Abstract
Study Objective
Endometriosis is a recognized cause of pelvic pain in adolescents with menstrual symptoms
that significantly affect education, activity, and social interactions. We aim to
provide an updated systematic review of the prevalence of endometriosis in adolescents
with pelvic pain presenting for gynecological investigation.
Data Sources
We searched Medline, Embase, and Cinahl from 2011 to July 2019.
Methods of Study Selection
We included cohort studies of adolescents with pelvic pain undergoing gynecological
investigation. Two authors independently selected studies and extracted study characteristics
and prevalence data. Methodological quality was assessed using the Critical Appraisal
Skills Program for cohort studies.
Results
This updated systematic review evaluated a total of 19 studies including 1243 symptomatic
adolescents. In all, 648 of 1011 (64%) adolescents undergoing laparoscopy were found
to have endometriosis. The prevalence ranged from 25% to 100%, with a mean prevalence
of 64%. Thirteen studies including 381 participants categorized disease severity using
the revised American Society of Reproductive Medicine classification. Among these,
53% of participants (201/381) had stage I, 28% (105/381) had stage II, 20% (76/381)
had stage III, and 13% (49/381) had stage IV disease.
Conclusions
The prevalence of endometriosis among adolescents with pelvic pain symptoms is high.
Endometriosis is treatable, and prompt recognition will help to ensure that adolescents
are signposted earlier to appropriate specialists. The management of adolescents with
suspected endometriosis should be consistent with best practice guidance. Despite
recommendations to increase the awareness and knowledge of endometriosis in adolescence,
minimal research has followed.
Key Words
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Article info
Publication history
Published online: July 28, 2020
Footnotes
MH and RD-S contributed equally to this work.
Identification
Copyright
© 2020 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
