Purpose of review: Limited evidence is available on the diagnosis and management of adenomyosis in adolescents. This review highlights the postulated pathophysiologic mechanisms, the prevalence of the condition among adult women and new reports of adenomyosis or adenomyotic cysts occurring in adolescents. Diagnostic criteria as well as treatment options are discussed.
Recent findings: Very few cases of adenomyosis conditions are reported in the literature, and management schemes differed with regard to medical versus surgical approaches. It is clear from reports in adolescents presenting with severe refractory dysmenorrhea that MRI can help establish a diagnosis of adenomyosis, possibly avoiding or delaying surgery to allow for medical management in some cases.
Summary: Adenomyosis may be present during adolescence. Because mechanisms of disease appear to be similar, goals of treatment in the adolescent are toward fertility preservation. Medical management appears to be a good option for certain types of adenomyosis, although surgery may be appropriate in the case of well circumscribed adenomyotic cysts, adenomyomas or noncommunicating horns.