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Peer-reviewedCC BYInternational journal of medical sciences

Adolescent and Early-Onset Adenomyosis: Phenotypes, Diagnostic Challenges, and Fertility-Conscious Care.

  • Shuhong Yang1,2,3
  • Yuling Chen1,2,3
  • Xiangyi Ma1,2,3
  1. 1Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
  2. 2National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, Hubei, 430030, China.
  3. 3Key Laboratory of Cancer Invasion and Metastasis, Ministry of Education, Wuhan, Hubei, 430030, China.
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Abstract

Adolescent and early-onset adenomyosis is increasingly recognized in symptomatic young patients, but its clinical significance remains uncertain. This narrative review synthesizes English-language literature on adolescent and early-onset adenomyosis, distinguishing direct adolescent and young-adult evidence from supportive evidence derived from adult populations. Current data suggest that adenomyosis-like imaging features may be identified in adolescents with severe dysmenorrhea, heavy menstrual bleeding, chronic pelvic pain, or coexisting endometriosis. Early disease often appears as subtle diffuse inner-myometrial change, focal lesions, or cystic/juvenile forms rather than the classic diffuse adult phenotype. Ultrasound is the first-line imaging modality, whereas MRI is reserved for equivocal findings, atypical cystic lesions, suspected congenital anomalies, or endometriosis overlap. Management requires a stepwise, symptom-oriented approach that considers future reproductive options and avoids unnecessary uterine intervention. Overall, adolescent adenomyosis should be considered in patients with severe or treatment-resistant menstrual symptoms, while uncertain imaging findings should not be overinterpreted.

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Cite

BibTeXRIS
BibTeX
@article{yang2026adolescent,
  title = {{Adolescent and Early-Onset Adenomyosis: Phenotypes, Diagnostic Challenges, and Fertility-Conscious Care.}},
  author = {Shuhong Yang and Yuling Chen and Xiangyi Ma},
  journal = {International journal of medical sciences},
  year = {2026},
  month = oct,
  doi = {10.7150/ijms.140803},
  url = {https://europepmc.org/article/MED/42910152},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Adolescent and Early-Onset Adenomyosis: Phenotypes, Diagnostic Challenges, and Fertility-Conscious Care.
AU  - Shuhong Yang
AU  - Yuling Chen
AU  - Xiangyi Ma
PY  - 2026
DA  - 2026/10/02
JO  - International journal of medical sciences
DO  - 10.7150/ijms.140803
UR  - https://europepmc.org/article/MED/42910152
AB  - Adolescent and early-onset adenomyosis is increasingly recognized in symptomatic young patients, but its clinical significance remains uncertain. This narrative review synthesizes English-language literature on adolescent and early-onset adenomyosis, distinguishing direct adolescent and young-adult evidence from supportive evidence derived from adult populations. Current data suggest that adenomyosis-like imaging features may be identified in adolescents with severe dysmenorrhea, heavy menstrual bleeding, chronic pelvic pain, or coexisting endometriosis. Early disease often appears as subtle diffuse inner-myometrial change, focal lesions, or cystic/juvenile forms rather than the classic diffuse adult phenotype. Ultrasound is the first-line imaging modality, whereas MRI is reserved for equivocal findings, atypical cystic lesions, suspected congenital anomalies, or endometriosis overlap. Management requires a stepwise, symptom-oriented approach that considers future reproductive options and avoids unnecessary uterine intervention. Overall, adolescent adenomyosis should be considered in patients with severe or treatment-resistant menstrual symptoms, while uncertain imaging findings should not be overinterpreted.
SN  - 1449-1907
ER  -