Endometriosis In Teenagers: Endometriosis is often misunderstood as a condition that affects only adult women, but the reality is quite different. It can begin right at puberty, sometimes as early as 10 or 12 years of age. In teenagers, signs such as painful periods, fatigue, or abdominal discomfort are often dismissed as “normal growing pains.”
This normalisation leads to delayed diagnosis, leaving many young girls to suffer silently. We asked experts about early signs that parents and young girls should look out for.
Endometriosis may Start Early
Dr Smeet Patel, Endometriosis Specialist, Mayflower Women’s Hospital, Ahmedabad, reveals, “Endometriosis has a tendency to be viewed as a disease specific to adult women, but in fact, it may start as early as adolescence, even at 10 to 12 years of age. Because endometriosis is estrogen-dependent, it may surface shortly after menarche (the first menstrual period) when hormonal activity is highest.”
“The adolescent years are marked by deep physical and emotional transformation, but if pain is persistent or unusually severe, it cannot be written off as ‘normal period pain.’ Recurring pelvic pain, painful periods, fatigue, or bowel pain can all be symptoms of endometriosis. Mild discomfort in the early cycles is to be anticipated, but severe pain that lasts six months or disrupts school, athletics, or everyday life requires a visit to the doctor,” says Dr Patel.
Normalisation of Pain
This age presents a complicated diagnosis. Endometriosis in its early stages is not seen on ultrasounds or MRIs, and thus it is usually delayed. Normalisation of pain in this scenario has significant long-term effects because the disease silently advances and impacts fertility.
Dr Patel says, “There are two popular theories about the etiology of early endometriosis. One is retrograde menstruation, wherein menstrual blood travels backward through the pelvic cavity, where endometrial-like tissue finds a chance to develop outside the uterus. Another theory is the presence of fetal Müllerian cells that eventually become endometrial tissue. Both explain why the disease can occur during early adolescence.”
“Some girls go through a lot of discomfort during their period. If there is extensive pain in the initial 2–3 years, it could be something that one needs to get checked,” says Dr Patel. Early gynecological consultation not only aids in the diagnosis of endometriosis but also rules out PCOS or hormonal disorders, providing young girls with early assistance and confidence in handling their health.
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Dr Renu Raina Sehgal, Chairperson – Department of Obstetrics & Gynaecology, says, “Endometriosis is a health problem that happens when tissue that looks like the lining of the uterus grows outside of it. This can cause pain and other problems. Many people think endometriosis only happens to women in their 20s and 30s, but it can start in the teen years. Unfortunately, the early signs are often confused with regular period pain, which makes it harder to find and treat.”
Severe menstrual pain is one of the first signs. If a teen often misses school or other things because of cramps, it could be more than just a normal period. Another sign that something is wrong is that over-the-counter painkillers may not be enough to help.
Pain that Lasts Longer than Periods
Dr Renu further says, “It’s also common to have heavy or irregular periods. Teens might notice that they are bleeding too much, passing big clots, or having to change their pads a lot. Another sign that is often ignored is pain that lasts longer than periods. This includes pain when you pee, poop, or even all month long in your lower back and pelvis. Bloating, nausea, or diarrhea around your period can feel like stomach problems, but they might be caused by endometriosis. It matters what your family has been through. A teen is more likely to get endometriosis if their mother or sister has it.”
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If teens can spot these signs early, they can get the right medical help and support. Endometriosis isn’t just bad period pain, being aware of it is the first step toward better care and a better life.
Dr Sanjay Patel, Endometriosis Surgeon, Mayflower Women’s Hospital, Ahmedabad, says “Adolescence is a high-risk period for reproductive health but endometriosis among teenagers tends to escape attention. Though most people connect it to adulthood, endometriosis can strike at the age of 12 years, as the flood of estrogen hits puberty.”
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Cramps, Exhaustion, and Gastrointestinal Issues
Dr Sanjay reveals, “A teenager can have debilitating cramps, persistent exhaustion, gastrointestinal issues, or inability to concentrate because of pain. Mild cramps with the first cycles are to be expected, but pain that regularly interferes with daily activities or persists for many months is not. Alas, since imaging studies such as ultrasounds or MRIs will often seem normal, the diagnosis is often delayed, and teens must suffer in silence.”
Early identification is important—not just for pain management, but also for the prevention of disease progression and preservation of fertility. “If the pain is bad in the first two or three years of menstruating, it could be something more than just growing pains during puberty,” cautions Dr Patel. A gynecologist can differentiate between changes of puberty, endometriosis, and others like PCOS that also manifest during adolescence.
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Regular Medical Check-ups are Essential
Outside of diagnosis, regular medical check-ups provide adolescent girls with information on menstrual well-being, irregular menstruation, and even preventive upkeep such as the HPV vaccine. Early lifestyle interventions such as eating a healthy diet and exercise also cure obesity-associated endocrine issues, which typically come along with menstrual well-being issues.
Dr Sanjay says, “Understanding potential causes of endometriosis is significant as well. Hypotheses such as retrograde menstruation and embryonic Müllerian cells indicate why endometriosis may start early. Both indicate it is not just “bad periods,” but rather a complicated, systemic disease.”
Finally, adolescence is the basis of reproductive health throughout a lifetime. Educating young girls about menstruation and promoting early medical care guarantees they become strong women who can control their bodies and their lives.
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