Spectrum of symptoms in women diagnosed with endometriosis during adolescence vs adulthood

Clinical diagnosis of endometriosis: a call to action

“…2,40,41 Pain is typically initially menstrual (dysmenorrhea), but may progress to include nonmenstrual pelvic pain, which is prevalent among women with diagnosed endometriosis. 42 When asked about their experiences living with endometriosis, participants in the qualitative study by Moradi et al 5 universally described their pain as "severe and progressive during menstrual and nonmenstrual phases." Women with endometriosis are more likely to report dyspareunia, dyschezia, and dysuria than unaffected women.…”

Dysmenorrhea, Endometriosis and Chronic Pelvic Pain in Adolescents

“…In adolescents that can tolerate a single digit vaginal exam, the bladder neck, levator ani, cervix, adnexa and uterosacral ligaments should be palpated for tenderness. Uterosacral nodules indicative of deep invasive endometriosis are rare adolescents (6,18). If there is concern about obstruction, a moistened cotton swab can be gently inserted into the vagina (19).…”

“…HCP should have a high suspicion for endometriosis in adolescents with ongoing pain. Younger age has been associated with delay in diagnosis, however more recent studies suggest this is no longer the case (6,35). Approximately two-thirds of women with endometriosis experience symptoms before the age of 20 (37).…”

“…Heavy menstrual bleeding, headaches, dizziness, low back pain are also more prevalent (37). Abdominal symptoms can include bloating, constipation, diarrhea, nausea, pain with defecation and pain that improves after bowel movements (6). Severe dysmenorrhea associated with missed activities should raise the suspicion of endometriosis.…”

“…They present later for assessment, see multiple physicians, and suffer more, compared to adults (4). Functional impairment is the primary reason for seeking medical care in adolescents with dysmenorrhea (6). Health care practitioners (HCP) should not normalize dysmenorrhea.…”