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Spectrum of symptoms in women diagnosed with endometriosis during adolescence vs adulthood

Spectrum of symptoms in women diagnosed with endometriosis during adolescence vs adulthood Spectrum of symptoms in women diagnosed with endometriosis during adolescence vs adulthood
Spectrum of symptoms in women diagnosed with endometriosis during adolescence vs adulthood Spectrum of symptoms in women diagnosed with endometriosis during adolescence vs adulthood

The endometriosis usually begins at a young age, and the time between symptom onset and endometriosis investigation can be of numerous years.

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Key take away

Symptoms of endometriosis usually begin during adolescence. But the prevalence rate is unknown due to misdiagnoses or delay in diagnosis. It is also unclear that whether the symptoms that are experienced by adolescents differ from adults. For better understanding, the present study showed that symptoms of endometriosis did not vary between women surgically diagnosed during adolescence compared with those diagnosed as adults.

Background

The endometriosis usually begins at a young age, and the time between symptom onset and endometriosis investigation can be of numerous years. Whether the signs felt by adolescents vary from adults is unknown. This analysis aimed to identify symptom in adolescents as compared with adults to assess whether differences existed, based on age at the surgical examination that could influence time to diagnosis.

Method

Two tertiary care centres and the surrounding communities selected the population-based cohort. A total of 295 adolescents and 107 adults with verified endometriosis and were registered in The Women’s Health Study: From Adolescence to Adulthood were selected for the analysis. All the participants accomplished the Biobanking Harmonization Project standard clinical questionnaire involved pain, menstrual history, associated symptoms and an extended version of the World Endometriosis Research Foundation Endometriosis Phenome. Wilcoxon rank sum tests were used for continuous data and Fisher’s exact or Chi-square tests for categoric data.

Result

Maximum of the participants exhibited moderate-to-severe menstrual pain. On average, three doctors were consulted before the examination, despite age at presentation. Time from symptoms to diagnosis averaged five years for adults and two years for adolescents. Fewer adults than adolescents recorded with pain beginning at menarche and nausea following pain. Noncyclic, general pelvic pain was frequent. One-half of the subjects exhibited relief of their widespread pelvic pain following a bowel movement. Pain impeded with daily activities, exercise, work/school, and sleep to a moderate-extreme degree; complications were related by age at diagnosis.

Conclusion

Pelvic pain was noncyclic, severe and negatively affected the quality of life.  Endometriosis symptoms did not vary between women surgically diagnosed during adolescence than those diagnosed as adults. More cases of nausea and symptom onset at menarche were noticed among adolescents. Multi-year delays in diagnosis were common. Doctors should be aware of these substitute symptom patterns and introduce endometriosis in their differential diagnosis for both young adult and adolescent women who encounter with noncyclic pelvic pain and nausea.

Source:

American Journal of Obstetrics and Gynecology 2018; 218(3):324.e1-324.e11

Article:

Spectrum of symptoms in women diagnosed with endometriosis during adolescence vs adulthood

Authors:

Amy D et al.

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