Endometriosis in Adolescent and Young Girls: Report on a Series of 55 Cases


      Study Objective

      The aim of this retrospective study was to evaluate endometriosis in adolescent and young girls and further to review the menstrual, reproductive characteristics, and risk factors.

      Design and Setting

      We reviewed the medical records of adolescent and young girls with endometriosis from 2 different countries. Data were collected and analyzed from charts of 900 patients with endometriosis.

      Participants and Interventions

      Fifty-five female adolescents aged between 13 and 21 years (mean age 18.3 years) participated in our series. This study was conducted in the Obstetric and Gynecology Department of Venizeleio General Hospital of Crete and involved all patients diagnosed with endometriosis between 1996 and 2016.

      Main Outcome Measures

      Statistical methods included χ2 and Mann-Whitney U test.


      Of 900 patients with endometriosis we found 55 female adolescents (6.1%). The mean age was 18.3 ± 2.3 years, significantly younger compared with the advanced endometriosis patients (32.7 ± 7.2; P < .001). Regarding the menstrual reproductive and others characteristics, we observed several differences in adolescent young girls compared with the advanced age endometriosis group. The factors associated with an increased risk for young women include age at menarche, dysmenorrhea, history of asthma, and a positive family history of endometriosis. Additionally, we report on 16 of 55 (32%) adolescent women with endometriosis and congenital malformations (P < .01) and 5 patients who were diagnosed with dry eye syndrome.


      There is an association between endometriosis in adolescent and young women and risk factors including early menarche, early onset of dysmenorrhea, history of asthma, previous surgical procedures, obstructive genital anomalies, and family history of endometriosis.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Pediatric and Adolescent Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Laufer M.R.
        • Goitein L.
        • Bush M.
        • et al.
        Prevalence of endometriosis in adolescent girls with chronic pelvic pain not responding to conventional therapy.
        J Pediatr Adolesc Gynecol. 1997; 10: 199
        • Brosens I.
        • Gargett C.E.
        • Guo S.W.
        • et al.
        Origins and progression of adolescent endometriosis.
        Reprod Sci. 2016; 23: 1282
        • Deligeorglou E.
        Endometriosis in adolescence.
        in: Matalliotakis I. Arici A. New Developments in Endometriosis, 17. 2011: 394
        • Sanfilippo J.S.
        • Wakim N.G.
        • Scehikler K.N.
        • et al.
        Endometriosis in association with uterine anomaly.
        Am J Obstet Gynecol. 1986; 154: 39
        • Upson K.
        • Sathyanarayana S.
        • Scholes D.
        • et al.
        Early-life factors and endometriosis risk.
        Fertil Steril. 2015; 104: 964
        • Arvanitis D.A.
        • Koumantakis G.E.
        • Goumenou A.G.
        • et al.
        CYP1A1, CYP19, and GSTM1 polymorphisms increase the risk of endometriosis.
        Fertil Steril. 2003; 79: 702
        • Matalliotakis I.M.
        • Arici A.
        • Cakmak H.
        • et al.
        Familial aggregation of endometriosis in the Yale Series.
        Arch Gynecol Obstet. 2008; 278: 507
        • Greene R.
        • Stratton P.
        • Cleary S.D.
        • et al.
        Diagnostic experience among 4,334 women reporting surgically diagnosed endometriosis.
        Fertil Steril. 2009; 91: 32
        • Laufer M.R.
        Gynecologic pain: dysmenorrhea, acute and chronic pelvic pain, endometriosis, and premenstrual syndrome.
        in: Emans S.J. Laufer M.R. Pediatric & Adolescent Gynecology. 6th ed. Wolters Kluwer Lippincott Williams & Wilkins, Philadelphia2012: 238
      1. Revised American Society for Reproductive Medicine classification of endometriosis: 1996.
        Fertil Steril. 1997; 67: 817
        • Smorgick N.
        • As-Sanie S.
        • Marsh C.A.
        • et al.
        Advanced stage endometriosis in adolescents and young women.
        J Pediatr Adolesc Gynecol. 2014; 27: 320
        • Dun E.C.
        • Kho K.A.
        • Morozov V.V.
        • et al.
        Endometriosis in adolescents.
        JSLS. 2015; 19 (
        • Ragab A.
        • Shams M.
        • Badawy A.
        • et al.
        Prevalence of endometriosis among adolescent school girls with severe dysmenorrhea: a cross sectional prospective study.
        Int J Health Sci (Qassim). 2015; 9: 273
        • Schliep K.C.
        • Mumford S.L.
        • Peterson C.M.
        • et al.
        Pain typology and incident endometriosis.
        Hum Reprod. 2015; 30: 2427
        • Zannoni L.
        • Forno S.D.
        • Paradisi R.
        • et al.
        Endometriosis in adolescence: practical rules for an earlier diagnosis.
        Pediatr Ann. 2016; 45: e332
        • Cramer D.W.
        • Missmer S.A.
        The epidemiology of endometriosis.
        Ann N Y Acad Sci. 2002; 955: 11
        • Audebert S.
        • Lecointre L.
        • Afors K.
        • et al.
        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: 834
        • Chang A.S.
        • Siegel C.L.
        • Moley K.H.
        • et al.
        Septate uterus with cervical duplication and longitudinal vaginal septum: a report of five new cases.
        Fertil Steril. 2004; 81: 1133
        • Jacquinet A.
        • Millar D.
        • Lehman A.
        Etiologies of uterine malformations.
        Am J Med Genet A. 2016; 170: 2141
        • Nyholt D.R.
        • Low S.K.
        • Anderson C.A.
        • et al.
        Genome-wide association meta-analysis identifies new endometriosis risk loci.
        Nat Genet. 2012; 44: 1355
        • McBean J.H.
        • Brumsted J.R.
        Septate uterus with cervical duplication: a rare malformation.
        Fertil Steril. 1994; 62: 415
        • Türkçüoğlu I.
        • Türkçüoğlu P.
        • Kurt J.
        • et al.
        Presumed nasolacrimal endometriosis.
        Ophthal Plast Reconstr Surg. 2008; 24: 47
        • Oner A.
        • Karakucuk S.
        • Serin S.
        Nasolacrimal endometriosis. A case report.
        Ophthalmic Res. 2006; 38: 313
        • Sullivan D.A.
        Sex and sex steroid influences on the dry eye syndromes.
        in: Pflugfelder S.C. Beuerman R.W. Stern M.E. Dry Eye and Ocular Surface Disorders. Marcel Dekker, New York2004 (165)