Abstract
Endometriosis is a common finding in adolescents who have a history of chronic pelvic
pain or dysmenorrhoea resistant to medical treatment, however the exact prevalence
is unknown. Both early/superficial and advanced forms of endometriosis are found in
adolescents, including ovarian endometriomas and deep endometriotic lesions. Whilst
spontaneous resolution is possible, recent reports suggest that adolescent endometriosis
can be a progressive condition, at least in a significant proportion of cases. It
is also claimed that deep endometriosis has its roots in adolescence. Optimum treatment
is far from clear and long term recurrence is still a significant problem. The most
frequently reported treatment approach in the published literature is a combination
of surgery and postoperative hormonal treatment with the combined oral contraceptives,
progestins, levonorgestrel intrauterine system or gonadotrophin releasing hormone
analogues. Use of gonadotrophin releasing hormone analogues and long term progestins
should be carefully considered due to concerns over continuing bone formation in this
age group. There is currently no consensus as to whether surgery should be avoided
as much as possible to prevent multiple operations in the long term, or surgical treatment
should be considered at an early stage before more severe lesions develop. Further
research is required to determine which approach would offer a better long term outcome.
Keywords
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Article info
Publication history
Published online: June 15, 2016
Accepted:
May 13,
2016
Received in revised form:
May 7,
2016
Received:
January 18,
2016
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.
