Adolescent Endometriosis (Early onset Endometriosis (EOE))

Background: Until recently, adolescent endometriosis has been considered a rare, often transient, condition not particularly serious for the young patient. However there are evidences that show early onset endometriosis (EOE) may at times be severe. This study was conducted to examine pathophysiology, symptomatology and risk factors of EOE.Methods: Electronic databases PUBMED, SCOPUS and CENTRAL were searched using the following mixture of terms: endometriosis, endometrioma, adolescent, teenager, juvenile, neonatal, dysmenorrheal and pelvic pain.Findings: Early onset endometriosis originating from neonatal uterine bleeding (NUB). This implies seeding of naive endometrial progenitor cells into the pelvic cavity with NUB; these can then activate around thelarche. Clinical conditions linked to an increased risk of neonataluterine bleeding including low birth weight, preeclampsia, post-maturity and feto-maternal incompatibility (ABO or Rhesus blood group incompatibility at term). The phenotype of adolescent endometriosis is different from adult endometriosis in terms of symptoms, ovarian endometrioma, deep endometriosis and concomitant pathology. Endometriosis theoreticallyprogresses if not intervened, and, ultimately leads to fibrosis, if the fibrosis of inner cortex and devascularization progress, they can also progressively affect follicle reserve.Conclusion: Adolescent endometriosis has its own pathophysiology, symptomatology and risk factors. It can also be progressive, endangering future reproductive capacity. EOE represents a condition necessitating early diagnosis and stepwise management.

Keywords:

adolescent endometriosis , endometrioma , endometriosis , adolescent , dysmenorrheal , pelvic pain