Endometriosis in adolescent: a review of current diagnostic and therapeutic guidelines and expert consensus

OBJECTIVES: : Endometriosis is a widespread gynecological condition characterized by the presence of endometrial like tissue outside the uterine cavity. According to the literature, the frequency of endometriosis in adolescents remains unclear; however, studies suggest that histologically confirmed disease may be present in up to 47% of girls with chronic pelvic pain (CPP) and in nearly 70% of girls with primary dysmenorrhoea unresponsive to nonsteroidal anti-inflammatory drugs (NSAIDs) or hormonal therapy. The aim of this study was to review and compare current diagnostic and therapeutic recommendations and expert consensus for adolescent endometriosis. MATERIAL AND METHODS: : A descriptive qualitative review of the clinical guidelines and expert consensus statements by the American College of Obstetricians and Gynecologists (ACOG), the European Society of Human Reproduction and Embryology (ESHRE), the North American Society for Pediatric and Adolescent Gynecology (NASPAG), and the Polish Society of Gynecologists and Obstetricians (PTGiP) was conducted. NASPAG guaidance present a textbook-based expert consensus and was included due to the limited availability of high-quality evidence in adolescent populations. RESULTS: : Adolescent endometriosis remains underrecognized and insufficiently studied. Current clinical guidelines and expert consensus statements emphasize the importance role of through symptom assessment and detailed medical history in the diagnostic process. The reviewed literature supports a clinical diagnosis based on symptoms presentations and response to hormonal therapy, without routine laparoscopic confirmation. CONCLUSIONS: Endometriosis in adolescents requires an age-specific diagnostic and therapeutic process. Adherence to current clinical guidelines and expert consensus may help reduce diagnostic delays, limit unnecessary invasive procedures, and improve long-term quality of life.