Teen Girls With Endometriosis Often Face Intense Pain and Heavy Periods, New Study Finds

 Teen Girls With Endometriosis Often Face Intense Pain and Heavy Periods, New Study Finds

Overview

A recent multi-center study reveals that many teenagers with confirmed endometriosis experience severe menstrual cramps and heavy bleeding, significantly affecting their daily lives and school attendance. These findings emphasize the urgent need for early diagnosis and personalized treatment strategies in adolescent gynecology.

Key Findings From the Study

Adolescents under age 22 with histologically confirmed endometriosis commonly reported:

• Progressive dysmenorrhea (76.7%)

• Heavy menstrual bleeding (50.8%)

• Missed school or social activities due to pain (55.1%)

These symptoms were analyzed in a group of 305 patients across eight tertiary hospitals in the Midwestern United States. All had undergone diagnostic laparoscopy and were evaluated for demographic and clinical characteristics.

Patient Demographics and Background

• Median age at diagnosis: 15.6 years

• Average age at first period (menarche): 12 years

• Race: 83.3% White

• Insurance: 70.5% held private insurance

• Family history of endometriosis: 45.3%, with most involving first-degree relatives

Notably, most patients (80.1%) had used nonsteroidal anti-inflammatory drugs (NSAIDs) for pain management, while opioid use was very low (5.9%).

Initial Treatment Approaches

Before undergoing laparoscopy, nearly all adolescents (92.8%) had already tried hormonal treatments to manage their symptoms. Types of hormonal therapies used included:

• Oral contraceptives – 62.3%

• Medroxyprogesterone injections – 15.7%

• Low-dose norethindrone (≤5mg/day) – 14.8%

• High-dose norethindrone (>5mg/day) – 13.4%

• Hormonal intrauterine devices (IUDs) – 13.1%

• Contraceptive implants – 5.3%

Healthcare Access and Provider Types

Teens sought care from a variety of specialists before seeing a pediatric gynecologist:

• Primary care providers – 75.1%

• Adult gynecologists – 22.3%

• Gastroenterologists – 18.7%

• Physical therapists – 13.4%

This highlights a potential gap in specialized care and suggests many patients may experience delays in appropriate diagnosis and intervention.

Comorbidities and Mental Health Risks

A striking 73.4% of patients had at least one other health issue. Psychiatric disorders were the most frequently reported comorbidity. This aligns with a broader body of research showing that adolescents and women with endometriosis face elevated mental health risks:

• Anxiety: Prevalence ranged from 10% to 87.5% in endometriosis patients vs. 6% in the general population.

• Depression: Rates ranged from 9.8% to 98.5%, compared to 6.6%–9.3% in control groups.

• Symptomatic patients were more likely to report depression than those without symptoms.

Limitations of the Research

Researchers noted several limitations:

• Potential selection bias in the patient population

• Variability in documentation across hospitals

• No long-term follow-up to assess surgical outcomes

Despite this, the study offers critical insights into the challenges faced by adolescents with endometriosis.

Conclusion

This multi-institutional research underscores the significant burden of endometriosis in teens, from chronic pain to school disruption and mental health challenges. The findings call for:

• Earlier diagnosis

• Standardized care protocols

• Integrated mental health support

“Early recognition and a structured approach to care are essential for improving outcomes in adolescents with endometriosis,” the authors concluded.

Sources:

1. Bergus KC, Rachwal B, Asti L, et al. J Pediatr Adolesc Gynecol. 2025.

2. EndoNews, May 30, 2025.

3. Krewson C. Contemporary OB/GYN, December 10, 2024.

Dr.Ifrah Hassan Hilaac