Endometriosis in the Adolescent Patient

Mallory A. Stuparich; Nicole M. Donnellan; Joseph S. Sanfilippo

doi:10.1055/s-0036-1597121

Seminars in Reproductive Medicine, Table of Contents

Semin Reprod Med 2017; 35(01): 102-109
DOI: 10.1055/s-0036-1597121

Review Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Endometriosis in the Adolescent Patient

Authors

Mallory A. Stuparich

¹Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
Nicole M. Donnellan

¹Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
Joseph S. Sanfilippo

¹Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

Abstract

The recognition and management of endometriosis in the adolescent patient is challenging. A strong clinical suspicion for endometriosis should be maintained in the adolescent who suffers from acyclic pelvic pain as well as absenteeism from school and lack of participation in daily activities. Risk factors include the presence of an obstructive Mullerian anomaly, a family history of endometriosis, and conditions that prolong exposure to endogenous and exogenous estrogens. Empiric medical therapy with nonsteroidal anti-inflammatory drugs and combined oral contraceptive pills may be considered in most adolescents with endometriosis. Failure of empiric therapy may warrant diagnostic laparoscopy, which affords a concomitant opportunity for treatment via excision of endometriosis. Endometriotic implants in the adolescent tend to be more atypical, appearing red/flame-like, clear/polypoid, or vesicular. Endometriosis tends to recur more often in adolescents when compared with adults, and the role of postoperative medical therapy for the suppression of disease progression is not entirely clear. Current knowledge on the impact of adolescent endometriosis on future fertility is limited but overall reassuring.

Keywords

adolescent - endometriosis - laparoscopy

Full Text

References

References
1 Sarıdoğan E. Endometriosis in teenagers. Womens Health (Lond) 2015; 11 (5) 705-709
2 Dun EC, Kho KA, Morozov VV, Kearney S, Zurawin JL, Nezhat CH. Endometriosis in adolescents. JSLS 2015; 19 (2) e2015
3 Janssen EB, Rijkers AC, Hoppenbrouwers K, Meuleman C, D'Hooghe TM. Prevalence of endometriosis diagnosed by laparoscopy in adolescents with dysmenorrhea or chronic pelvic pain: a systematic review. Hum Reprod Update 2013; 19 (5) 570-582
4 Redwine DB. The distribution of endometriosis in the pelvis by age groups and fertility. Fertil Steril 1987; 47 (1) 173-175
5 Redwine DB. Age-related evolution in color appearance of endometriosis. Fertil Steril 1987; 48 (6) 1062-1063
6 Davis GD, Thillet E, Lindemann J. Clinical characteristics of adolescent endometriosis. J Adolesc Health 1993; 14 (5) 362-368
7 Templeman C. Adolescent endometriosis. Curr Opin Obstet Gynecol 2012; 24 (5) 288-292
8 Brosens I, Gordts S, Benagiano G. Endometriosis in adolescents is a hidden, progressive and severe disease that deserves attention, not just compassion. Hum Reprod 2013; 28 (8) 2026-2031
9 Sanfilippo JS, Wakim NG, Schikler KN, Yussman MA. Endometriosis in association with uterine anomaly. Am J Obstet Gynecol 1986; 154 (1) 39-43
10 Steenberg CK, Tanbo TG, Qvigstad E. Endometriosis in adolescence: predictive markers and management. Acta Obstet Gynecol Scand 2013; 92 (5) 491-495
11 Chapron C, Borghese B, Streuli I, de Ziegler D. Markers of adult endometriosis detectable in adolescence. J Pediatr Adolesc Gynecol 2011; 24 , (5 Suppl): S7-S12
12 Roman JD. Adolescent endometriosis in the Waikato region of New Zealand--a comparative cohort study with a mean follow-up time of 2.6 years. Aust N Z J Obstet Gynaecol 2010; 50 (2) 179-183
13 Simpson JL, Elias S, Malinak LR, Buttram Jr VC. Heritable aspects of endometriosis. I. Genetic studies. Am J Obstet Gynecol 1980; 137 (3) 327-331
14 Audebert A, Lecointre L, Afors K, Koch A, Wattiez A, Akladios C. Adolescent endometriosis: report of a series of 55 cases with a focus on clinical presentation and long-term issues. J Minim Invasive Gynecol 2015; 22 (5) 834-840
15 Laufer MR, Goitein L, Bush M, Cramer DW, Emans SJ. Prevalence of endometriosis in adolescent girls with chronic pelvic pain not responding to conventional therapy. J Pediatr Adolesc Gynecol 1997; 10 (4) 199-202
16 Reese KA, Reddy S, Rock JA. Endometriosis in an adolescent population: the Emory experience. J Pediatr Adolesc Gynecol 1996; 9 (3) 125-128
17 Smorgick N, Marsh CA, As-Sanie S, Smith YR, Quint EH. Prevalence of pain syndromes, mood conditions, and asthma in adolescents and young women with endometriosis. J Pediatr Adolesc Gynecol 2013; 26 (3) 171-175
18 Laufer MR. Current approaches to optimizing the treatment of endometriosis in adolescents. Gynecol Obstet Invest 2008; 66 (Suppl. 01) 19-27
19 Trotman G, Gomez-Lobo V. Pelvic pain in the adolescent. Available at: http://contemporaryobgyn.modernmedicine.com/contemporary-obgyn/news/user-defined-tags/endometriosis/pelvic-pain-adolescent . Accessed August 29, 2016
20 Mansuria S, Sanfilippo JS. Surgical problems in the pediatric patient. In: Bieber EJ, Sanfilippo JS, Horowitz IR, , eds. Clinical Gynecology. 1st ed. Philadelphia, PA: Churchill Livingstone Elsevier; 2006: 520-521
21 Smorgick N, As-Sanie S, Marsh CA, Smith YR, Quint EH. Advanced stage endometriosis in adolescents and young women. J Pediatr Adolesc Gynecol 2014; 27 (6) 320-323
22 Laufer MR. Helping “adult gynecologists” diagnose and treat adolescent endometriosis: reflections on my 20 years of personal experience. J Pediatr Adolesc Gynecol 2011; 24 , (5 Suppl): S13-S17
23 Stavroulis AI, Saridogan E, Creighton SM, Cutner AS. Laparoscopic treatment of endometriosis in teenagers. Eur J Obstet Gynecol Reprod Biol 2006; 125 (2) 248-250
24 Kennedy S, Bergqvist A, Chapron C , et al; ESHRE Special Interest Group for Endometriosis and Endometrium Guideline Development Group. ESHRE guideline for the diagnosis and treatment of endometriosis. Hum Reprod 2005; 20 (10) 2698-2704
25 Practice bulletin no. 114: management of endometriosis. Obstet Gynecol 2010; 116 (1) 223-236
26 Sanfilippo JS, Mansuria SM, Donnellan NM. Surgical problems in the pediatric patient. In: Bieber EJ, Sanfilippo JS, Horowitz IR, Shafi MI, , eds. Clinical Gynecology. 2nd ed. Cambridge, United Kingdom: Cambridge University Press; 2015: 576-578
27 Yeung Jr P, Sinervo K, Winer W, Albee Jr RB. Complete laparoscopic excision of endometriosis in teenagers: is postoperative hormonal suppression necessary?. Fertil Steril 2011; 95 (6) 1909-1912 , 1912.e1
28 Tandoi I, Somigliana E, Riparini J, Ronzoni S, Vigano' P, Candiani M. High rate of endometriosis recurrence in young women. J Pediatr Adolesc Gynecol 2011; 24 (6) 376-379
29 Doyle JO, Missmer SA, Laufer MR. The effect of combined surgical-medical intervention on the progression of endometriosis in an adolescent and young adult population. J Pediatr Adolesc Gynecol 2009; 22 (4) 257-263
30 Unger CA, Laufer MR. Progression of endometriosis in non-medically managed adolescents: a case series. J Pediatr Adolesc Gynecol 2011; 24 (2) e21-e23
31 Yang Y, Wang Y, Yang J, Wang S, Lang J. Adolescent endometriosis in China: a retrospective analysis of 63 cases. J Pediatr Adolesc Gynecol 2012; 25 (5) 295-299
32 Shakiba K, Bena JF, McGill KM, Minger J, Falcone T. Surgical treatment of endometriosis: a 7-year follow-up on the requirement for further surgery. Obstet Gynecol 2008; 111 (6) 1285-1292
33 Ventolini G, Horowitz GM, Long R. Endometriosis in adolescence: a long-term follow-up fecundability assessment. Reprod Biol Endocrinol 2005; 3: 14