Endometriosis in teenagers and young people

Endometriosis is not only a disease of adults; it can start in adolescence. Severe period pain is very common in teenagers, so the disease is often missed. According to the 2022 ESHRE guideline, when symptoms begin in adolescence diagnosis can come with a delay of more than 12 years. Pain that disrupts school and daily life should be taken seriously at any age.

How common is it in teenagers?

The true frequency in the general adolescent population is unknown. In adolescents with chronic pelvic pain, the reported frequency of endometriosis ranges from 25% to 73% across studies. These figures come from people already being investigated for pain and cannot be applied to young people in general. In a review of adolescents who had a laparoscopy (880 people), endometriosis was found in 62%, again a selected group operated on because of pain.

Why is diagnosis later?

• Period pain is common in teenagers, so the complaint gets normalised.
• Awareness of endometriosis in adolescents is low among health professionals and family members; ESHRE says so explicitly.
• In a study of 4,334 people reported in the ESHRE guideline, those whose symptoms began in adolescence waited three times as long as those whose symptoms began in adulthood, and more often reported not being taken seriously and being told nothing was wrong.

What can families and young people do?

• Note how pain affects daily life, such as missing school, sport and social events.
• If painkillers are not enough, see a doctor. ESHRE advises that clinicians take a careful history in adolescents and discuss with the young person whether an examination is acceptable.
• If the answer stays at “you’ll grow out of it” and the symptoms continue, do not hesitate to ask for a second opinion.

For the full list of symptoms see the symptoms page, and for when pain should not be treated as normal read our period pain article.