Psychological and Clinical Impact of Adolescent Endometriosis

Recognizing endometriosis early in adolescence is vital to protect both reproductive health and emotional well-being.

Key Points

Importance:

• Adolescent endometriosis is underdiagnosed and undertreated, often leading to long-term physical, emotional, and social consequences.
• Early recognition and integrated care can improve quality of life and long-term outcomes.

Highlights:

• Timely diagnosis and multidisciplinary management are key to minimizing physical pain and psychological distress in adolescents with endometriosis.

What's done here:

• This narrative review by an Italian research team evaluates the psychological and psychosocial effects of endometriosis in adolescents.
• 215 study covering pathogenetic theories, epidemiology, psychological implications, imaging modalities, and treatment options for adolescent endometriosis were reviewed.

Key Insights:

• Endometriosis during adolescence disrupts social life, self-esteem, and emotional development.
• Hormonal and inflammatory pathways (e.g., altered serotonin, BDNF, and elevated IL-6, TNF-α) contribute to mood disorders.
• First-line imaging includes transabdominal and transvaginal ultrasound; MRI aids in complex cases.
• Novel biomarkers (e.g., microRNAs) and digital tools (e.g., wearables, AI) may improve early diagnosis and monitoring.
• While treatments may alleviate pain, effects on mental health remain uncertain.
• Multidisciplinary care involving gynecologists, pediatricians, psychologists, and pain specialists is essential.

Lay Summary

Alarmingly, two-thirds of individuals with endometriosis report symptom onset before the age of 20, underscoring the importance of timely recognition and intervention for adolescent endometriosis.

In adolescent age group, severe menstrual pain is the most common symptom, often interfering with daily activities, social life, and school attendance. Unfortunately, this pain frequently responds poorly to common treatments like non-steroidal anti-inflammatory drugs or oral contraceptives. Other symptoms include dysuria, dyspareunia, abnormal bleeding, gastrointestinal discomfort, and infertility.

Delays in diagnosis are common due to low awareness, overlapping symptoms with other conditions, and frequent misdiagnosis.

Yet adolescence is a critical period for physical and emotional development, making early intervention essential.

Panvino and colleagues from Sapienza University of Rome conducted a narrative review exploring the psychological and clinical aspects of adolescent endometriosis, analyzed 215 studies published between 1999 and 2025.

Ultrasound is the preferred first-line imaging method, while MRI and laparoscopy are used in selected cases. Emerging diagnostic tools—including microRNAs, cytokines, and metabolic profiles in blood and urine—show promise for earlier, non-invasive diagnosis. Digital technologies such as smartwatches, fitness trackers, and artificial intelligence are increasingly being integrated into symptom tracking and individualized care.

Surgical treatment should prioritize fertility preservation. Hormonal therapies are often used to manage symptoms, though their long-term impact on adolescent mental health remains uncertain.

The authors emphasize the importance of a multidisciplinary approach—engaging gynecologists, pediatricians, psychologists, and pain specialists—to address the full spectrum of adolescent needs. Supportive strategies such as yoga and family education also play a valuable role.

This comprehensive review, recently published in Diagnostics (Basel), calls for early diagnosis, personalized treatment, and integrated care to improve outcomes in adolescent endometriosis.

Research Source: https://pubmed.ncbi.nlm.nih.gov/40075795