Endometriosis is a condition that can occur when tissue that is normally found lining the uterus, known as the endometrium, begins to grow outside of that organ. With this disorder, the tissue can be found growing around other nearby organs the ovaries, intestines, and even tissue that lines your pelvis.

Because endometrial tissue is affected by hormonal changes during the menstrual cycle, its not uncommon for people with endometriosis to experience pain and discomfort just like they would with endometrial tissue in the uterus. And just like that tissue, this tissue breaks down too but isnt expelled.

As a result, endometriosis can lead to the growth of scar tissue, irritation, and even infertility. But while much is known about endometriosis in adult women, the condition isnt as well-researched in children or adolescents.

Officially, there is no known cause of endometriosis regardless of the age at which its discovered. And almost all researchers agree that limited studies in younger age groups, as well as healthcare professionals delaying diagnosis by several years, can contribute to its progression that often leads to infertility and other negative outcomes.

There are a few theories that highlight potential reasons, but no theory has proven to be conclusive yet. Well take a closer look at the best supported theories to-date:

Retrograde menstruation is a condition in which blood that is expelled from the uterus flows back toward the fallopian tubes rather than out of the body through the vagina. This scenario is more common than you may expect, with roughly 90% of women experiencing it at some point during their menstruating lives.

But for some, this backflow can lead to endometrial cells adhering to organs or cavity tissues, or whats known as endometrial lesions. This is why it is currently considered a key factor in developing endometriosis.

A 2013 study conducted in Japan found a link between the incidence of menstrual pain and the need for medical interventions. While the study found that roughly a third of all menstruating Japanese women experienced pain significant enough to require medication, of that group, 6% did not experience any improvement after taking medication.

More importantly, this study found that roughly 25 to 38% of adolescents that complained of chronic pelvic pain were later diagnosed with endometriosis. Meanwhile, the most common solution offered to adolescents is pain medications, which will not treat the cause of the pain.

That same 2013 Japanese study noted that some respondents were diagnosed with endometriosis while having never menstruated (premenarchal). This discovery has encouraged researchers to consider that other underlying mechanisms might contribute to endometriosis rather than retrograde menstruation.

Some researchers further hypothesized that endometriosis diagnoses in premenarchal participants could be caused by stem cells that later develop into endometrial tissue and are later activated when menstruation begins.

While we often think of endometriosis as a condition exclusively impacting women, the reality is that it can also develop in nonbinary or transmasculine (people assigned female at birth that later transition to boys) adolescents as well.

A 2020 study reviewed previous research that focused on 35 trans participants ages 26 and younger that were diagnosed with dysmenorrhea (or menstruation-related pain) and treated for that condition. Of the 35, seven of the patients were evaluated and found to have endometriosis some of which were diagnosed after transitioning and included one participant that had already begun testosterone treatment.

Of the seven patients, treatment varied from oral contraceptives, testosterone treatment, and other drugs such as danazol and progestins. The study found that results were mixed. While some respondents found success with testosterone therapy for resolving symptoms, this wasnt the case for everyone.

Ultimately, the study recommended that trans masculine people experiencing dysmenorrhea symptoms should be screened for endometriosis, and that testosterone therapy alone isnt necessarily a complete solution.

Although less is known about endometriosis in adolescent or teenage populations, symptoms tend to be consistent with those found in adult women. These include:

If you or your child is experiencing symptoms of endometriosis, keep reading to learn about getting diagnosed.

Consistently, the research and medical communities agree that early detection of endometriosis is the best way to prevent acute spread which can lead to infertility. Checking for endometriosis on your own is not possible. But letting your doctor know that youre experiencing chronic pelvic pain, heavy or long periods, or any of the other common symptoms associated with endometriosis is important.

Your physician might start the diagnostic process by performing a pelvic ultrasound to ensure that any other underlying conditions or infections arent causing your symptoms. Usually, endometriosis is diagnosed with laparoscopy. This is a minimally invasive procedure where your physician inserts a thin tube with a light and lens through a small incision into the lower abdomen. With this procedure, they can look for endometrial lesions to determine if endometriosis is present.

Unfortunately, its common for period pain to be dismissed as a regular part of life, and for many people it can take more than a decade to receive a proper diagnosis. If this is the case for you, dont hesitate to advocate for yourself and seek a second opinion if youre unable to find a treatment plan that works for you.

Currently, there is no cure for endometriosis. However, just as in adults, the goal of treating adolescent endometriosis is to control and prevent disease progression, provide symptom relief, and preserve fertility.

Several treatment methods may be recommended depending on the amount of endometrial tissue that is present (disease progression).

Treatment options can center on hormonal therapy to control estrogen levels a key factor that influences endometrial growth. For some patients, this might include taking oral contraception, or a progestin-only agent to prevent or minimize the onset of periods, as well as nonsteroidal anti-inflammatory drugs (NSAIDs) for pain management.

Be aware that you might need to try several different types of hormonal therapies before you find the right option that controls your condition.

Some patients might also be prescribed Gonadotropin-releasing hormone (GnRH) agonist therapy. But this is usually reserved for adults, because research suggests that this treatment can impact bone mineralization in adolescents.

Surgery is often used for both diagnosis and treatment. While some surgeries can remove endometrial lesions, this is not a permanent solution for everyone.

Research has proven that even with surgery, endometrial lesions can return.

Most endometriosis conversations center around female patients. But its important to remember that trans men as well as those born male are also at risk of developing this disease.

Once thought to only be an issue for menstruating females, research suggests that endometriosis can also be detected in premenarchal youth.

Theres no cure for endometriosis. But experts, advocates, and the medical community agree that early interventions for the condition are critical for limiting its spread, controlling symptoms that can impact everyday life, and preserving fertility especially in adolescents.

Excerpt from:
Endometriosis in Teens: Causes, Symptoms, and Treatment - Healthline