Do not ignore the indicators of heavy and painful menstrual bleeding and search well timed medical consideration because it could possibly be an indication or symptom of endometriosis as not solely middle-aged girls however even adolescent ladies can get detected with endometriosis. According to health consultants, many ladies are having this drawback and are struggling in silence.

In an interview with HT Lifestyle, Dr Jainesh Doctor, Advanced Gynae Endoscopic Surgeon, International Operating Faculty and Trainer at Motherhood Hospital in Kharghar, revealed, “The most common complaints of women with endometriosis have is heavy bleeding (menorrhagia), painful menses (dysmenorrhoea), abnormal uterine bleeding presented as spotting and/or even gastrointestinal symptoms such as constipation or diarrhoea and the urogenital symptoms such as burning and painful urination.”

Talking about endometriosis in adolescents, he defined, “If a young girl is having abdominal pain or bleeding then she may not understand the significance and will be unaware that it can be endometriosis. She might be busy with her studies and extracurricular activities and will hide the pain due to the lack of understanding of the condition. Since the girls fail to get educated regarding periods they will dismiss it as a normal period pain. If the girl communicates the symptoms to the parents then they have to act quickly. Endometriosis is a pandemic which has come to focus in the last decade. But, the mothers who themselves haven’t suffered will not know about endometriosis.”

Highlighting the prognosis, Dr Jainesh Doctor mentioned, “Remember that endometriosis in adolescents can present as cyclical menstrual pain or even acyclical abdominal pain. If routine medical therapy prescribed by a physician is not providing any relief, the child should be taken to a gynaecologist. Studies have reported earlier diagnosis when the primary doctor has been a gynaecologist. Otherwise, the delay in diagnosis of endometriosis is around 10-12 months and in extreme case upto 2 years, from the onset of the pain. Usually, the endometriosis is suspected and diagnosed in women who want to get conceive and are undergoing evaluation for fertility. Their history might reveal subtle signs like painful intercourse or fertility evaluating sonograms may reveal an ovarian cyst.”

He elaborated, “When these patients undergo hysteroscopy or laparoscopy, endometriosis is spotted and the doctor in the same sitting can secure a biopsy to confirm the diagnosis of endometriosis. The most important thing is that, Endometriosis is a surgical diagnosis. This becomes another reason for the delay in diagnosis as parents are reluctant to allow a surgical procedure in their child on just the clinical suspicion of the disease. However if there is a delay in diagnosis, the grades of endometriosis increase over the years and progressive damage keeps on occurring. Early diagnosis is key to managing endometriosis. To that effect, studies have reported that in families in which any elderly woman has suffered from endometriosis, the average age of diagnosis in the child is at an earlier age and at an earlier stage of endometriosis.”

Pointing out that the presentation of endometriosis is adolescent age group is completely different from the center age girls, Dr Jainesh Doctor emphasised, “When it comes to middle-aged women, there are usually big nodes and chocolate cysts or ovarian cysts. The treating doctor should be aware about how the early-stage endometriosis will be presented in the adolescent age group and advice surgical evaluation followed by medical management to halt progression of the disease.”

He suggested, “The patients should be monitored and asked to watch for symptoms of progression and/or remission of the disease. Hence, if any adolescent girl has cyclical menstrual pain which is not responding to medical therapy needs to consult a gynaecologist who specializes in endometriosis as it requires a high level of suspicion and the doctor can do clinical examination. If the doctor finds any of the red signals then he/she can post the patient for a diagnostic laparoscopy and tissue biopsy to protect the girl child. There is no cure for endometriosis but it can be taken care of if detected at an early stage. Delay in diagnosis can have catastrophic effect on her quality of life and even damage the ovaries leading to incurable infertility.”