Adolescent Endometriosis: From Clinical Management to an Early Recognition and Prevention-Oriented Paradigm-A Narrative Review.
5 affiliations
- 1Faculty of Nursing and Health Sciences, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
- 2Department of Anatomy and Embryology, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
- 3Department of Pathology, County Emergency Clinical Hospital, 400347 Cluj-Napoca, Romania.
- 4Genomics Department, Medfuture-Institute for Biomedical Research, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
- 5Department of Public Health and Management, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
Abstract
Background
Adolescent endometriosis remains underrecognized, although symptoms often begin after menarche and diagnosis may be delayed for years. Severe dysmenorrhea, chronic or acyclic pelvic pain, school absenteeism, and impaired functioning should not be normalized. This narrative review synthesizes evidence on adolescent and early-onset endometriosis, focusing on early recognition, non-invasive assessment, individualized care, and function-preserving follow-up.Methods
A structured narrative review search supported by PubMed/MEDLINE was updated on 9 August 2026, focused mainly on the last decade, with selected older studies included when relevant. Adolescent-specific evidence was prioritized; adult or mixed-age data were used only when applicable to diagnosis, imaging, treatment safety, or pathophysiology. Evidence was synthesized descriptively; no meta-analysis, formal risk-of-bias assessment, or formal evidence grading was performed.Results
The synthesis included 58 unique publications. Direct adolescent evidence supports early suspicion in severe dysmenorrhea, refractory or acyclic pain, functional impairment, family history, and obstructive Müllerian anomalies. Imaging may identify endometriomas, deep endometriosis, adhesions, or adenomyosis-related features, but normal imaging does not exclude superficial disease. Biomarkers remain investigational in adolescents. Hormonal treatment is primarily supported for pain, bleeding, and functional outcomes.Conclusions
Early recognition, timely referral, expert imaging when appropriate, individualized treatment, and follow-up centered on functional impact may reduce symptom burden in adolescents. Hormonal suppression is a clinically plausible strategy for symptom control and preservation of functioning, but it is not a proven disease-modifying or fertility-preserving intervention in adolescents.
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BibTeX
@article{gaiaoltean2026adolescent,
title = {{Adolescent Endometriosis: From Clinical Management to an Early Recognition and Prevention-Oriented Paradigm-A Narrative Review.}},
author = {Adriana Ioana Gaia-Oltean and Teodora Telecan and Laura-Ancuta Pop and Miana Gabriela Pop and Alexandru Florin-Badea and Romeo Micu},
journal = {Healthcare (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/healthcare14193241},
url = {https://europepmc.org/article/MED/42881679},
note = {CC BY},
}
RIS
TY - JOUR
TI - Adolescent Endometriosis: From Clinical Management to an Early Recognition and Prevention-Oriented Paradigm-A Narrative Review.
AU - Adriana Ioana Gaia-Oltean
AU - Teodora Telecan
AU - Laura-Ancuta Pop
AU - Miana Gabriela Pop
AU - Alexandru Florin-Badea
AU - Romeo Micu
PY - 2026
DA - 2026/10/01
JO - Healthcare (Basel, Switzerland)
DO - 10.3390/healthcare14193241
UR - https://europepmc.org/article/MED/42881679
AB - Background Adolescent endometriosis remains underrecognized, although symptoms often begin after menarche and diagnosis may be delayed for years. Severe dysmenorrhea, chronic or acyclic pelvic pain, school absenteeism, and impaired functioning should not be normalized. This narrative review synthesizes evidence on adolescent and early-onset endometriosis, focusing on early recognition, non-invasive assessment, individualized care, and function-preserving follow-up.Methods A structured narrative review search supported by PubMed/MEDLINE was updated on 9 August 2026, focused mainly on the last decade, with selected older studies included when relevant. Adolescent-specific evidence was prioritized; adult or mixed-age data were used only when applicable to diagnosis, imaging, treatment safety, or pathophysiology. Evidence was synthesized descriptively; no meta-analysis, formal risk-of-bias assessment, or formal evidence grading was performed.Results The synthesis included 58 unique publications. Direct adolescent evidence supports early suspicion in severe dysmenorrhea, refractory or acyclic pain, functional impairment, family history, and obstructive Müllerian anomalies. Imaging may identify endometriomas, deep endometriosis, adhesions, or adenomyosis-related features, but normal imaging does not exclude superficial disease. Biomarkers remain investigational in adolescents. Hormonal treatment is primarily supported for pain, bleeding, and functional outcomes.Conclusions Early recognition, timely referral, expert imaging when appropriate, individualized treatment, and follow-up centered on functional impact may reduce symptom burden in adolescents. Hormonal suppression is a clinically plausible strategy for symptom control and preservation of functioning, but it is not a proven disease-modifying or fertility-preserving intervention in adolescents.
SN - 2227-9032
ER -