Teenagers With Endometriosis
Endometriosis symptoms are often ignored in people, especially in teenagers, since they are considered to be too young to have endometriosis. In some cases, the symptoms can start before the first signs of menstruation, and they get worse after the first periods. Many of the teenagers who are experiencing symptoms will miss school and daily activities because of pelvic pain. Since some of the teens have pelvic pain during periods, they are often told by friends, family, teachers and doctors that the symptoms are "normal period pains". This, of course, will make the teenager accept painful periods as being a normal thing and that she will have to put up with the pain. Endometriosis should be suspected and included in the differential diagnosis in young pre - or perimenarcheal patients with chronic and cyclical pelvic pain especially with no response to oral contraceptives and non-steroidal anti-inflammatory medicine. Teenagers will start experiencing pelvic pain up to 1-2 weeks before menstruation if they are sexually active, depending on the location of the lesions and the affected areas, then intercourse might be painful. Other symptoms include painful bowel movements, pain when sitting down, leg pain, back pain, etc. The youngest ever diagnosed patient with endometriosis was 9 years old. Diagnosis of endometriosis in teenagers can be done mostly based on the symptoms such as pelvic pain since the disease might be superficial to be picked up by ultrasounds or MRI, or they are not sexually active. The treatment of endometriosis in teenagers is mainly based on the doctors experience with endometriosis and the way she interprets the treatment. In most cases, the patients are started first on painkillers, followed by birth control pills. Due to age, possible complications and the impact on fertility, surgery is offered quite rarely, despite the teenager being in pain. Some of them are instead put on GnRH drugs for long time use, which has been shown to have a high negative impact on bone density in adolescents with endometriosis.