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, it’s 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 isn’t 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 isn’t as well-researched in children or adolescents.
In this article, we use “male and female” to refer to someone’s sex as determined by their chromosomes, and “men and women” when referring to their gender (unless quoting from sources using nonspecific language).
Sex is determined by chromosomes, and gender is a social construct that can vary between time periods and cultures. Both of these aspects are acknowledged to exist on a spectrum both historically and by modern scientific consensus.
Officially, there is no known cause of endometriosis — regardless of the age at which it’s 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. We’ll take a closer look at the best supported theories to-date:
At what age can you get endometriosis?
While the condition is most common for women in their 30s and 40s, in truth, endometriosis
As of publication, there hasn’t been enough research into adolescent endometriosis for us to know for sure how early it can develop. In rare cases, even males or children that were premenarchal (not yet menstruating) have been diagnosed with endometriosis.
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
But for some, this backflow can lead to endometrial cells adhering to organs or cavity tissues, or what’s known as endometrial lesions. This is why it is currently
Menstrual pain and endometriosis
More importantly, this study found that roughly
Stem cells and endometriosis
That same 2013 Japanese study noted that some
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.
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 wasn’t the case for everyone.
Endometriosis in teenage males
While very rare,
Similar to females, the endometrial tissue attaches to organs or other tissues in the lower genitourinary tract (this is the system that connects the kidneys, bladder, and genital organs). Most commonly, it’s found on the bladder or lower abdominal wall.
As with all cases of endometriosis, there is no confirmed cause for the condition in males. However, researchers have offered several theories including estrogen therapy, liver cirrhosis, chronic surgical inflammation — and even hormonal changes caused by obesity — as potential causes of endometriosis in males.
Although less is known about endometriosis in adolescent or teenage populations, symptoms tend to be consistent with those found in adult women.
- Period-related pain: severe cramping, chronic back or pelvic pain, intestinal pain — especially if the pain interferes with quality of life or doesn’t respond to traditional over-the-counter (OTC) pain medications
- Stomach problems: constipation, diarrhea, bloating, and nausea — especially during periods
- Bleeding or spotting between periods (if an adolescent has begun menstruating)
- Heavy periods
- Chronic pain throughout a menstrual cycle
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
Your physician might start the diagnostic process by performing a pelvic ultrasound to ensure that any other underlying conditions or infections aren’t 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, it’s 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, don’t hesitate to advocate for yourself and seek a second opinion if you’re unable to find a treatment plan that works for you.
What happens if endometriosis is left untreated?
Endometriosis is a
Chronic pelvic pain, as well as painful and heavy periods, are other side effects of untreated endometriosis. These can impact your overall quality of life.
For adolescents, this might mean more missed days in school or an inability to participate in extracurricular activities, especially during your period.
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.
Living with endometriosis
Endometriosis can be a difficult diagnosis to receive at any age, but especially so as you’re also grappling with puberty. And since chronic pain associated with the disease as well as other associated risks can impact your quality of life and emotional outlook, it’s important to have a strong support group around you.
Consider reaching out to the following organizations to find support groups near you or to connect with online communities.
Most endometriosis conversations center around female patients. But it’s 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.
There’s 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.