Center for Young Women's Health


A Guide for Teens


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  • Endometriosis is a condition that occurs when tissue similar to the inside of the uterus is found outside of its normal location.
  • The only way to be 100% sure that a person has endometriosis is to have a laparoscopy.
  • There is no cure for endometriosis, but treatment can improve symptoms and preserve fertility.
Getting Treatment:
The Gynecology Program at Boston Children's Hospital offers special services in the diagnosis and treatment of endometriosis.

Endometriosis, pronounced, "end–o–me–tree–o–sis" can affect girls of all ages. Most girls have mild cramps or pelvic pain during their menstrual cycle, but if you have unexplained pelvic pain, or menstrual cramps that are so bad that you miss school, you may have endometriosis. There could be other reasons for your symptoms too, but only your health care provider can tell for sure. This guide was created to help you understand endometriosis and available treatments.


What is endometriosis?

Endometriosis is a condition that occurs when tissue similar to the inside lining of the uterus is found outside of its normal location. Endometrial implants can be found on the ovaries, fallopian tubes, and ligaments that support the uterus and tissue covering the bladder and rectum. The most common locations of endometrial implants in teens are in the cul–de–sac area (behind the uterus), and near the bladder. (See illustration below.)



What are the symptoms of endometriosis?

Endometriosis can cause different symptoms. Pelvic pain and/or severe period cramps are the most common symptoms. There can be pain before, during, or after your period. The pain may occur at regular times in your cycle, or it may occur at any time during the month. It's often referred to as "chronic" pelvic pain. The location of the endometrial implants and the way in which the lesions affect the pelvic organs contribute to the symptoms teens may have. Some teens may have pain with exercise, sex, and/or after a pelvic exam. Although not as common, some young women may have painful or frequent urination, diarrhea, or constipation with pelvic pain. It's important to remember that some teens have a lot of endometriosis and have very little pain, while others may have a small amount of endometriosis and severe pain.


What causes endometriosis?

Although we know that some young women may be slightly more likely to develop endometriosis because female relatives have it, the fact is that we do not know the cause of this disease.


The three most accepted theories are:

How is endometriosis diagnosed?

The ONLY way to be 100% sure of this diagnosis is to have a procedure called a laparoscopy. There is no blood test, x–ray, ultrasound, or MRI that can diagnose endometriosis at this time. A laparoscopy allows your doctor to look inside your abdomen (belly) at your pelvic organs with a special lens to identify the endometriosis (implants). Other tests that may be ordered before a laparoscopy might include blood tests, vaginal cultures to check for infection, ultrasound, or an MRI (to make sure it's not something else). If you think you could have endometriosis, you will want to be evaluated by a gynecologist who specializes in taking care of teens and young women with endometriosis.


What can I do if I think I might have endometriosis?

If you think you might have endometriosis, it is very helpful to keep track of your pain for a while. You can find a Pain and Symptom Tracker here, and a Pain Mapping worksheet here. These tools will help you explain your pain to your medical team.


Bring your completed Pain and Symptom Tracker and Pain Mapping worksheets to your appointment, and talk with your gynecologist about your symptoms. It's also a good idea to bring copies of test results, operative notes (a summary by your doctor if you have had surgery) and/or radiology reports. (You can ask for copies of these from the x-ray department of the health care facility where you had your ultrasound or x-ray.)


Is there a cure for endometriosis?

While there is no cure for endometriosis, you can be treated with surgery and medicine to keep the endometriosis from getting worse and harming your future fertility.


What kinds of treatment are available?

Once a diagnosis of endometriosis has been made, treatment falls into the following categories:

Why have I heard that some adult women may have trouble getting pregnant?

If endometriosis is not found and treated, it can grow and damage the fallopian tubes and ovaries. This can make it more difficult to get pregnant. Studies done at Boston Children's Hospital have shown that if endometriosis is found in young women and treated early, it usually doesn't get worse.


What else do I need to know about endometriosis?

The goal of the treatment for endometriosis is aimed at relieving pain, controlling the progression of the endometriosis, and preserving fertility for future childbearing. Treatment can make a big difference in improving the quality of your life.


    Next: Endometriosis FAQ's


Written and reviewed by the CYWH Staff at Boston Children's Hospital


Updated: 7/10/2012

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