Endometriosis in Teens

If you’re a teen dealing with painful periods, you are not alone. Surveys show that 70% to 90% of young people have period pain.^1,2

It may just be mild cramps, or it may be pelvic pain that causes you to miss out on important activities like school, sports, or time with friends. If pelvic pain is keeping you from doing things you want to do, you may be wondering if endometriosis is the reason.

Is my pain normal? Could my pain be endo?

Mild cramping, bloating, or a feeling of heaviness or discomfort in the pelvis during your period can all be normal.³ And while period pain is a classic symptom of endometriosis in adults, it can look different in young teens.

Here are some things that can mean there could be a medical issue causing the pain:^3,4

• The pain is severe and doesn’t feel better with over-the-counter medication like ibuprofen or acetaminophen (aka Tylenol)
• The pain gets worse over time rather than better
• You have pain throughout the month, not just with your period. Nearly 2/3 of teens with endometriosis have both types of pain. The pain usually starts when periods start, or soon after, but it can even start before you ever get your period.
• You have irregular bleeding
• You also have bladder pain, or intestine problems (like diarrhea or constipation), or migraine headaches. Half of the young people with endometriosis have pain that gets better after a bowel movement⁵
• Intercourse is painful
• There’s endometriosis in your family. If your mother or sister has endometriosis, you’re more likely to have it as well

If you’ve tried a hormonal treatment for pelvic pain for 3-6 months and it hasn’t improved, it’s more likely that there is a medical problem causing the pain. Endometriosis is the most common cause of pain like this: one study found that 67% of teens who had pain that didn’t get better with birth control pills had endometriosis.

None of these symptoms tells you for sure that it’s endometriosis, but if you do have any of these problems it’s a good idea to talk to your health care practitioner.

Do I have to have a pelvic exam?

Some teens may feel uncomfortable with the idea of having a pelvic exam. Your first pelvic exam is always awkward, no matter what.

But don’t let that keep you from seeing a gynecologist. Depending on your symptoms, a pelvic exam may not be needed.

If your doctor thinks the exam is necessary, they should explain the reason to you. Then you get to decide. An abdominal ultrasound may be a helpful alternative. (3)

Does treatment really help?

It does! The good news is that most teens have milder (earlier stage) endometriosis. (4, 6)

Laparoscopy is still the only way to diagnose endometriosis for sure and is used to remove endometriosis as well. Treatment is really effective: in one study, 80% of patients reported that their pain was either improved or gone a year later when they continued medical therapy (like birth control pills) after laparoscopy. (3, 7).

If you’re not ready to schedule laparoscopy, there are other treatments that a gynecologist can help with.

It can be hard to talk about pelvic pain or periods. It can feel awkward having these conversations with your parents or doctors, or you might worry about having a pelvic exam. Severe, long-lasting period pain isn’t normal, and there are treatments that can help.

Your health care practitioner can help you make a plan that’s best for you.