureters

What Are The Recovery Options For Endometriosis?

Diagnosing the condition early and following a treatment plan are the best strategies to manage endometriosis. Stopping a treatment plan will invite the reoccurrence of the symptoms. A second-look laparoscopy is done to ascertain the reoccurrence of the disease.
Laparoscopic surgery is an invasive procedure and often gives internal scars and injuries. It takes a while to recover from the surgery.

  • A typical recovery timeline can be a few days and might extend up to a few weeks if a more invasive surgery option was used.
  • After recovery, it is usual to take some time to gain the previous agility in activities.
  • Maintaining a healthy lifestyle and following a good exercise routine will help the teen heal early.

Frequently Asked Questions

1. What is the youngest age I can get endometriosis?

According to the Children’s Mercy Hospital, girls as young as eight years have endometriosis in the US (8).

2. Does endometriosis start at puberty?

Generally, endometriosis can occur in any girl who has started having her periods. However, in some cases, it may begin before their first menstrual cycle (10) (11).

3. Is endometriosis worse before the period?

According to experts, endometriosis pain typically worsens during menstrual periods (12). Some girls or women experience endometriosis pain before their period. However, the pain may be much worse during their period.

4. What happens if endometriosis is left untreated?

If left untreated, endometriosis may improve in some cases. However, in some other cases, it may lead to aggravated symptoms. In severe cases, it might cause complications such as infertility (13).

5. Are people born with endometriosis or does it develop?

Experts suggest that endometriosis runs in families and may be inherited (3). The symptoms of the disease typically manifest during adolescence or may come later in adulthood.

Endometriosis is a painful and progressive disease in females. It usually has an onset during adolescence; however, the symptoms may become apparent only years after it, thus delaying the prognosis and treatment of the disease. Seek medical help if your teen experiences symptoms of endometriosis to avoid complications.

Key Pointers

  • Excruciating menstrual cramps, constant pain in the lower back, painful intercourse, blood in the urine or stool, and pain while peeing during periods are some signs of endometriosis in teenagers.
  • Early menarche, oral contraceptives, short menstrual cycles, and high estrogen levels are some common risk factors.
  • Pelvic infections, adhesions, severe bleeding during surgery, and damage to the walls of other organs are possible complications of endometriosis surgery.

References

  1. Martin Hirsch et al.; (2020); The Prevalence of Endometriosis in Adolescents with Pelvic Pain: A Systematic Review.
    https://www.sciencedirect.com/science/article/abs/pii/S1083318820302874
  2. I. Brosens et al.; (2013); Endometriosis in adolescents is a hidden progressive and severe disease that deserves attention
    not just compassion.
  3. Endometriosis.
    https://www.womenshealth.gov/a-z-topics/endometriosis
  4. Endometriosis.
    https://www.hopkinsmedicine.org/health/conditions-and-diseases/endometriosis
  5. Carlo Bulletti et al.; (2013); Endometriosis and infertility.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941592/
  6. C. Matthew Peterson et al.; (2013); Risk factors associated with endometriosis: importance of study population for characterizing disease in the ENDO Study.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4114145/
  7. Complications-Endometriosis
    https://www.bladderandbowel.org/associated-illness/endometriosis/
  8. Endometriosis in Teens.
    https://www.childrensmercy.org/departments-and-clinics/gynecology/endometriosis-in-teens/
  9. Laparoscopic Surgery for Endometriosis.
    https://www.uofmhealth.org/health-library/hw101171
  10. Endometriosis in Girls.
    https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/endometriosis/
  11. Endometriosis of young girls and teenagers.
    http://nezhat.org/endometriosis-of-young-girls-and-teenagers/
  12. Severe Menstrual Pain is NOT Normal.
    https://www.ohsu.edu/womens-health/severe-menstrual-pain-not-normal
  13. Treating endometriosis.
    https://www.thewomens.org.au/health-information/periods/endometriosis/treating-endometriosis
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Dr. Arva Bhavnagarwala did her post-graduation from Masina Hospital in Mumbai and worked at Jaslok Hospital and Research Center as a Clinical Associate. With seven years of experience, she currently practices pediatrics at her private clinic in South Mumbai and is attached to Masina Hospital as a consultant pediatrician.

Read full bio of Dr. Arva M Bhavnagarwala
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