More Teenage Girls Have Endometriosis Than You May Think

Endometriosis is a condition in which tissue similar to the tissue lining the uterus (the endometrium) grows outside of the uterus. Doctors believe the condition affects more than 11 percent of women between the ages of 15 to 44 in the United States. Endometriosis can cause significant pain, which tends to occur around menstrual periods, but can also occur with sex, during bowel movements, or on a chronic basis.¹

Endometriosis is most common in women in their 30s and 40s, leading researchers to think it is less common in teenage girls. This means many teenagers are not being thoroughly evaluated for endometriosis, possibly delaying proper diagnosis and treatment.

However, new research has found that endometriosis might be more common in teenage girls than previously thought.¹ This could be a breakthrough for teenage girls living with pelvic pain that significantly impacts their lives on a regular basis.

What does the new research show?

A new study examined the rate of endometriosis in teenagers with pelvic pain who went to the doctor for gynecologic evaluation. The researchers analyzed the results of 231 international studies, making it the largest study of its kind. The results were published in the Journal of Pediatric & Adolescent Gynecology in July 2020.²

The 19 studies that were ultimately included for their important data found that 64 percent of adolescents who had laparoscopy (minimally invasive surgery to examine the organs inside the abdomen) for pelvic pain were found to have endometriosis.²

Researchers also looked at 13 studies to classify the severity of the endometriosis using the revised American Society of Reproductive Medicine classifications. They found that:²

• 53 percent of the adolescents had Stage I (minimal) endometriosis
• 28 percent of the adolescents had Stage II (mild) endometriosis
• 20 percent of the adolescents had Stage III (moderate) endometriosis
• 13 percent of the adolescents had Stage IV (severe) endometriosis

Stage IV endometriosis can cause blockages and impair the functioning of other organs like kidneys or bowel. Infertility is also very likely.²

Early treatment is important?

These findings show that a large number of teenage girls who experience pelvic pain may in fact have endometriosis. In many cases, doctors assume it is dysmenorrhea (painful periods) and therefore prescribe pain medication. However, endometriosis may be the underlying cause for the pain.²

Endometriosis is treatable. If endometriosis is left undiagnosed and untreated, it can become more extensive, causing more pain and leading to more serious problems as time goes on.

What research is next?

Teenagers who are experiencing pelvic pain should be evaluated for endometriosis and if need be, referred to a doctor who has experience treating endometriosis. More research needs to be done to better understand endometriosis in teen girls, including the best ways to diagnose, treat, and manage the condition in this population.

Things to consider

If you are a teen with pelvic pain or painful periods, or have a teen girl who experiences these symptoms, talk with your doctor about the possibility of endometriosis. Ask your doctor about laparoscopic evaluation for endometriosis if other treatments have not been effective. If your doctor is unfamiliar with endometriosis or does not listen to your concerns, ask for a referral to a specialist.

Endometriosis is treatable, but it needs to be properly diagnosed so the right treatment can be used.