Endometriosis More Common in Teenage Girls Than Previously Thought

Priscilla Lynch 

September 04, 2020

The prevalence of endometriosis among adolescents with pelvic pain symptoms is high, and they are just as likely to suffer with endometriosis as adult women, the largest study of its kind, in press publication in the  Journal of Pediatric & Adolescent Gynecology,  has found.

UK researchers undertook a systematic review and meta-analysis of 231 international studies to understand how likely it was for symptomatic adolescent girls to have endometriosis.

In total, researchers evaluated 19 studies including 1243 symptomatic adolescent girls.

Of 1011 adolescents undergoing laparoscopy investigation, 648 (64%) were found to have endometriosis (prevalence ranged from 25% to 100%)

Thirteen studies, 381 participants, categorised disease severity using the revised American Society of Reproductive Medicine classification. Amongst these, 53 per cent (201/381) had stage I, 28 per cent (105/381) had stage II, 20 per cent (76/381) had stage III and 13 per cent (49/381) had stage IV disease.

As part of the systematic review, the team also assessed evidence where adolescent girls were offered a magnetic resonance imaging (MRI) or ultrasound to diagnose endometriosis, rather than a laparoscopy. This review also found high rates of endometriosis, with the accuracy of diagnosis proving similar to that found in adult women.

The research team believes the evidence of endometriosis disease burden shown in the study should signal a change in the national diagnostic pathway, including earlier referral for MRI or ultrasound scans.

Co-lead author Dr Rima Dhillon-Smith said: “The increasing accuracy and availability of both MRI and ultrasound for the detection of endometriosis allows for speedy and minimally invasive diagnosis for those girls and parents wanting an answer to often debilitating symptoms."

“This opens the door for a change in how GPs manage this disease, meaning doctors can make more informed decisions earlier and provide individualised treatments which could help to prevent the condition from progressing.”

Hirsch M, Dhillon-Smith R, Cutner A, Yap M, M Creighton S. The prevalence of endometriosis in adolescents with pelvic pain: a systematic review. J Pediatr Adolesc Gynecol. 2020 Jul 28 [Epub ahead of print]. doi: 10.1016/j.jpag.2020.07.011. PMID: 32736134 View abstract

This article originally appeared on Univadis, part of the Medscape Professional Network.

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