Comparison of Endometriosis Characteristics in Adolescents and Women of Advanced Reproductive Age

Ottowgeissler Yabes Melaneson Paiki; Marta Isyana Dewi; Ali Budi Harsono

doi:10.24198/obgynia.v8i3.991

Comparison of Endometriosis Characteristics in Adolescents and Women of Advanced Reproductive Age

Ottowgeissler Yabes Melaneson Paiki, Marta Isyana Dewi, Ali Budi Harsono

Abstract

ABSTRACT
Objective: To compare clinical and pathological characteristics of endometriosis between adolescents (10–19 years) and women of advanced reproductive age (35–45 years) to guide early diagnosis and tailored management.
Methods: A retrospective, cross-sectional study of 68 patients (31 adolescents; 37 advanced-age women) with laparoscopically and histopathologically confirmed endometriosis at Dr. Margono Soekarjo Regional General Hospital between January 2022 and December 2024. Statistical analyses included independent t-tests, chi-square tests, and multivariate logistic regression.
Results: Adolescents exhibited higher dysmenorrhea prevalence (80.6% vs. 43.2%; p=0.003), more early-stage disease (Stage I–II: 71% vs. 22%; p<0.001), and increased peritoneal lesions (29% vs. 8%; p=0.030). They also had lower BMI (21.4 vs. 24.3 kg/m²; p=0.007) and earlier menarche (12.9 vs. 13.8 years; p=0.016). Advanced-age women predominantly presented with late-stage disease (Stage III–IV: 78%) and showed significant associations with age (OR 1.15; 95% CI 1.02–1.30), primiparity (OR 5.67; 95% CI 1.23–26.12), multiparity (OR 6.23; 95% CI 1.34–28.98), and Stage III–IV disease (OR 4.89; 95% CI 1.25–19.16).
Conclusion: Endometriosis in adolescents manifests as severe dysmenorrhea, milder stages, and peritoneal involvement, whereas older women present with advanced disease linked to age and parity. Age-specific diagnostic vigilance and management are essential

Keywords

Endometriosis; adolescents; advanced reproductive age; dysmenorrhea.

Full Text:

PDF

References

Saunders PTK Insights from genomic studies on the role of sex steroids in the aetiology of endometriosis Reprod Fertil 2022;3(2):R51-R65 Published 2022 Apr 4 doi:101530/RAF-21-0078.

Fryer J, Mason-Jones AJ, Woodward A Understanding diagnostic delay for endometriosis: A scoping review using the social-ecological framework Health Care Women Int 2025;46(3):335-351 doi:101080/0739933220242413056.

Janssen EB, Rijkers AC, Hoppenbrouwers K, Meuleman C, D’Hooghe TM Prevalence of endometriosis diagnosed by laparoscopy in adolescents with dysmenorrhea or chronic pelvic pain: a systematic review Hum Reprod Update 2013;19(5):570-582 doi:101093/humupd.

Khashchenko EP, Uvarova EV, Fatkhudinov TK, et al Endometriosis in Adolescents: Diagnostics, Clinical and Laparoscopic Features J Clin Med 2023;12(4):1678 Published 2023 Feb 20 doi:103390/jcm12041678.

Salmanov AG, Yuzko OM, Tofan BY, et al Epidemiology of endometriosis in Ukraine: results a multicenter study (2019-2021) Pol Merkur Lekarski 2024;52(3):277-285 doi:1036740/Merkur202403103.

Andres Mde P, Podgaec S, Carreiro KB, Baracat EC Endometriosis is an important cause of pelvic pain in adolescence Rev Assoc Med Bras (1992) 2014;60(6):560-564 doi:101590/1806-92826006015.

Agostinis C, Balduit A, Mangogna A, et al Immunological Basis of the Endometriosis: The Complement System as a Potential Therapeutic Target Front Immunol 2021;11:599117 Published 2021 Jan 11 doi:103389/fimmu2020599117.

Chauhan S, More A, Chauhan V, Kathane A Endometriosis: A Review of Clinical Diagnosis, Treatment, and Pathogenesis Cureus 2022;14(9):e28864 Published 2022 Sep 6 doi:107759/cureus28864.

Lee JS, Lee YA, Shin CH, Suh DI, Lee YJ, Yon DK Long-term health outcomes of early menarche in women: an umbrella review QJM 2022;115(12):837-847 doi:101093/qjmed/hcac187.

Lv C, Turel O, He Q The Onset of Menstruation and Social Networking Site Use in Adolescent Girls: The Mediating Role of Body Mass Index Int J Environ Res Public Health 2021;18(19):9942 Published 2021 Sep 22 doi:103390/ijerph18199942.

Hemmert R, Schliep KC, Willis S, et al Modifiable life style factors and risk for incident endometriosis Paediatr Perinat Epidemiol 2019;33(1):19-25 doi:101111/ppe12516.

Saei Ghare Naz M, Farahmand M, Dashti S, Ramezani Tehrani F Factors Affecting Menstrual Cycle Developmental Trajectory in Adolescents: A Narrative Review Int J Endocrinol Metab 2022;20(1):e120438 Published 2022 Mar 2 doi:105812/ijem120438.

Gubbels A, Spivack L, Lindheim SR, Bhagavath B Adolescent Endometriosis Obstet Gynecol Surv 2020;75(8):483-496 doi:101097/OGX0000000000000808.

Zhang Q, Ma X, Sun A, et al Interpretation to the American College of Obstetricians and Gynecologists’ Committee Opinion No 760: dysmenorrhea and endometriosis in the adolescent Medicine Published February 25, 2020 doi:103760/CMAJISSN2096-291620.

Martire FG, Lazzeri L, Conway F, et al Adolescence and endometriosis: Symptoms, ultrasound signs and early diagnosis Fertil Steril 2020;114(5):1049-1057.

Bai SW, Cho HJ, Kim JY, et al Endometriosis in an adolescent population: the severance hospital in Korean experience Yonsei Med J 2002;43(1):48-52 doi:103349/ymj200243148.

Martire FG, Giorgi M, D’Abate C, et al Deep Infiltrating Endometriosis in Adolescence: Early Diagnosis and Possible Prevention of Disease Progression J Clin Med 2024;13(2):550 Published 2024 Jan 18 doi:103390/jcm13020550.

Ranjan YS, Ziauddeen N, Stuart B, Alwan NA, Cheong Y The role of parity in the relationship between endometriosis and pregnancy outcomes: a systematic review and meta-analysis Reprod Fertil 2023;4(1):e220070 doi:101530/RAF-22-0070.

DOI: http://dx.doi.org/10.24198/obgynia.v8i3.991